While Nora was still fighting the hemorrhage, the clear and loud cry of the child echoed in the venue.
"How is your breathing and heart rate?"
“They’re all pretty good.”
The uterine bleeding was successfully stopped and the baby survived. The cesarean section was 80% completed. This time, victory was really in sight. Seeing that the operation was in sight, Hills wanted to regain the position of surgeon, so he immediately overcame Carvey's words.
"Take the child away first, give it to Teacher Marcus, and send him back to the hospital." He slowly removed his hands from the abdominal cavity and jumped off the operating table, "Remember to keep warm."
"Um."
As an old doctor who has been in emergency surgery for decades, Kawei has experienced many ups and downs. Although he has never performed a cesarean section himself, he has seen many cases of cesarean section accidents.
Everyone thinks that caesarean section is better, but only doctors who have done it know that there are traps everywhere in a small caesarean section. If at the beginning he still had the energy to let Hills do the incision and choose to intervene depending on the situation, then in the final stage, he did not dare to do so.
Yu Gong, intrauterine dissection of the uterus, suturing of the sarcoplasmic layer, and exploration around the uterus are all necessary tasks. No matter which step is done wrong, all the efforts of the operation will be wasted. 【1】
In private, Kawei is not that easy to talk to in the first place. He has done all the dirty work of stopping bleeding, so how could he give up the surgery again. So when Hills looked at him wanting to take over, Kawei shook his head slightly.
He did not respond. He just said everything he had to do before closing the abdomen in order, and continued to do it again: "The first thing we have to do is to clean the uterine cavity. Don't think that delivering the placenta is enough. We also need to do more." Check it out, Ms. Nora is still in sleep anyway, so she shouldn’t object.”
The medical students and surgical colleagues on the stage knew very well that a great victory in cesarean section was about to be born.
But what they didn't expect was that there were still so many ways to go after the surgery. The entire cesarean section starts from the selection of incision, which is full of dense knowledge points, and it is also knowledge points that no one has ever talked about.
Those guys with a keen sense of smell had already taken out pen and paper and recorded the operations performed by Kawei and what he said verbatim.
Surgical theater has always been about winning and losing heroes, but pedigree and status are also needed in surgical circles.
The reason why Ingnatz has received so much attention is not only because he is good enough, but also because of the baron hat on his head. It is extremely rare for a nobleman to perform in a theater, and it will naturally win enough attention.
It's just that Kawei's victory was so complete, and it was foreshadowed by Laszlo's Qi Cut, that the audience actively ignored his current assistant position.
Kawei used gauze to clean the uterine cavity, and then touched the mucosa inside the uterus back and forth with his hands. After knowing that there was no problem, he started to suture:
“I remember there was a successful cesarean section in Tsarist Russia five years ago. A little-known surgeon at the time chose double-layer suturing by chance. For the first layer, he chose a continuous suture of catgut muscle layer. ....”
"I Have a Picture Book of Ghosts and Gods"
Herman has become an out-and-out instrument nurse, handing over needles and threads immediately.
Kawi held the incision with crow's-beak forceps in his left hand and sutured the needle [2] in his right hand. Looking at the uterus with stagnant bleeding, he tried to slow down his hand speed: "The inside of the uterus is full of blood vessels. You can't suture too fast. You have to do it step by step slowly. .”
Perhaps due to different standards for speed, Kawei's stitching speed still exceeds most people's definition of "take your time".
Surprised, they didn't even have a chance to ask questions. They had just finished writing the previous knowledge points, and Kawei's first layer of stitching had already come to an end.
"... After the first layer of suturing is completed, we still need to reinforce the interrupted sutures... Because the catgut tension is not strong enough and it is easy to break, so after the reinforcement, a second layer is needed. That is, a continuous suture of the serosal layer.”
Kawei waved to Herman and took the silver thread he found while rummaging through the box: "Teacher Yingenatz prepared enough silver thread for this operation, but it's a pity that he can't use it today."
His ridicule attracted a lot of laughter, but Kawei's hands were not idle, and he completed the suturing of the uterus in the blink of an eye. 【3】
"The suturing is complete, but according to my father's long-standing request for surgery, I still need to look around the uterus more." Kawei once again put the credit on the father who never existed. "There are important organs around the uterus. Organ tissue, and it is full of supply blood vessels. If it is not explored clearly..."
