Nineteenth Century Medical Guide

Chapter 286 282. Sending Letters
[I changed the e-book, the map is much clearer, I also made some revisions to the operation process in this chapter, it took some time, sorry]

Franz suffers from not having the opportunity to communicate directly with the high-level Berlin, but since the prince "disappeared", the initiative on the battlefield has come to him.

Regardless of whether it was the consumption of manpower and materials, or the loss of land or allies, Austria was undoubtedly defeated.It's just that in the eyes of outsiders, the war is not over yet, and this kind of failure is not complete enough.

It means that there are still fights, and it is not time to admit defeat.

But being able to fight does not mean that Franz is willing to fight.

War is only a means to achieve an end rather than the end itself. Now that the casualties are so heavy, since he holds the trump card that can quickly end the war, he hopes to force the other party to make a compromise with a deadly attitude, so as to end this war. It is very likely to lose face in a war.

Of course, there are still flaws in saying that it is a killer feature.

It is not the prince alone who is responsible for inheriting the throne, brothers can also be, and the capture of the only son will not affect the continuation of Prussia.But just think about it differently, if his only son was captured by Prussia, Franz would be willing to exchange some victories.

He was very anxious at first, but he became less anxious after seeing Prussia stop at the front line, because he now knew very well that Prussia on the opposite side must be more anxious than himself.

After a clear knock on the door, Franz looked towards the door, pointed at the door which was gently pushed open, and issued a eviction order very tactfully: "Mr. Edward, if there is nothing else"

Mick arrived in Berlin on November 11rd, received a reply from the other party on the 3th and returned to Vienna quickly.

"It's only four o'clock in the afternoon, can't we see him?"

"Oh, although I can't get in, people I know can get in." Li Ben no longer hesitated, "I can deliver the letter to him tomorrow, and if everything goes well, I can deliver it to those two people the day after tomorrow at the latest." hand."

Li Ben didn't dare to say much, he just turned around to look for the wine and the glass: "You must be thirsty after coming all the way, the wine in Berlin is not bad, why don't you have a glass first."

"This"

He put on his tall hat, lifted his cane, and strode to the door to exchange greetings with the chief guard before leaving the office.

Mick looked back at him, finally stopped, raised his hand to look at the surface, and said, "Leave it to him today, and let those two see it tomorrow."

There was no difficulty in suturing blood vessels and cutting ligaments, but Carvey still carefully touched the position of the tumor on the left side, trying to find its lower edge.

"Go, go back to the hotel first, I need to rest."

The chief guard looked at Edward who had gone away, closed the door, and then took out a letter from the file in his hand: "Your Majesty, he has sent a letter. This is the deciphered translation of the library."

"Is there anything else?"

"So when you are freeing the bladder and prostate, you must always pay attention to the arteries supplying the yin." Carvey pointed to a small blood vessel looming in front of him with tissue forceps, "This is one of them, and it is a very common accessory yin artery. In dissection exercises, 15 out of 10 cadavers had this artery."

"Oh?"

"We can understand the nerves. Eckhard reported a few years ago that electrical stimulation can cause swelling, which is a neurovascular phenomenon. The nerve bundle in the pelvis is connected to the penis, so it must be avoided. "

With the experience on the left side, Mocier has become more confident, and the stitching and knotting are also very beautiful.

So far, all the supporting tissues on both sides and back of the bladder and prostate have been thoroughly cleaned, and the degree of completion is very high

Carvey beckoned to the nurse, and clamped the vascular pedicles of sperm and prostate with tissue forceps: "Pay attention to the location of the tumor here, even if you really want to damage the neurovascular bundle, you must cut it clean. After all, the neurovascular bundle is an adult That's right, if one part is broken, there is another one, and as long as one part is kept, there is still a chance of recovery."

"Prepare the gauze, there will be a lot of bleeding here."

"Long time no see."

Those two were brought out by Mick to test the waters. It is obviously unrealistic to hand them over directly: "It cannot be handed over to them, but at least it must be handed over to their cronies. At least they must be cronies. This letter needs to be handed over to them in person. "

Then, the needle tip goes up to find the perichondrium of the upper pubic symphysis, and pierces in and out in the same way. 【5】

Carvey shrugged: "It's very simple. I injected water into all the blood vessels in the pelvis when I was doing exercises. As long as it is a blood vessel supplying the genitals, it can cause swelling after water injection. This blood vessel is hidden under the pubis prostatic ligament It's typical of that."

