Chapter 91 88. This is a business

Originally, Kawei was supposed to stand on the podium together as an assistant, but after the commotion just now and the mood in the audience was unstable, Kawei stopped joining in the fun.

Anyway, I need to go on stage twice in the afternoon, so I have plenty of opportunities to show off.

Compared with several previous reports, Ignatz's new surgical technique returned to the high standard expected of the Royal College of Surgeons, setting the tone for the following meetings.

However, the "new trends" themselves are some brand-new surgical attempts, suggestions and an exploration of surgical possibilities, which are not universal. The triangular flap method for cleft lip repair given by Kawei is exciting enough, from the oral process and the final giving

Judging from the photos of corpse restoration, the effect of this new technique is definitely good.

But it is still an old problem, and there is a lack of examples that can be used to verify the effect of surgery.

"I have already contacted two cleft lip patients who are willing to try new surgeries. If nothing goes wrong, these two surgeries will be carried out next week."

Ignatz said: "At the same time, I will also start trying to repair cleft lips in young children. Repairing cleft lips before children grow up will appropriately reduce subsequent deformities and speech disorders."

Although there are no surgical examples, the new triangular flap surgery method is attractive enough and draws the attention of the audience from postoperative wound ulceration back to the surgery itself.

Next on the stage was Vice President Edinson, who brought his own surgical instruments: "Everyone should have done excision surgery for purulent tonsillitis. The tonsils are inserted into the tonsils with a circular knife sheath, and then inserted into the tonsils with a silver fork.

Among them, fixing is done, and cutting is done at the end.【1】

Of course, in small clinics in the countryside, we can still see lancets used decades ago. No matter how the cutting tools are iteratively updated, the fixing method is the same, which is a silver fork. Because using other tweezers or pliers will cause damage

Different degrees of slippage.”【2】

During this kind of cutting operation, the patient should not lie down, because the congested tonsils often bleed heavily during surgical removal. Lying down will cause blood to choke into the trachea, causing surgical accidents.

So Edinson developed his own tonsil grasping tool.【3】

The effect of the tool is definitely good, but this is not uncommon in the new trend of surgery, and it is basically regarded as a warm-up item and placed at the forefront.

Now being ranked behind Ignatz shows that Edinson has other things:

"Everyone, I have discovered during thousands of tonsillectomies that the partially removed tonsils will continue to grow, and the original infection symptoms are difficult to subside. This makes me have to consider whether I should perform a complete tonsillectomy, including other tonsillectomies.

Remove the capsule together."

At this point, he brought up a simple hand drawing showing how to perform this new tonsillectomy.

"The 'guillotine' developed by the French in the 18th century is still usable, but it requires some minor skills in operation." [4]

Edinson made a simple gesture: "After the tonsils are encircled by the knife ring, we will not perform the removal first. Instead, we will use our fingers to squeeze the palatoglossal arch and wait until the tonsils are completely exposed before performing the removal." [5]

"What is the success rate of the operation?" Someone suddenly asked in the audience.

"Of the 30 surgeries I tried, 12 were completely resected, and the success rate was 36-37%." Edinson knew that the success rate was not high, and defended, "The surgery requires some experience and skills. I feel that I

I’m almost getting the hang of it, and out of the last 10 surgeries, 5 have achieved complete resections.”

"With complete resection, there will be no recurrence?"

"Of course."

"I have also encountered cases where tonsils have re-grown. It is necessary to try this method."

After the two deputy deans took turns, the new trend was finally back on track.

If from cleft lip and palate repair to tonsillectomy, Kawei saw the efforts of these Vienna surgeons in fine plastic surgery, then the next case of huge paracervical fibroma resection + postoperative repair has already formed the prototype of modern plastic surgery.

.

The tumor is almost the same size as the patient's face. In order to ensure postoperative recovery, the doctor specially reserved a piece of skin as the face. The tumor was removed first, and then a skin flap was left for skin suturing.

After a long three-hour operation, she finally returned to her normal self.【6】

"This should be the largest face and neck tumor resection + plastic surgery in history, right?"

"Indeed, this fibroid weighs 4.5kg, which should set a new record."

"How was the recovery after surgery?"

"The fibroids have not affected the bones and muscles, and there is no problem with the bite. However, due to long-term compression, the patient's face still has some deviation. I did not think of this when making the flap during the operation, so I still have some regrets.

"

After neck plastic surgery, I went to ophthalmology.

Dr. Ledo, who specializes in ophthalmology at Hartman Hospital, brought his eyeball fixation technology to everyone, using a metal fork to gently penetrate the patient's conjunctiva and sclera, so that the eyeballs no longer move randomly during strabismus correction surgery.

.【7】

The cataract removal surgery that followed was an operation from Germany.

