Chapter 288 284. The miserable man
In the eyes of others, the in situ urethral diversion mentioned by Kawei is not his own "conjecture", but more like an innovation based on the wisdom of previous generations. It's just that the leap of this kind of innovation is so large that people can't see the shadow of a springboard.
"There is a urology-related journal in the medical school library, which records a ureterocolic anastomosis."
Carvey asked the young assistant standing aside to bring an abdominal cavity model and said: "After removing the patient's exstrophy of the bladder, a French doctor named Simon chose to connect the ureter to the sigmoid colon to form an effective urination channel. Access."[1]
Waterman nodded and said: "Good idea."
“But at that time, we didn’t notice that the urinary system and the digestive tract are different.” Kawei explained, “Urine is much cleaner than feces full of bacteria. Once connected, intestinal bacteria will invade the urinary system. "
After more than half a year of preparation, the concepts of "bacteria" and "infection" have taken root in Vienna.
Especially the Municipal General Hospital and the College of Surgery, whose ideas were directly transmitted by Kavi, except for a few hard-line opponents, the vast majority of doctors have already acquiesced in these two important concepts. In contrast, Mosier, who was standing by the operating table, was still unable to accept this brand-new idea.
"In the same year, a surgeon named Lloyd also performed a similar operation on a patient with bladder exstrophy."
Kawei has repeatedly checked each suture surface in the pelvic cavity, protected it with wet gauze, moved the surgical position upward, and started looking for a suitable bladder substitute:
"The former lived for a year and died of infection. The latter only lived for a week and died of peritonitis caused by suture leakage. In the following more than ten years, surgeons from all over the world tried this operation, but the result was Not too good”
"So you made improvements to the surgery?" Waterman asked.
"Yes." Kawei said, "It is definitely not possible to connect the ureter directly to the colon, but those two surgeries were not without merit and gave me a lot of inspiration. I believe that in the near future, my surgery will also become an inspiration to others. , regardless of success or failure.”
Having said that, in fact, urinary diversion has not changed much in the hundred years since the ureterosigmoid anastomosis in 1851.
It was not until the late 1950s that medicine officially entered a period of rapid modernization, and clinicians began to discover the various drawbacks of this type of surgery. 【2】
Since then, lower urinary tract reconstruction has begun to develop in three different directions [3]. Among them, orthotopic neobladder surgery, which began to appear in the 1980s, has gradually become the gold standard for clinical urinary diversion during a large number of clinical practices. .
Kawei has improved the maturity of this surgery for more than a hundred years at a time. Against the background of insufficient hardware and soft power, it may not be possible for anyone to replicate this surgery by the end of this life.
After all, if you want to achieve autonomous urinary control, you need to preserve the intact vaginal nerves, and at the same time, you must carefully handle the urethral sphincter. Any accident will cause difficulty in postoperative recovery.
There are difficulties everywhere in the selection, treatment and anastomosis of the intestinal tube with the ureter and urethra. Even if you watch the operation repeatedly at close range, you may not be able to grasp the key points.
"When choosing a bladder replacement, the bowel is the easiest and probably the only option." Kavey, who was originally standing on the left side of Edem, changed positions with Mosier at this time, and the original bladder retractor After being removed, an ordinary retractor was first replaced, "In the intestine, no matter which type of intestinal tube is chosen, it will have its own advantages and disadvantages."
As he talked, he looked for one of the important signs of the operation, the appendix.
“Of the stomach, jejunum, ileum and colon, I choose the more moderate ileocolic.”
Kawei began to look for the junction of the ileum and colon: "The ileum is sufficiently mobile and has rich blood supply. The colon has a large space, and although its position is relatively fixed, it is easy to loosen and move to any part of the pelvic cavity. But no matter which one you choose , will produce corresponding complications, which is inevitable."
The appendix is not difficult to find. It didn’t take long for Kawei to pinch Edem’s ileocecal part: “The appendix is right here. Let’s choose a section of the ascending colon and a section of ileum, and keep the ileocecal valve in the middle [4]. Come on. , give me the tissue forceps, the first step is to 'untie' the colon."
