Chapter 80 77. Satan Hidden in front of the Sanctuary Door

Kawei did not retreat despite the difficulties, but easily found the appendix hidden in the cecum. Regardless of whether his suspicion was right or wrong, the slightly hard and thick texture was indeed very different from the soft and thin intestinal wall of the cecum.

What lies before Ignatz now is a fork in the road.

A stable and conservative approach would not make any serious mistakes. As long as the appendix was not found, the operation could be ended by quickly sewing the priest's belly in accordance with Western European surgeons' practices for intra-abdominal surgeries.

Although the process was very dull and hardly exciting, at least the doctors did not make any mistakes. Outsiders just saw the surgery as a thrill and were not qualified to be picky about the surgery itself.

The other path is full of thorns and requires a challenge to the authoritative consensus.

Of course, Ignatz prefers the first option, because his operations have always been fast and stable, and he attaches great importance to intraoperative and postoperative mortality. In his eyes, if the patient dies after the operation, then the operation itself is gone.

Meaning, no matter how beautifully completed it is, it still has flaws.

That's why he was willing to believe that Kawei's disinfection could indeed bring about some changes.

But at the same time, this idea also has certain limitations.

He likes to use classic surgical techniques to show off his skills. As long as the mortality rate is reduced on the basis of predecessors, it is a success. Rather than choosing to find another way and using patients to create a new surgical method, he fundamentally

to change the difficulty, success rate and duration of the surgery.

Although this conservative attitude towards surgical procedures can stabilize the outside world's evaluation, it will inevitably be criticized by some people.

Varela is one of them.

Now that the abdomen is closed, the priest's abdominal pain will not be relieved, but this has nothing to do with the operation itself. It can only mean that Schmidt has a rare disease, or the disease can be classified as a trial from God or another gift.

Of course, if he wanted to find out the cause of the disease, Schmidt could choose to send the priest's body to the autopsy room.

No matter how you look at it, this is a win-win situation, and Ignatz will be very happy.

It's just that the possibility of an autopsy is very low, because the Catholics in the church will come forward to dissuade him. In order to save the priest's life, it is understandable that he undergoes surgery. But it is different to send him for an autopsy after death. That is a disservice to the priest.

The blasphemy of the soul.

But in any case, the priest's death had nothing to do with Ignatz's operation.

But if he really cuts through the serosa of the cecum and finds the appendix, if he fails to find it, his operation, which is in full view of the public, will become the target of public criticism and consume all the popularity that Kawei gathered last night.

Moreover, Ignaz will definitely be charged with "accidental injury". Even the headline in the newspaper was drafted for Varela, which was called "Carelessness and ignorance ruined the priest's appendix!"

Ignatz was unwilling to take risks.

Kawei also knew that he was unwilling to take risks, so he immediately sounded the alarm: "Teacher, you won't forget, right? We tricked the priest into going to the operating table. If you go back after the operation, let him know that you were the one who made the incision."

But nothing happened to his stomach, and he changed hands and pushed him back to the ward to continue to endure double the pain. This"

Appendicitis + wound is indeed twice as painful.

This small reminder immediately made Ignatz sober up.

"Everyone, a journalist friend once criticized me for not daring to innovate and being timid in the face of innovation. Now I must give the necessary response. I don't know if Mr. Varela is here or not."

He glanced back and forth in the operating theatre, and did not realize that his old acquaintance was watching behind him. He could only say disappointedly: "If anyone can contact him, please pass the message on his behalf. For the sake of the priest's health, I am here today.

The authority of the European abdominal surgery community must be challenged.”

After a passionate statement, the audience's response gradually became enthusiastic.

As loyal fans of Ignatz, when faced with the courage to challenge, many people responded quite positively: "Okay! Crush those so-called authorities in Western Europe to pieces!"

"Varela knows a lot about surgery and can only write some articles."

"come on!"

Amidst the cheers, Ignatz picked up the scalpel again and continued: "Judging from Kavi's judgment just now, this inflamed appendix should be surrounded by the serosal layer of the cecum. I have used

After judging with my fingers, this place is indeed different from the ordinary cecal intestinal wall tissue, and it is most likely the appendix."

Making a decision requires repeated thinking and a lot of courage, but when it comes to actually doing it, it only takes a few seconds.

Standing on both sides of the open abdominal cavity were two hot surgeons, and their cooperation was much better than during the first inguinal hernia repair. Kawei tightened the cecal wall with his fingers, and Ignatz's

The forceps picked up a serous membrane, picked it up with the tip of the knife, and bluntly separated it with the fingers, and soon saw the light red appendix embedded in it.

"It's the appendix. Everyone, I dare to say that this is the appendix of the priest!"

Ignatz was glad that he listened to Kawei's advice and quickly separated the remaining serous membrane, slowly exposing the root of the appendix to everyone.

"This is undoubtedly a major discovery in the surgical community."

“The Austrian surgical community finally has something of its own?!”

"The King invested so much money in establishing the Institute of Surgery and spent so many years studying it. What's the result?"

