At the same time and space, the vast majority of operations performed by other director-level surgeons were limited to two hours, and most of them were simple minor operations of less than one hour. But Kawei had extended the operation time to a full three hours, and there was no sign of it ending.
This time has already made history. Regardless of whether the operation is successful or not, the three-hour operation has firmly established itself as the world record.
This is definitely not delaying time. If you are really serious about the surgery, you will never say this. The general view of everyone present is that the content of the operation greatly exceeds the time of the operation. If it were anyone else, they wouldn't be able to finish it in less than four or five hours.
The first two hours of splenectomy + venous shunt were very fast-paced, like putting on a child's clothes from two years ago, which didn't fit very well.
The next surgery was for the rectum. Although it was a child's clothing of similar size, it was tighter since it was an adult's.
With the support of the equipment provided by Laszlo Equipment Factory, Kawei seemed to have found the feeling before time travel again, and he compressed a large number of tedious surgical details into a short time. Not to mention that the general audience couldn't understand it, many doctors couldn't understand it either. Even on the operating table, few of the three assistants could understand it.
The pelvic floor has a rich blood supply, and Kawei speeds himself up again, leaving many small bleedings unchecked. They do not affect Fernand's body, but they significantly affect the view of the surgical area.
What they saw now was a bloody hole in which soft tissue, fascia, peritoneum, mesentery, omentum and intestines were all mixed together. Without experience, it was impossible to understand the anatomical relationship between them.
Therefore, after Kawei began the operation, many self-aware viewers simply gave up watching the operation before the climax came and focused their attention elsewhere.
Fortunately, the successful removal of the spleen has boosted the sluggish popularity, and the sight of Berget and Damirgaard exsanguinating the spleen together is really exciting. Watching the blood slowly flowing into the metal basin with the help of the two people, the audience finally regained the feeling of watching the surgery.
It is because of this strange feeling that besides Kavi, the third assistant Berget is the most popular on the operating table.
He not only handled the spleen blood with Damirgang, but also took on the important task of blood transfusion. At the same time, he also had to help deliver various equipment from time to time, which was much more conspicuous than Heman and Damirgang.
Although he is an assistant, he is still not sloppy in his work, and being able to perform this operation watched by thousands of people already shows his strength, which makes his mother Elena in the audience extremely happy. From the beginning of the operation to the present, her face is full of smiles: "Beget has really grown up."
Compared with internal medicine, surgery is indeed much inferior. Bergert, who had the best grades in the entire medical school, chose surgery, which once puzzled his father Chrissy. After officially entering the Municipal General Hospital, he didn't even think about what achievements Berget could make. He just hoped that he wouldn't be too embarrassed.
Now it seems that being able to work in front of such a large audience is actually not bad.
Chrissy had nothing to say, so he just followed his wife's words and said, "Yes, I have indeed grown up."
Naturally, this statement has two meanings. One refers to work, and the other refers to life. After Chrissy finished speaking, he turned to look at Laszlo next to him, but unexpectedly Felix, who was right next to him, came up first: "Is Mr. Laszlo looking for someone?"
"Oh, no, no..."
Felix is only 19 years old. No matter how capable he is, he cannot dominate his sister Naya's marriage. Chrissy cannot tell him directly. But in order to get the words right, I still have to give a little guidance: "Mr. Felix is 19 this year?"
"Yes, Mr. Viscount." Felix watched the operation on the stage carefully, with a smile on his face from beginning to end.
"It's almost time to talk about marriage."
"Me?" Felix pointed at himself with a smile, shook his head and said, "I'm not in a hurry. It's my sister who should be anxious."
Chrissy heard the opportunity came: "Yes, Naya is 21 years old, it's time to get married."
"I think Mr. Bergt is quite good." Felix was like a free uncle, and directly named Bergt. "Graduated from the best medical school in Austria, with a doctorate, and his grades have always been excellent. Number one. A job with a future is more meaningful, and with Mr. Viscount as my backing, I am completely worthy of my sister."
Krissy watched blankly as he said all his thoughts, but he was a little unable to react in time. In the end, he could only find a random sentence to fill up the embarrassment: "I didn't expect that Mr. Felix would treat me right after he returned to Vienna. My son understands so clearly.”