Since the letter was to be handed over to those two for review, the content in it must have full weight, at least the identities of the writers needed to be equal.Li Ben is not stupid, this matter is no small matter, if he can handle it well, the previous mistakes may be wiped out.

"gone."

"Thank you."

"Only the front is left."

Mick received instructions from his superiors five nights ago, and crossed the border overnight by relying on the informant network he had laid before, and finally arrived in Berlin, the capital of Prussia, two days ago.

"Okay." Mick didn't say much, he took back the envelope, got up and put on his hat, and was about to leave, "I'll go find someone else, you stay here and wait for my order."

"Yes."

Carvey took the needle holder from the nurse: "The reason why it is called a complex is because the veins are very rich, and if you want to stop bleeding at one time, you need to do a bunch of ligation. This requires a high strength of the suture, so I came up with Two ligatures were performed. The distal end was treated first, and then the proximal end was ligated."

"How could I see two heavyweights?" Li Ben didn't know what he was going to do, but said truthfully, "Besides, the two of them have always been in the palace, which is not something ordinary people can enter."

"Yes."

"Oh, that's right. It's blood flow!"

"Tell me, what's the matter?"

Li Ben shook his head again.

"Can't the baron enter the palace?"

But at this time, Carvey suddenly stopped, and then he asked another question: "Everyone, I just said that the nerve is an important anatomical structure that controls swelling, and it cannot be damaged during the operation. But maintain Is it only the nerves that can function?"

"Don't worry, don't worry, Mr. Meek." Li Ben stopped in front of him.

"Now that the two countries are fighting so fiercely, everyone who can see them basically lives in the headquarters."

"Good luck."

The operation lasted for a whole hour, and finally came to the final excision link.

"I never lie to anyone." Mick walked out of the room slowly, and stuffed a stack of banknotes into his pocket by the way, "This is expenses, save it."

Mick took two sips of wine, and then took out a letter from his bag: "I need you to deliver this letter to the top of the Prussian military, such as old Moltke or the emperor."

Once the free work is done, Kavey starts to speed up.

"This..." the chief guard shook his head, "I don't know."

Franz suddenly regained his energy, put the documents in his hand aside, took the letter from the head of the guard, and said, "I thought it was time to send news. I really want to send you whatever you want. Do you think it is good news or bad news? information?"

"Can't you see?"

The suture needle enters the apex of the prostate under the guidance of the needle holder, bypasses the venous complex and exits on the other side. 【4】

Li Ben looked at his figure, his brain was running fast.

"Ok."

"Really, really?"

"The next step is the main part of the prostatectomy, the separation of the apex of the prostate, and this first step is the dorsal vein complex. During the dissection exercise, the bleeding here is very serious, and the clear water that often fills the lumen of the blood vessels is very fast. lost."

"I asked you why you live in this kind of place. Didn't you say that you are doing well?" Mick found a chair and sat down, put down the bag in his hand, and seeing that he had no intention of answering, he said for him : "It seems that you didn't stop it again, you lost it all."

"We need to find the pelvic fascia and Dieter's fascia of the prostate, and then stick to the prostate to push the neurovascular bundles on both sides outward."【1】

"Ah what?"

"I wish Mr. Edward all the best."

As soon as the words fell, the small venous plexus branches on the superficial surface of the prostate ruptured under the pull, and dark red blood soon seeped out: "No, the compression can't be stopped. Now the neurovascular bundle has been avoided, and the sutures need to be replaced. "

Li Ben hesitated for a moment, but still took the envelope bravely: "Please rest assured, I will definitely handle this matter well."

Compared with the rapidly changing Berlin, Vienna is more like a frightened bird, feeling the uncertainty of war all the time.But the most nervous people at this time were not the ordinary people who cared about the frontline war, but the few surgeons in the surgery theater of the Municipal General Hospital.

Seeing Li Ben close the door, Mick hurried downstairs and got into a carriage parked on the side of the street.There were still two men in black sitting in the carriage. Seeing him coming, they gave up their seats consciously.

Li Ben shook his head again and again: "I'm just a useless baron."