The words were cut off by him, and Kawei took two gauze strips from the side: "I need to emphasize that if there is bleeding at the needle hole where the uterus is sutured, you don't need to panic and don't use sutures to sew it up again. , but this will increase the burden on the uterus. In fact, the method is very simple, and it only takes three minutes of compression to stop the bleeding."
If Count Morasso's intestinal anastomosis reflected Yingenatz's speed, then this cesarean section showed Carvey's stability and ease.
The stability when encountering heavy bleeding, and the leisure in the closing stage, the ultimate leisure.
In the next three minutes, while pressing the bleeding point of the uterine suture, he looked at Nora's open belly, like a surgeon professor who had the whole situation in his hands, and answered many people's questions: "You guys I am asking about the reagent that was injected into the uterus just now. It was an ancient prescription that my father got when he traveled to the East."
"East? India?"
"No, no, further north, a."
"Oh, it's the place where silk, tea and porcelain are produced."
"This reagent is a special medicine used by locals when mothers have difficulty in giving birth. It has been passed down for thousands of years. After my father's research, it was found that it can help the uterus contract." Kawei said, "That is exactly the case, Ms. Nora The uterine contractions are very powerful and can compress and stop bleeding better than physical clamps."
Since it was an ancient recipe that had never appeared in the outside world and was so effective, the audience was very interested and did not ask about the details of the preparation.
"The hemostatic effect is really excellent."
"If Mr. Kawei is interested, my pharmacy can sell this hemostatic drug on his behalf."
Kawei corrected: "Please note that this is a drug that is only used by pregnant women to help the uterus contract. It is not a hemostatic drug in the true sense. I will improve the experiments on the drug in a while, hoping to calculate a Appropriate dosage.”
After asking about medicines, they quickly changed their goals and focused on surgery.
Delivering the child's placenta first, cleaning the placenta, contracting the uterus to stop bleeding, the method of suturing, and the need for surrounding exploration after suturing... These are all things they have never heard of. They are not in textbooks, and they are not mentioned in the professor's mouth.
Kawei had no choice but to drag out his father again: "The main reason was my father's three-year trip, which not only went to the East, but also went to Africa. He found that the local African indigenous people often performed cesarean sections, and The success rate is not low.”
This sentence went beyond everyone's understanding: "This is impossible, they lack decent surgical tools!"
"How could a black man have a cesarean section? I guess he must have seen it wrong!"
"The operation is so complicated, but they don't even know the words. If they were replaced by yellow people from the east, they might still be able to convince themselves."
"This is what my father saw with his own eyes... Can you please listen to what I have to say first?" Kawei sighed and said, "Their treatment method is very rough and still retains the bad habits of the Middle Ages, but it has a hemostatic effect. It’s not bad. Because it has been circulated for many years and the method is fixed, the mortality rate is definitely there, but it has never been too high.”
"How did they do the anesthesia? They wouldn't just let the local witch doctors cut open the stomach, would they?"
"Cocaine, it's everywhere in the rainforest."
"What about stopping the bleeding?"
"Soldering iron, although it is cruel, you should know that this method is indeed very effective, especially if the patient does not know it."
"What about sutures? They don't have such sophisticated suture needles, catgut, and silver thread."
"The thinnest palm rope is used for the womb."
"What about the skin? If rough palm rope is used on the skin, it will definitely cause skin ulcers. This is already a consensus among surgeons."
Kawei also admitted this and replied: "Use ant heads."[4]
"Ant?"
"The ants' huge mandibles can bite the skin tightly, pass through the incisal edge like a suture needle in my hand, get stuck there with the barb, and once the bite is tight, cut off their body. And these giant ants can also Secretes a saliva that prevents ulceration and helps wounds heal.”
Kawei explained with a smile: "Don't look down on those backward places. Even if you see 99% of the dregs and discard them like worn-out shoes, you can always find some shining points worth learning from the last 1%."
There was another sound of writing. Kawei removed the gauze strip and carefully inspected the sutured wound: "Very good, the bleeding was stopped successfully."