The earliest cataract removal was extracapsular removal without anesthesia. The doctor and the patient sat face to face. The doctor would incise the lower edge of the patient's cornea and expand it to 120 degrees, then incise the anterior capsule and press the lower limbus of the cornea with his fingers to expel the nucleus.

【8】

There is no need to scrape off the cortex, reposition the cornea, then wrap the eye and suture it.【9】

What Dr. Ledo showed to the public this time was the transscleral small incision lens removal performed by a German doctor.【10】

When anesthesia gradually reduces the hand speed of all surgeons, the refinement of operations gradually becomes something they compare with each other's skills. Small incisions and low bleeding begin to become indicators of the success of the operation, so once small incision surgery is mentioned

It aroused everyone's interest.

Because there is no phacoemulsification technology, the lens nucleus is not a chylous liquid. If you want to remove it, you need an incision that matches the size. Therefore, the size of the ordinary cataract removal incision is 6-8mm.

A small incision less than half the classic surgery?

How to get out the hard crystal core?

Magic?

"The German doctor's incision is only 3mm." Dr. Ledo took out his hand-drawn manuscript and explained, "He first incised the lens core in the eye and cut it into four parts. After the incision was completed, he made another small incision.

Pull it out."

As soon as these words came out, many people immediately praised her. They did not expect to give birth after the separation.

But soon, some different voices of doubt emerged, which is the norm in the new trend: "Will intraocular incision cause unnecessary burden on the eyes? For example, corneal edema? Capsular rupture?"

"Not only the damage during the operation, I am also skeptical about the visual recovery after the operation."

"Indeed, surgery should not pursue beauty on the scene. What is more important is whether the postoperative recovery can meet expectations. The small incision may seem exciting, and it probably won the applause of many viewers, but in the end it still depends on whether the patient is satisfied or not."

Ledo did not avoid these questions and answered them one by one: "Among the 20 cases of small-incision cataract surgery performed by this German doctor, 17 did have corneal edema, 3 of them recovered on their own within 3 days, and the rest recovered.

It took a little longer, about 5-7 days.”

"The probability of edema is a bit high, but what about capsule rupture?"

"There are 3 people."

"How is your vision recovery going?"

“Five patients failed to recover, and the rest improved slightly.”[11]

"There are actually 5 people? The proportion is a bit high."

"And it's just a slight improvement. It should be no different from ordinary removal."

Ledo was a little embarrassed when he was told: "After all, it is a small incision. It is a brand new attempt. These shortcomings need to be overcome slowly."

"Small incisions and large incisions require the same post-operative treatment, and they have no essential impact on the recovery of vision. I personally don't like to take such risks."

"Me too, such a high probability of corneal edema must be caused by excessive cutting operations during the operation. It is better to use the classic surgical mode to avoid unnecessary trouble."

Kawei benefited a lot from listening to these discussions, including the subsequent syphilitic nose reconstruction and maxillomandibular resection + postoperative plastic surgery based on dental disease. He was amazed by the strong plastic surgery atmosphere of the surgical college.

The regular meeting in the morning wasted a lot of time because of the unharmonious "Nightingale". By the time the new wind direction ended, it was already past 12 o'clock.

Kavi thought he would have to sit on the bench for another two or three hours, and was going to take the dining room tray and enjoy the delicious food in the college. Who would have thought that Ignatz would take him to the college during the lunch break?

Changshi.【12】

Ignatz's father, Dean Waterman, was waiting for them in the room.

The old man was sitting quietly at his desk, smoking a pipe, wearing glasses, with white hair on his back. In his hand was an old surgical report.

Seeing them coming, Waterman didn't show any politeness but asked directly like an old friend: "How was the regular meeting in the morning?"

"There's a little trouble." Ignatz took Kawei to sit on the sofa, "You actually moved the British things into a new direction. Isn't this just to make them make trouble?"

"What does it matter?" Waterman was still looking at the operation report in his hand, as if everything was under his control, "Anyway, there will be two brand-new surgical methods by you and Edinson, and those people will definitely calm down.

of."

"It's just hard on Corigo."

"Haha, his cleft palate repair was nothing more than that. He was the last one to squeeze in to make up the numbers." Waterman said with a smile, "According to Corigo's irritable and conceited character, he must have left halfway, right?"

"Um"

"It ended at 12 o'clock, which is a little later than the previously scheduled time." Waterman took off his glasses and asked, "What do you think of Dr. List's point of view?"

"Surprisingly, I have never connected wound ulcers with microorganisms." Ignatz shook his head, "The idea is very novel, but I haven't seen the French chemist's experimental report. I think we should wait for a new experiment.

The conclusion is good.”

"If you haven't seen it before, take it and have a look."

Waterman handed the report in Ignatz's hand just now, and then looked at Kawei beside him: "You should also take a look at it after reading it."
To be continued...