"Still smart."

Mick yawned, put the bag at his feet, leaned his head on the back of the chair, looked out the window at the dilapidated apartment that was slowly moving away from his sight, and said lightly: "Send him to see God after the matter is over." .”

"Remember, the envelope can only be opened by those two, and the others will be responsible for the consequences." Mick patted him on the shoulder with a smile and said, "As long as the matter is done, I will take you back as soon as the war is over. What I promised you before will also be given to you."

For the first time, Mick did not get angry, but raised his legs and said very flatly: "I am indeed a little thirsty."

"today?"

Carvey reset the bladder, and then lightly pressed the bladder neck, revealing the puboprostatic ligament: "Here are two ligaments, we separate and ligate the superficial branch of the deep dorsal vein that is deformed in it, and then cut this ligament. Note, Gently remove the surrounding fibrofatty tissue, as close as possible to the pubic symphysis”【2】

When the posterolateral separation of the prostate is clean, the separation of the central cavity across the Dieter's fascia is also much easier.Adhesions caused a lot of bleeding, but the full exposure of the surgical field was offset accordingly.

After that, he lifted the artery with forceps and carefully separated the fascia surrounding it. 【3】

It took a lot of time to work on the bilateral accessory yin arteries, but the real trouble was still to come.

"People are gone?"

Franz took out the letter, which contained a very simple paragraph, but contained a very high amount of information.It took less than a few seconds to finish reading, and the king, who was worried about the future of Austria, finally breathed a sigh of relief: "Mick is really efficient."

This blood vessel is actually very inconspicuous, just like other blood vessels that we usually see, so it is difficult for Carvey's remarks to be convincing.

Massimov, who was sitting on the side and busy taking notes, said, "But how do you prove that this blood vessel must be in charge of the swelling function?"

Li Ben's head was buzzing, and the wine glass in his hand couldn't stop shaking: "Yes, I was wrong! Mr. Meek! I really, I really just want to win back what I lost before. Who knows what will happen?" .”

When the familiar voice came into the ear of the other party, the body of this "old friend" trembled like a mouse seeing a cat: "Mr. Mimic? You, why are you here?"

He was still dressed in black as usual, with no extra decorations on his body, only carrying a black bag to hide his identity.As soon as he arrived at the train station, he found a chess piece placed here, and immediately touched the residence of an "old friend".

Mick glanced left and right, raised his hand and pushed him into the room. He didn't continue to speak until the door was closed, "Why do you live in this kind of place?"

Holding the heavy money, Li Ben finally felt more at ease: "I promise to complete the task."

Li Ben was overjoyed by the sudden kindness, and sent him a glass of wine: "Mr. Meek must have a mission when he came here. Tell me, what kind of mission is it? As long as it is within my ability, I promise to complete it."

".Fortunately, the tumor just touched the prostate, and it's not as serious as imagined." Carvey just figured out the ingrown tumor after the surgery. "However, for safety reasons, we still have to cut off the prostate and its urethra."

"Of course not."

Edward turned his head and saw the head of the head of the guard. He sighed lightly, got up and straightened his coat immediately, and said, "I'll take my leave first."

"You are not an ordinary person." Mick said, "Aren't you a nobleman here?"

"You know I don't like wasting time." Mick picked up the bag and was about to go out the door.

I don't know which doctor on the stage suddenly asked a question, which made Watman very displeased: "Where's the brain? Does it rely on muscles?"

"what?"

Because it is directly related to the resection site and subsequent reconstruction of the bladder.

Carvey quickly finished the needle threading, and then handed over the end of the thread to Mosier for ligation: "Keep the end of the thread, don't need to cut it off, it will be useful later."

Seeing that Mossier nodded, he continued to take another needle holder given by the nurse, and made a figure-of-eight suture on the proximal end of the complex: "When dealing with blood vessels and then dealing with the transverse plane of the prostate, we must pay attention to the sphincter, which is related to Ed Mu's future urination function"【8】

Mosier handed back the needle holder, Carvey gave the needle holder and thread ends again, and he himself took the tissue scissors given by the nurse, and the three completed another quick and pleasing exchange.

At the same time, the dorsal vein complex was completely severed under the action of scissors. 【7】

(End of this chapter)