"Oh, don't get me wrong, Mr. Viscount." Felix explained quickly, "I am not targeting Mr. Berget, I do this to everyone."
Chrissy was a little surprised. Then he looked at Laszlo, who was sitting next to him and didn't respond at all, and then he understood why this guy dared to hand over the steel plant business to his son. As fathers, they are afraid that their sons are not capable enough, and if they are capable enough, they are afraid that they are not stable enough.
Now it seems that what Felix said just now seems to be praising Berget, but in fact it is using this method to praise him Krissy.
Chrissy knew that he shouldn't say this to a junior, but considering that he was solely responsible for the steel plant, and he couldn't talk to Laszlo, he could only chat first and then said: "Oh? Miss Naya doesn't care about Berget either. interesting?"
"Well..." Felix smiled, "A woman's mind is so difficult to understand."
"What about your father?" Chrissy lowered his voice slightly.
"My dad?" Felix looked back at Laszlo, then shook his head and said, "He said he didn't want to care about it. Just don't find someone to go home with on the street."
Um?
What kind of education method is this?
Chrissy had never heard of anyone being so casual about the marriage of their children, and thought it was just Felix who was talking nonsense. Unexpectedly, the 19-year-old young man immediately taught him a lesson: "Just like when I was 17 years old, He didn't stop people when they ran to New York, he helped pay for the ferry tickets and just ignored them."
"Did you go to New York alone?"
"Yeah." Felix learned a lot in this year, "New York is a good place, but..."
"Um?"
"Haha, it's nothing. Let's talk about my sister's marriage." Felix smiled and said to him, "No matter how you look at it, I am firmly on Mr. Begut's side, but the final decision still rests with my sister. In my own hands.”
"Logically speaking, I shouldn't be too involved in my child's marriage." Kerry said with a smile, "But I still hope Mr. Felix can help me with this matter."
"That's for sure, for sure."
At this point, Felix finally revealed his purpose: "There is no problem in helping. I also value Mr. Berget's talent. But some things are mutual. I don't know if Mr. Krissy can help." Can I do a small favor?"
Chrissy was stunned and immediately understood what he meant: "What's the deal?"
"Recently, some people are not pleased with my father's industry, and they always want to suppress us in every aspect." Felix withdrew his gaze from the operating table, "Once the Laszlo family's steel factory is suppressed, I'm afraid Hungary... ..."
"I understand what you mean."
Nowadays, there are not many people who dare to touch Laszlo's business territory. It is estimated that only the House of Lords and the King in Austria have this ability. But the vast majority of these people are unwilling to have a tense relationship with Laszlo. After all, who doesn't love money.
But if the time range is narrowed to the last month, someone has to pay attention.
"Is it Edinson?"
Felix did not nod, but just said: "Some people have no business sense. The prices of steel products in Austria are naturally decided by the steel companies themselves. What is the point of limiting price fluctuations? Although I know that the country is temporarily in some small difficulties, but it is not It’s time to take action on our small businesses.”
After his reminder, Clichy did remember that there was a proposal from the Edinson family in the House of Representatives, which was about Austrian steel companies. The proposal clearly states that there is a serious imbalance trend in Austrian steel companies, which is detrimental to the long-term development of the country.
Although Franz was not enthusiastic about the proposal, he couldn't bear to ask a question repeatedly. If something went wrong, Chrissy didn't know what would happen to others, at least he would definitely be unlucky.
"If Mr. Felix is talking about the steel plant proposal, there are indeed recent rumors that are not favorable to Mr. Laszlo." Krish said, "But they are just rumors. Who will talk to Laszlo?" Mr. Luo is against him..."
Felix glanced sideways at him, a little surprised by his reserved and careful style: "Mr. Viscount, you don't believe in our intelligence capabilities?"
"Are the rumors true?" Chrissy hesitated for a moment and tried to appear embarrassed. "Although it is very troublesome, I can try to think of a solution."
It is typical to say only three points out of ten, but for Felix, holding the Hungarian factory in his hand, it is enough to express his position with three points: "Then I will wait for the good news from Mr. Viscount... .”
"Me too."
