Modern surgical techniques emphasize meticulousness and gentleness, whether treating nerves, blood vessels, skin, fascia, or muscles.

This is due to the stable anesthesia environment, such as the induced analgesia of deep sleep, and the quiet muscle relaxation without any resistance. It is also due to the advanced surgical instruments, such as the quick coagulation of the electric knife, the exquisite and tough suture needles, and various conveniences.

staplers, etc., and it also stems from the surgeons’ advanced anatomical knowledge and understanding of surgery.

Every step of the operation is under the control of the surgeon. New bleeding points will be blocked as soon as possible, and hidden blood vessels in the tissue will be easily avoided.

With such multiple blessings, an ordinary elective operation, including an operation that goes deep into the abdominal cavity such as cesarean section, will result in very little bleeding as long as no accidents occur. Of course, doctors will still choose to prepare blood before surgery, but what is really needed is

There are very few surgeries that can prepare blood.

However, patients in the 19th century were not so lucky.

Interfered with the words "lower uterus" and "pararectus abdominis incision" from Kawei's mouth, Hills' thoughts guided the scalpel to draw a strange arc next to Nora's navel. This

Although the incision is also considered a pararectus abdominis incision, it always gives Kawei a sense of immediate acetabular fracture surgery.【1】

It looked similar because he had seen it before.

But Kawei had no time to think further, because the blade quickly penetrated the soft tissue and fascia under the skin.

Hills did get the true inheritance of Ignatz, and the movements of his hands were quick and smooth, which was very entertaining to outsiders, but seemed very rough to Kavi.

When Ignatz was young, he always pursued the speed of surgery because there was no anesthesia. However, the rise of anesthesia made him realize that speed is not everything. At this age, he has begun to switch to more refined operations closer to modern surgery.

Of course, the characteristic of being fast for the sake of speed still exists, and roughness is inevitable. However, this roughness is the product of Ignatz's deliberate control and does not have much impact on the operation itself.

But Hills, who only wants to be quick, is different.

For subcutaneous bleeding points, he usually uses cloth to compress the bleeding, or simply stops the bleeding. It was only when Kawei said the crow's beak forceps and put something into his hand that he reluctantly used the forceps.

"We have used forceps here, what should we do with the uterus? There are only seven crow's beak forceps."

"Don't worry, you can loosen the clamps after ligating the two big bleeding points."

Hills reluctantly clamped the bleeding point as Kawei asked, and then took the needle and thread from the nurse: "You just need to explain to them the process I did, when to use forceps, and when to use it."

I have the final say on the gauze."

"..."

"There is no need to suture this kind of bleeding point. When the incision is opened, compression can be used to stop the bleeding."

What he said is true, but Kawei also wanted to be on the safe side. There is no such thing as blood preparation in the current surgical environment. The total amount of blood is fixed, so you can save whatever you can...

never mind.

Seeing that his face was not somber and his tone was extremely firm when he was suturing, Kawei could only sigh and continued to raise his voice: "Teacher Hills' technique is exactly the same as that of Teacher Ignatz, fast and sharp. The incision has been completely broken.

When we opened Nora's skin, we could even see the rectus abdominis sheath inside.

Now we have reached the first key point. Next, the teacher will separate the anterior abdominal wall, rectus abdominis... Hello..."

Carvey's previous commentary was still ahead of Hills, helping him avoid pitfalls from time to time.

But when it came time for the actual operation, Hills' movements were like a runaway wild horse, completely inconsistent with his gentle and elegant appearance. Before Kawei could finish speaking, the tip of the scalpel had already entered the abdominal cavity.

This knife directly penetrated the anterior abdominal wall, rectus abdominis muscle, rectus abdominis sheath, and transversalis fascia. It can be said that the concept of "quick knife" was taken to the extreme, just like Fernand wielding a knife to cut a pig leg, it was refreshing.

But Dr. Hills, who can inherit Ignatz's title of "fast knife", is not so happy now. Because the knife was inserted too quickly, without the necessary blunt separation, and without detecting the shape of the blood vessels, the blade was cut directly

Cut off the blood vessels under the abdominal wall.【2】

Blood immediately flowed out.

This is a very important blood vessel, responsible for the nutrition of the anterior wall muscles and external skin, as well as the blood circulation around the lower abdomen and perineum. With this responsibility, the blood vessels will naturally become thinner.

The transverse incision in modern cesarean section will also cut off these blood vessels, but they will be ligated and then severed if prepared. Carvey knew that Hills and Herman did not know enough about the anatomy of the abdominal cavity and had chosen not to.

It was too easy to cut off the vertical incision of the blood vessels under the abdominal wall, but things were still moving rapidly in a direction that he could not change.

"Two pairs of crow's beak pliers!" Now is no longer the time to play pretend surgery with Hills, "Gauze, hurry up!"

Hills didn't understand what happened, so he immediately shut up and started to stop the bleeding.

Kawhi is very fast.

While Hills and Herman were sucking up the blood, the two crow's-beak forceps were like having eyes, stuck directly on the bleeding part of the incision, and instantly stopped the bleeding: "Dr. Hills cut a piece just now.

