Chapter 293
Chapter 291: Chapter 148: The Female Patient Who Suffered from Domestic Abuse, The First Endoscopic Surgery_2
Some of the injured are in particularly serious condition and temporarily do not meet the requirements for surgery, and may need to stay in the ICU for a while. Life preservation comes first, then surgery.
Also, there are cases where the patient’s injury is extremely severe and the condition complex.
For safety, doctors need to consult with multiple specialties together. After discussion, a surgical plan is established.
After rounding, Tang Li issued some new medical orders and adjusted some patients’ medication.
After handling everything, they then went to the operation room with Zhou Can and others.
At this moment, the patient had already been placed on the operation table.
The anesthesiologist was carefully examining the patient.
Dr. Zou was watching with two resident doctors by his side.
“You’re quite fast!”
Tang Li said with a smile.
“There are only a few patients in the ICU. After we finished rounding, we three directly brought the patient to the operation room.”
Dr. Zou shrugged his shoulders.
There were only twenty beds in total in the ICU, and the number of critically ill patients assigned to their group should not be many.
Additionally, since there are always attending physicians on duty in the ICU, making rounds is relatively procedural.
Zhou Can looked at the patient on the operating table and saw tubes inserted all over the person’s body and dried bloodstains visible.
The most severely injured part seemed to be the head.
The patient was currently in a coma.
At this time, Director Wen finally arrived.
“How is the patient’s condition? I’m guessing this craniotomy will take at least four to eight hours, can he withstand that?”
Director Wen’s words were obviously inquiring of the anesthesiologist.
“The situation is still relatively ideal. I rate his surgical tolerance as quite low. However, if the intracranial hematoma is not removed, his life is likely not to be saved. Therefore, it is still very meaningful to perform surgery as soon as possible, in my opinion.”
The patient remained in a coma without waking up until now.
This in itself speaks for the severity of the issue.
The ICU can only provide some basic life support, which does not mean they can keep someone alive indefinitely.
In Tuya Hospital’s ICU wards, patients often die.
Moreover, when the deaths are frequent, it is not unusual for three or four people to die in a single day.
Of course, some of the deaths are due to family members insisting on removing life support.
After all, the cost of staying in the ICU is simply too high.
If it’s an older person with slim chances, or the patient’s prospects are bleak, using too much money for emergency treatment may not seem worth it to the family, who might then request the hospital to remove life support.
“Prepare for craniotomy to remove the hematoma!”
Director Wen spoke up.
The car accident victim’s report indicated a serious intracranial hematoma, suggesting very severe internal bleeding.
A craniotomy to stop bleeding and remove the hematoma is a very proactive treatment method.
The patient is very young, only in his twenties.
Reportedly, he was racing late at night and suffered this severe injury from a horrific car accident.
Zhou Can had seen the patient’s scans, the situation was not optimistic.
Because the patient had a subdural hemorrhage.
Usually, more than 30ml of supratentorial bleeding requires surgery, while over 10ml of infratentorial bleeding already meets surgical criteria.
After the patient was under general anesthesia, Director Wen selected the spot for the craniotomy, cut through the scalp to reveal the skull, and directly went in with the electric saw.
Just as they began cutting into the skull, the anesthesiologist hastily called a halt.
“Director Wen, the patient’s vital signs are plummeting. If we keep going with the craniotomy, I fear he won’t make it off the operating table.”
The patient’s blood pressure, respiration, body temperature, heart rate, and blood oxygen index were all dropping rapidly.
This was a very frightening sign.
During a craniotomy, various factors could cause the patient’s condition to worsen.
At this point, the patient was like a flickering candle in the wind.
A slightly stronger gust, and the flame of life would be extinguished.
Director Wen’s face was grave.
Handling critical patients in Neurosurgery is genuinely challenging, with numerous cases of unsuccessful outcomes.
Doctors perform surgeries doing their utmost to lower the mortality rate.
Because this is related to various assessments and personal reputation.
Imagine, if a certain director conducted a hundred surgeries and seven or eight patients died, who would dare to let this doctor operate again?
Even if the hospital is aware those who died were in extremely critical condition.
But during assessment, such a high mortality rate will still get the vice president or even the president’s personal criticism in a meeting, resulting in warnings, or possibly a reduction in surgical privileges.
An excessively high rescue mortality rate affects not only the doctor and their team but also impacts the overall evaluation of the hospital.
“It seems the patient’s condition is more serious than I imagined! This complicates matters!”
Director Wen stared at the rapidly declining vital signs on the life-monitoring screen, feeling apprehensive.
Even if they stopped surgery now and transferred the patient back to the ICU, it would still be hard for him to pull through.
“An intracranial hematoma must be removed, otherwise, he won’t survive. Traditional surgery is indeed very harmful to the patient. Before the surgery, I had prepared for the worst case scenario, and had a second surgical plan ready.”
Director Wen actually had a backup plan.
No wonder he remained calm in the face of emergency, still so composed when the patient was in danger.
“Go for endoscopic surgery through drilling! This should be the only way to save him now!”
Endoscopic surgery only requires drilling a small hole in the skull, causing minimal damage to the patient.
However, compared to traditional surgery, endoscopic surgery is extremely challenging to perform.
Tuya’s Neurosurgery department truly lacks talent in this area.
Director Wen’s expertise in advanced surgical procedures is rather common, which is why he initially considered traditional craniotomy as the primary option.
Traditional surgery aims for extensive surgical visibility.