Suddenly, the nurse's voice came from the operating table. It seemed that there was something wrong with her blood pressure and heart rate. Felix looked at the operating table again: "Let's take a quick look at the operation. I feel like we won't have a chance if we don't look at it."
...
Unstable blood pressure is often encountered during surgery, especially in elderly patients, who have a very high chance of hypotension.
Although major bleeding accidents during surgery need to be ruled out, in many cases, this type of hypotension is just a manifestation of hemodynamic instability, reflecting a phenomenon in which vital sign values are dynamically changing at all times.
However, because there was no detection method, such fluctuations could not be detected immediately by human hearing and finger touch in the 19th century.
This surgical nurse is worthy of being the elite left after Kawei's screening. Even after three hours of work, she still maintains a certain degree of sensitivity. At least she captured the changes in blood pressure and heart rate, which is pretty impressive.
Intraoperative mean arterial blood pressure has a critical value of blood pressure and time. Theoretically, it cannot be lower than 70mmhg for more than 10 minutes, and 65-60mmhg cannot be longer than 5 minutes. Once it is lower than 55-50mmhg, there will inevitably be damage to the heart, kidney and brain, but the degree is different. That’s all.
Fernand's blood pressure is still some distance from the critical value, which is acceptable as long as it is not lower than 90/50.
But Kawei was far from having modern first aid measures. It could be said that everything that could be used was put on the table from the very beginning of the operation, leaving no room for backhand processing. Therefore, he must nip all factors that may cause accidents in the cradle: "Speed up the dripping speed for bottle No. 1."
"Okay." Amor slightly adjusted the leather strap valve, staring at the liquid in the glass tube, "...it's 10 drops/min more than before."
"Well." Kawei continued to look at the surgical area with his head buried in the air. "You should pay more attention to the patient's blood pressure and heart rate, as well as the depth of anesthesia. The time should be up soon."
"There are still about 20 minutes left." Amor had figured out Fernan's physical reaction to applying ether in the past three hours. "The amount given this time is quite large, so it should last a little longer."
This approach was a bit drastic, but considering the length of the operation and the short-term effect of ether, it was justifiable.
"Well, pay more attention."
Kawei didn’t have much to suggest. In ordinary minor surgeries, he could still focus on the patient’s vital signs, but this surgery really couldn’t spare his attention: “Give me your blood pressure and heart rate in five minutes, and we’ll continue the surgery. I've pulled the retractor firmly, exposing my vision."
"good."
"Come here with the lamp." Kawei pinched Beget's wrist holding the oil lamp, pulled it to a suitable position, and then said, "Just put it here for now, don't move."
"good."
"I will slowly pull the rectal segment that needs to be removed out of the incision. Where is the gauze I prepared just now?"
"Here it is." Berget held the oil lamp and did not forget to bring a metal basin filled with warm water and gauze to the operating table. "I have prepared it before."
"Okay." Kawei found two right-angled forceps from the pile of instruments and clamped the rectum at the lower edge of the mass. "First determine the cutting position, right next to the lower edge of the mass. Then let's not rush to cut. Instead, the patient’s rectum must be thoroughly disinfected again.”
Hermann asked: "Carbolic acid?"
"Well, just use carbolic acid. Alcohol is a bit too irritating."
Carvey still followed the rectal disinfection method he used when performing hemorrhoid surgery on Alphonse before. He used a pair of gauze forceps to clamp a ball of carbolic acid gauze and stuffed it directly into Fernan's anus to clean it: "It's okay. The intestinal emptying was done well before the operation, otherwise this scene would be unimaginable."
This is not unnecessary, but is done to prevent the residue from spilling out and contaminating the pelvic cavity when the rectum is cut.
Because modern people are resistant to enemas, intestinal preparation is often inadequate, which can easily lead to infection during surgery. But this didn't seem to be a problem for people in the 19th century. At least not much residue was found on the gauze after disinfection, and it was still clean.
"You also need to be careful not to touch the lumps during disinfection, otherwise the lumps that invade the mucosal layer can easily cause bleeding."
After Kawei cleaned his rectum a little, he threw away the contaminated forceps and gauze and returned to the surgical area: "Okay, let's say goodbye to Mr. Fernand's rectum. Give me the scalpel. "
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