In operating

Neurosurgical operations, as a rule, are made under local anesthesia. The fact that these operations, especially the removal of brain tumors, often last for 3-4 hours. They require a neurosurgeon such care and subtlety movements that its work should not be even a hint of haste. Naturally, General anesthesia for several hours may be unsafe for some patients with serious diseases of the Central nervous system.
The method of local anesthesia currently (especially in the Soviet neurosurgery) are designed so thoroughly that for a long surgery the patient is completely painless. Therefore there is nothing surprising in the fact that the patient lying on the operating table, talking to the surgeon, answer questions, tells about his health. Even small children endure the surgery under local anesthesia. It is quite often possible to see during the operation sister sitting next to a child, telling him the tale, shows favorite toys.
And yet, with all the advantages and security of local anesthesia, which have firmly "adopted" modern surgery, it cannot be considered universal and the best method for all patients and for all operations. In some cases, in neurosurgery successfully used anesthesia - intravenous (when the narcotic substance is injected directly into the blood) or inhalation (when narcotic gases - air, nitrous oxide - are entered into the lungs). In the latter case are very complex modern anesthetic machines.
During neurosurgical operations requires particularly careful monitoring of the patient. Therefore, in neurosurgical operating, we can see not only doctors, but also many of their assistants - precise and complex instruments, apparatus and appliances.
They in throughout the operation sensitively register the work of the heart, vessels, the currents of the brain, breathing, temperature of his body, the level of saturation of blood with oxygen and so on,
Surgery on the brain begins with skin incision, which is usually done in a u shape. Removing this skin flap aside, the surgeon proceeds to craniotomies. With the help of special instruments in the bones of the skull form a round window with the diameter of about 6 to 8 inches. Through this hole after slit Dura neurosurgeon may come to the region of the brain where there is a tumor, abscess, metal splinter.
At the end of operation sawed area of bone is placed back into place, and soft covers the head and the skin carefully sew the silk sutures. 3-4 weeks only slight skin scar will testify that the man had a serious operation on the brain.
We can say that in neurosurgery no simple operations. The brain surgery require more knowledge and experience, the maximum concentration, precisely calculated and deliberate movements. So, for example, to remove a tumor of the pituitary gland, which is located deep in the brain, the neurosurgeon is extremely gently push aside the frontal lobe of the brain, and "rise" to the tumor through a deep and narrow the gap formed between elevated brain and bones of the skull base. At this point in the operating off a huge shadowless lamp above the operating table, turn off and frontal reflector, i.e. electric lamp with reflector fixed on a white cap surgeon. Only a tiny, the size of a match head, a light bulb on thin metal stalk, introduced by the assistant to the depth of the brain lights surgeon "path" to the tumor.

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