There was a small blood vessel, and I had to help with the ligation, but fortunately it was not a big problem."

In just a few dozen seconds, while Hills was still immersed in his own mistakes, Kawei's operation was completed, and he didn't even have time to be surprised.

Seeing that the severed end of the blood vessel flowing gurglingly was locked between the teeth of the pliers, the next thing he had to do was to pick up the needle and thread and sew out the blood vessel as quickly as possible.

"It turns out that it hasn't entered the womb yet..." Herman took a breath and muttered in a low voice, "I was scared to death."

"How could it go in so quickly?" Hills was reluctantly doing the most common suturing work, and warned, "The sutures are very thick, so be careful when you loosen the forceps, otherwise the cardiovascular system may break open again."

"I understand..."

After solving a problem, Kawei continued to talk about the explanation:

"Teacher Hills made a large incision at one time. Fortunately, the amount of bleeding was not much. Except for the blood vessels under the abdominal wall just now, there were no other bleeding points worthy of suturing. Now the two teachers will slowly pull apart the surrounding skin and

Muscle tissue, try to expand the field of view at the incision, and then expose Ms. Nora's enlarged uterus.

If you are an audience sitting in the front row, you should be able to see clearly the regular contractions of the uterus, which are the contractions of the mother during labor..."

The subabdominal blood vessels just now touched Hills very much. He seemed to be scratched. After suturing the blood vessels, his movements became much slower. It was like pressing the brake to the bottom while driving at a high speed.

The rhythm suddenly stopped, leaving Kawei not knowing how to continue.

"The teacher should further determine the exact position of the fetal head to ensure that the incision he makes next will not damage the fetal skin and head. As long as the position is found, use two crow's-beak forceps to lift the uterine serosa layer, and then

It can cut the uterus layer by layer..."

Kawei was anxious, and for his own sake, he told the whole process. Everyone should be able to do it, so why didn't he do it?

The people on the stage looked eagerly at the surgery area, and the place was completely silent.

Kawei had no choice but to continue: "...Uterine contractions will affect the location of the uterine incision, and will further affect the subsequent operation of exploring the uterus. Teacher Hills needs to wait for the contraction to end before making a suitable uterine incision.

.”

The smoothing words were natural and the tone was very gentle, but there was a fire in his heart: You are really cool!

Hills wanted very much to cut open the uterus and pull out the child inside as soon as possible. But the next operation was his blind spot. He needed to incise the uterus, stop the bleeding, perform sutures, remove the fetus, and then perform sutures.

Every step is blank, and he needs to complete it alone.

He needs to be as precise as possible while taking into account speed. Every wrong step will lead to Nora's immediate death.

Hills looked at Nora who was sleeping, her hands trembling slightly.

Fear, this is a process that a new surgeon must go through when facing an unfamiliar operation.

"Hiles..." Kawei walked up to him, and the reprimand he had prepared for a long time in his throat instantly turned into comfort, "What's wrong with you? Are you feeling uncomfortable somewhere? If you feel uncomfortable, just rest nearby.

Son."

Hills shook his head: "Nothing."

The operation started for more than ten minutes, and finally it was the most critical moment. The audience on the stage did not want to be so appetized. However, out of basic courtesy, they would only exchange a few words in a low voice and not say anything more.

But Varela on the side was not so easy to talk to: "What are you waiting for? Are you waiting for the child to pop out on his own?"

"The surgery is difficult, and Mr. Hills needs to be quiet," Kawei explained, "just like when you sit in the office writing your manuscript."

Everyone didn't know for a moment whether he was helping Hills or hurting him, but what was certain was that Kawei had reached the point where he could no longer tolerate Varela.

"It's a pity that I don't want to write a manuscript today. Without Ignatz, the cesarean section is doomed to fail." Varela took two sips of malt wine and continued to add, "Of course, even if he comes, it will be successful."

The odds are also very pitiful.”

"host......"

Seeing that Kawei was about to take action, Varela gave in and said, "Okay, okay, I'll shut up."

"Please stop talking until the operation is completed." Kawei warned him, then changed his face and said: "Everyone, the reason why cesarean section is called cesarean section is that the uterus needs to be exposed to...

..”

"Okay, Kavi."

After waiting for a long time, Hills spoke again: "Herman, give all the pliers in your hand to the nurse and go get the suction pump."

"kindness."

"Kavi helps with gauze packing to stop the bleeding. Next, I will cut open the uterus. The blood will stain every part of this bed. We must stop it."

"Don't worry."

Kawei looked at the uterus still shrinking in the abdominal cavity, picked up two pieces of gauze, folded them into small squares, and handed them to Hills: "I remember Teacher Ignatz said before that if you want to completely expose the uterus, you need to

Do some stuffing and lifting.”

"Did he say that?"

"I must have said that."

Hills nodded, and according to his instructions, he raised the uterus and pulled the incision outwards, so that the uterus was fully exposed. Then Hills and Herman located the fetal head, each selected a position, and performed the uterine

The membrane layer was lifted, and the scalpel quickly made an incision in the middle.
To be continued...