Nearly 2 hours had passed since the operation at this time, and the process was just over halfway. The bladder reconstruction was still being carried out nervously in the surgical theater.
At the Vienna train station on the other side, a train that had just arrived from Paris had just entered the station. According to the original plan, it will leave Vienna at 7 o'clock tonight and return to Paris, its previous departure point.
From the beginning, there were rumors that Edward, the ambassador to Austria, would take this train back home, along with a young doctor and his surgical team. So the train conductor specially vacated the first-class cabin and provided a sumptuous French meal for this diplomatic minister.
"Mr. Edward, it's a great honor to take you back to Paris." The conductor smiled and walked towards Edward, who had just arrived at the platform. "The first-class cabin has been vacated. You can get on the train now."
"No hurry, no hurry."
Edward's heart is not here at all. Even if he doesn't go to Paris today, he has to look at other people's faces: "I am just a companion when I return to China this time. The real protagonist is not me. After sending that person to Paris, I have to do it as soon as possible." Come back. After all, the fight between Pu and Austria is still going on, and anything can happen at this time."
"Oh, that's right"
"By the way, let me introduce you." Edward smiled and turned sideways and looked behind him, "This is Mr. Alphonse, who has worked in the palace for many years. This time he is also helping out, and the kitchen will be left to him. Him."
"I have admired you for a long time."
"Excuse me."
Alphonse has not returned to his country for a long time. After traveling around East Asia, he has settled in Vienna.
The main reason I got on this train today was for Kawei. After all, the other party had cured his hidden illness, and with his status, it was only right to help. Of course, he has many friends in Paris and Vienna, and can make some contributions to the relationship between France and Austria by Kavi's side.
"From the moment he got on the train, Dr. Kawei was responsible for all his meals."
Edward just stated his request in a conventional manner, not asking for advice. The conductor sounded uncomfortable, but he had no other choice: "What should we do with the cooks on the train?"
"In principle, all the chefs on the train have no right to touch the dishes. This is not because they don't trust their cooking skills, but for safety." After Edward finished speaking, he handed over the right to speak to Alphonse, "I am mainly responsible for Dr. Carvey and I don’t have time to care about the diet of my surgical team."
"Okay, I know."
After a brief exchange, Alphonse followed the conductor onto the train, while Edward continued to stay in the waiting room on the platform, anxiously waiting for the results of the operation.
For him, what troubles him now is actually the three forks in the road in front of him.
Everyone was happy that the operation was successful, and they drove back to Paris for handover. Edward could stay in Paris for a few more days, and then return to Vienna in glory. If you are lucky enough to get promoted, you may not come back to China this time.
But if something goes wrong with the operation, in principle, as diplomatic ambassadors and surgeons, both Edward and Kawi should stay here.
But the war between Prussia and Austria has tended to ease. If he misses this opportunity to perform, Edward doesn't know what will happen to him in the future. After all, the black information about him in the past few days has long been spread on the streets of Paris through the pervasive news newspapers.
"God, please help me, a miserable person."
There are thousands of miserable people in the world, and Edward is by no means the only one.
On the other side of Berlin, a middle-aged man who was enjoying his afternoon leisure time at a roadside cafe seemed to have to call himself a "miserable person".
It has been two days since Mick's letter was sent. No matter whether it was successful or not, he would find a reason to kill Li Ben so that he could vent the evil fire in his belly. But at this moment, two messages from his men made Mick's mood fall to the bottom.
Looking at the simple password letters on the letter paper, he felt resentful. Unfortunately, no matter what, this kind of expression should not appear on his face: "The mission is completed."
"Boss, if they handle it this way, we won't get any credit."
"What kind of credit do you need for doing things for the empire?" Mick stared at him. "As soon as this news comes out, the Prussians in Vienna will get in touch with our superiors. As long as the Prussian Emperor is not a fool, the war will soon be over. End with the 'smooth completion of the peace talks', and then the French will have nothing to worry about."
"Alas, the news didn't reach us, so this trip was in vain." The man in black picked up the cup, put it to his lips, and took a careful sip, "The coffee in Berlin is really terrible."