During the subsequent exploration, no missed bleeding points were found, and the operation finally came to the final stage. Following modern surgical procedures, Kawei checked the gauze strips used to lift the uterus again, and carefully counted the number of gauze strips, crow's-beak forceps and suture needles brought with the surrounding nurses before finally deciding to close the abdomen.
"Teacher Hills..."
Kawei finally gave up the needle and thread in his hand, because he knew that the next suture was not difficult and could be done with Hills' ability. But unfortunately, Kawei's smooth operation deeply hurt his self-esteem.
Hills refused.
"I'll do it." Herman took the needle and thread smoothly and gave Hills a step down. "He was not feeling well just now, so he should go to the preparation room to rest for a while."
Hills took off his leather skirt, glanced at the audience and Nora, bowed slightly, and left the theater with a straight face.
It was not difficult to suture the skin, and Herman quickly completed the finishing work with a little guidance from Kawei.
The operation ended successfully, and there was no room for further explanation. It was completely the moment for the host to show off:
"Ladies and gentlemen, first of all, congratulations on your well-deserved trip. The surgery was performed beautifully in the hands of the younger generation of surgeons from the Municipal General Hospital. No matter whether Ms. Nora's wounds will fester in the future, or what the fate of her child will be. , this cesarean section will definitely be recorded in surgical history.
And it was an Austrian doctor who successfully completed the operation and successfully saved Nora's life! This is a fact that other countries can only envy no matter what! ! ! "
...
The host very cleverly avoided the name of the surgeon, leaving plenty of face for Hills. However, it is not difficult to see from the post-operative interviews and questioning sessions that the surgeon in the audience's mind is obviously Kawei, who is surrounded by those black gentleman's dresses in the preparation area.
After asking about some details of the cesarean section operation, they also took the trouble to carefully visit the sterilization equipment.
Bleach, soap and alcohol, which were previously ridiculed as decorations, have now become the objects of their focus.
Unlike oxytocin, which requires controlled dosage and preparation processes, disinfecting the skin surface is not difficult. Anyone can do it as long as they have bleaching powder and alkali soap. Kawei is willing to seize this opportunity to make a big fuss about disinfection.
"Actually, like everyone else, I have reservations about disinfection." He used retreat to gain the trust of these people first. "I am very confused about the disinfection process."
"Then why go to all the trouble to make these preparations?"
"In order to prove that my father and his friends were wrong, gentlemen should never wash their hands." Kawei shook his head helplessly, "But now the concept of surgery in my heart that has been carried for hundreds of years seems to be collapsing."
"Is it because the patients recovered well after the operation?"
"Indeed." Kawei washed his hands and patted his chest, "In this era of innovation all the time, we should speak with facts. I have already treated 5 patients. If Nora is included, Those are the six, and none of their wounds have festered."
This is something that Yingnaz has told everyone before, and Kawei emphasized it again.
It's just that it's very difficult to completely eliminate this long-standing shortcoming. Even to the current level, Kawei still can't make everyone believe in him. Only a few doctors and medical students among these viewers are willing to try it, while others still choose the official website.
"It doesn't matter. I will continue to study the cause and mechanism of wound ulceration. Time will tell everyone the answer. I am not in a hurry."
At this time, two people squeezed out from the crowd, both wearing simple shirts and coats, not even hats. Regardless of the disgust and contempt of the people around them, they still came to the front: "Dr. Kavey, Dr. Kavey, we have a question, a very important question to ask you!"
Kawei nodded: "Please speak."
"I am a reporter from the Times, and he is a reporter from the Free Press." A young man with long curly hair adjusted his clothes excitedly and congratulated with a smile, "Before asking questions, we still want to congratulate you. You, the surgery just now was so wonderful."
"Thanks."
The two of them glanced at each other and knew that this question was a bit inappropriate, but the reporter's strong curiosity still made the young man speak: "We actually want to ask, Dr. Yingenatz, who was the original surgeon of this cesarean section." Where is it?"
"Because he just finished an operation with you this afternoon, so he should be able to come back in time."
"Yes, we are wondering if he has encountered any trouble, is he sick? Or has something unexpected happened..."