"As a result, except for the plastic surgery department inherited by the current dean, there is no one who can perform abdominal surgery!"

"Professor Ignatz still dares to do things, and Mr. Varela's comments are still too arbitrary. Wasn't it him who performed the first anesthesia operation? Instead, it was the former dean of the College of Surgery, and his father did it at that time

Stop it.”【1】

A short period of success can bury most of the mistakes. At least in the eyes of these viewers, Ignatz is still an Austrian surgical legend.

He also made similar remarks to his father, believing that anesthesia was dispensable, which would not only prevent him from observing the patient's operation conditions, but also potentially kill the patient. However, due to some public opinion and academic pressure, he still

He performed the first anesthesia operation in Austria.

No one can escape the law of true fragrance, not even top surgeons.

In comparison, missing last night's cesarean section actually contributed to Kawei's rise. After all, it was just a small thing.

However, not long after the argument similar to "Ignatz is still great" appeared, the operation process poured cold water on everyone's head: "Father's appendix is ​​too long."

Ignatz separated upward along the incision, hoping to pull out the appendix hidden in the cecum.

Unfortunately, the appendix and the cecum are closely connected, and the serosa layer is tightly pressing against the appendix. They are like a symbiotic relationship, hugging each other tightly and extending upward along the direction of the incision.

If the matter occurred in modern times, I am afraid that the surgeon would not hesitate to extend the incision again. After all, the most troublesome appendix has been found, and it is impossible to close the abdomen without success. [2]

But in the 19th century, the longer the operation took, the more resistance it encountered.

One's own reputation, the next day's newspaper, the reaction of the audience on stage, and the unprepared surgical process will bring endless pressure to the surgeons. In that era when giving up was not considered a medical accident, closing the abdomen was definitely not a good thing, but

At least it can let people put down their burdens and take a breather.

After all, if you want to continue the operation, you don't need to continue on the original basis. Instead, you need to expand the incision and continue to free the cecum and even up to the ascending colon.

The wax table chandelier and portable oil lamp in the surgical theater illuminated the surgical area brightly, but inside the incision, the priest's upper right abdomen was in darkness. There was no stable anesthesia, no first aid measures, and no God's perspective from Kawei. Continue

Expanding the incision increases the risk exponentially.

"Teacher, the current incision is 12cm, which is already the limit. I'm afraid there are not many abdominal surgeries with such a large incision in Austria." Hermann suddenly mentioned, "If the incision is extended further, it will be 17cm."

"17cm"

Even Kawei, who has undergone thousands of operations, knows the dangers of surgery, but he needs to consider it more comprehensively.

Although ether anesthesia sounds simple, and you can fall asleep just by smelling it, controlling the dose of anesthesia is actually a very complicated technical task. Once the dose exceeds the threshold, ether will inhibit the respiratory center and interrupt the patient's spontaneous breathing.

Finally, he suffocated to death on the operating table.

Therefore, the operation time in the 19th century was very short, and many patients could not withstand the second anesthesia.

During the preoperative preparation period, Kawei knew that the priest had a violent reaction to ether. He had several adverse reactions such as retching, choking, and salivation just after using it. The possibility of another anesthesia failure was very high. In this case,

There are indeed considerable risks in continuing the operation, and he is ready to give up at any time.

Because Kawei didn't have the confidence to convince Ignatz again, it was a very unwise choice to fall out with his "teacher" in front of so many fans.

However, Ignatz withstood the pressure and made a timely decision: "Continue to extend the incision upward and give me the scalpel!"

This was a rather bold decision, which surprised Kawei: "Teacher, further up is the liver area."

"I know."

Ignatz's scalpel did not hesitate, and carefully cut open the skin and muscles upwards, again exposing a large section of intestine: "The operation is quite difficult, we have reached the ascending colon, and we still haven't seen the tail of the appendix here.

.The entire appendix drilled out of the serosa layer of the cecum here and completely entered the retroperitoneum of the liver area."

Anyone can hear his helplessness.

The abdominal cavity is a restricted area for surgery, and the liver area is even more of a restricted area.

Even in restricted areas, a considerable number of surgeons are still taking risks to perform appendectomies and inguinal hernia repairs. But no one dares to perform surgeries on the liver and gallbladder, and no one has even touched them. There is not even a decent report.

For the priest, God's sanctuary is far away in heaven.

For abdominal surgery, the sanctuary of God is in this palm-sized liver area.

The entire ileocecal part has been completely freed, and the surgical area has entered the peritoneum from the outside of the peritoneum at the beginning, and now jumped out of the extraperitoneum. Ignatz's separation is still continuing, and the entire operation has passed from the beginning to the present.

It lasted for more than 50 minutes, and it was not far from the usual recovery time from ether anesthesia.

"Come on, teacher."

Kawei was like a prophet, helping Ignatz speed up with his hands and giving him hope: "I have a hunch that the appendix is ​​in front of me."

"Um"

Ignatz's hand speed did not slow down, but his voice became lower and lower, much like the way he used to do Morazo's groin.

He was prepared for the operation to fail.
To be continued...