Mick sighed: "Don't think so much. I'll go back and clean up later. I'll go back to China tonight. Remember to clean up."
The men were very surprised and couldn't help but look at Mick twice: "Leaving tonight?"
"Otherwise, why are we staying here? Touring?" Mick didn't let down his guard for a moment. He glanced at the many Prussians around him and said, "Besides being surrounded by these 'enemies' every day, we can't do anything here. It's easy. If your identity is exposed, it is better to return home as soon as possible. Even if the credit is gone, the material reward will never be less."
"That's true, there isn't much to see in Berlin."
At this time, the subordinate suddenly remembered another piece of bad news: "By the way, boss, what should I do with that guy?"
"That guy." Mick didn't want to lose his temper. Seeing that the other party mentioned that person too much, he suppressed his anger and asked, "How do you do things? Can a stinky rat trapped in the apartment escape?"
The man's body trembled slightly, knowing that he had said the wrong thing, so he could only explain: "He is too sensitive. We just knocked on the door lightly and aroused his suspicion. But when he came to his senses, he had already climbed out of the window and left. I found the apartment and couldn’t find it again.”
"Knock on the door? Why are you knocking on the door?"
"this"
"Didn't you learn to pick a lock in the library? Don't you know how to open the door secretly in the middle of the night? Even if you really can't, wouldn't you just kick in the door and shoot him directly? Even if you let him escape through the window, you will Have you ever thought about watching the door and windows downstairs?"
Mick asked a series of questions, leaving the other party with no room for resistance.
But no matter how hard they scolded them, they still missed the target after all, and the scolding was of no avail: "Do you know where he went?"
The subordinate shook his head: "The place where he lives is not big. We searched it several times without exception, but no reliable information was left."
"I don't even know where I'm going." Mick smiled bitterly, "This guy is really slippery, and he has a lot of secrets from us. If..."
"How about I look for my brother and then look for him?"
Although the importance of Li Ben has been mentioned, the silence is actually more of Mick's personal grudge. After all, he was deceived by Li Ben's fake identity before and was very humiliated. After becoming a pawn, he was very restless and even squandered his operating funds wantonly.
But with the lives and fortunes of more than a dozen people in his team, as well as several "threads" hidden in Berlin, he must weigh the pros and cons.
"Forget it, it's just a stinky rat crossing the street, let him fend for himself."
"What the boss means"
"Go to the newspaper office later and chat with the reporters inside about this young baron. Let him enjoy the Berlin sun."
If he knew that Edward and Mick both called themselves miserable people, then Li Ben, who had just escaped a disaster and was now preparing to leave Berlin, would definitely bang the table and spit out the fragrance.
At the beginning of the year, he escaped from Berlin all the way to Vienna, but soon he had to go from Vienna to Berlin. Now finally, all German-speaking places can no longer accommodate him. There are too many coincidences and bad luck in this, if it weren't for the French cook, if it wasn't for the doctor, if it wasn't...
Mick! ! !
Ever since he saw this guy in the apartment, Li Ben felt very uncomfortable because the bad things he had done had already crossed the bottom line of his immediate boss.
In Vienna, an informant with an extremely unstable behavior and numerous criminal records like him would not have survived more than three days. The reason why Mick kept him and gave him a lot of money was simply because of his previously forged identity.
After the incident was completed, Li Ben had been thinking about escaping, and the knock on the door was just an opportunity that was not so coincidental.
"Sir, where are you going?"
"Let's go where we want to go. I won't refuse to pay."
Li Ben now still has the 2,000 thalers (Prussian currency) that Mick gave him before, a decent set of luggage, and a forged Prussian baron certificate. It seems that he can still make a living, but the places he can go to are... There are very few already.
Russia in the east is too cold, and Britain has to take a boat. Italy in the south has a pleasant climate, but unfortunately he doesn't speak Italian. The only way he can go now is to the southwest, France.
Go to France! Go to romantic Paris to do my job! Those stupid rich people will definitely be fooled by me
After making up his mind, Li Ben knocked on the car window: "Send me to Berlin Central Station."
(End of chapter)
