My Medical Skills Give Me Experience Points-Chapter 297 - 150: Surgery was a great success, the most difficult cranial base brain tumor surgery_2
Chapter 297 -150: Surgery was a great success, the most difficult cranial base brain tumor surgery_2
They also said she had a dual-face.
When she smiled, one side had expression while the other side remained expressionless, looking particularly eerie.
Recently, a new symptom emerged where she easily choked while eating, and even swallowing food or drinking water felt difficult.
From her self-reported symptoms, it was basically determined to be a meningioma.
Later, through a CT scan, a tumor at the skull base was indeed discovered.
This time, surgery to remove it was necessary.
Among many meningioma surgeries, those at the skull base are considered the most difficult.
Because skull base meningiomas are closely related to normal brain nerves and vascular tissues, and they are hard to expose during the surgical removal process, making the surgery extremely difficult.
In fact, any surgery performed by a leading surgeon is never simple.
Director Wen, the chief neurosurgeon, faces numerous complex and critical cases every day, enduring far more pressure than ordinary doctors.
The surgery began soon.
Zhou Can had initially established his position in the team; he could now stand behind the two attending physicians as Third Assistant to observe the operation.
He squeezed several resident doctors and three research students behind him.
Zhou Can stood in the position of Third Assistant, and they all respected him.
Because Zhou Can’s surgical skills were indeed far superior to theirs.
“You must have already reviewed the films and reports; the patient’s meningioma is categorized as a sphenoid wing meningioma. It is one of the most challenging types among skull base meningiomas. Achieving complete removal without harming the patient’s neurological functions is extremely difficult.”
Director Wen was operating on the patient while teaching.
This surgery would be rated between level 3 and 4; the difficulty is even higher than many level 4 surgeries.
“Incision is typically centered around the sphenoid, entering through the frontotemporal region. Hemostasis!”
After making the incision, blood gushed out.
Dr. Zou took on the role of first assistant. His ability to stop bleeding was decent, almost at the level of an average attending physician, after all, he’s a forty-year-old experienced attending physician.
However, his ability was slightly weaker than Zhou Can’s.
But still acceptable.
He steadily operated the electrocautery knife for hemostasis, while Tang Li adeptly suctioned off the blood that flowed out.
“Do you know why I emphasize that the tumor’s diameter must not exceed 2cm?”
Director Wen looked at his two attending physicians.
“It’s too big to cut cleanly.”
Tang Li’s answer was a bit generic.
“Fear of damaging nerves and vessels.” Dr. Zou, being older, answered more precisely.
“Dr. Zou is right; if the tumor’s diameter is too large, complete removal is nearly impossible because it’s very likely to damage essential blood vessels and nerve tissues. Therefore, when you diagnose in the future, as soon as you suspect a meningioma, you must urge patients to get diagnosed and treated early. If the tumor grows to a large diameter, the difficulty of removal will increase exponentially.”
Director Wen provided an explanation.
Zhou Can took careful note of this.
These are extremely valuable surgical experiences, hard to learn from books.
These are passed down orally from experienced doctors, shared with younger doctors.
“Teacher, this patient’s tumor has reached 2.1cm, why did you still choose to operate on her?” a graduate student asked.
“Because she’s still young. If we don’t operate, her life might likely wither away. Moreover, her tumor volume is growing rapidly, which is a very bad sign. Typically, only malignant tumors grow rapidly. Benign tumors tend to grow more slowly.”
Although Director Wen somewhat likes to save face and display superficial efforts,
from his actions and willingness to perform this operation on this female patient, it’s clear that his thinking has its merit.
He is a respected doctor.
As they peeled back layers of epidermis and subcutaneous tissue, the tumor was now visible.
The tumor was over 2cm in diameter.
Zhou Can felt a surge of enthusiasm.
His separation and Incision Skill were both at level 4, all reaching the level of an attending physician.
He wasn’t fully confident in tackling this large tumor, but he was willing to give it a try.
Director Wen had begun separating the tumor from the middle cerebral artery, treading very carefully, as if on thin ice. Just when he was about to complete the separation, he stopped.
“This tumor is too tightly adhered to the wall of the artery; forcibly separating it will definitely breach the vessel. Even if it doesn’t break now, it could cause significant issues after the surgery. Unfortunately, we might have to leave a small part of the tumor wall.”
After much hesitation, Director Wen ultimately decided against forcefully separating it during surgery.
“Immediately send this removed tumor to pathology for urgent testing. I’ll wait here for twenty minutes for the pathology results before deciding whether to remove this piece of tumor wall.”
Once arranged, Director Wen continued to inspect the surrounding area for other tumors.
Zhou Can watched the removed tumor with a hunch, an ominous premonition.
He had seen several benign tumors; they usually looked more pleasing.
Just as humans, appearance corresponds to the heart. People with kind and honest eyes are often upright, kind-hearted. Those with fierce and evil expressions are generally brutal and vicious.
Tumor differentiation can also be felt through sight and touch.
Experienced doctors, dealing with cancers like breast or lymphatic cancers, can almost determine their nature just by touching.
However, the definitive results depend on pathological testing.
Intraoperative pathology testing is the fastest method.
