Nineteenth Century Medical Guide

Chapter 411 407. Another kind of transaction

Since seeing Bertha's abdominal aortic dissection, Kawei has put research on artificial blood vessels on the agenda.

The earliest research on artificial blood vessels was for aortic aneurysms and was used in pediatric cardiac surgery and vascular surgery, which was not the field of general surgery that Carvey was good at. His understanding of artificial blood vessels only stayed in modern times. They were the product of composite materials. Their functions and inner and outer membranes were basically the same as those of human large blood vessels.

He had only briefly heard about what the earliest artificial blood vessels were made of and how they were made, and his understanding was very limited.

The only memory I have is that when polyester artificial blood vessels were developed abroad in 1957, domestic samples could only be obtained, but processing technology was not available. Without artificial blood vessels, one can only watch the abdominal aortic aneurysm rupture, and with lower limb arterial occlusion, one can only wait until gangrene and amputation.

At that time, many hospitals' vascular surgeries and thoracic surgeries began independent research and development.

In the same year, the research team of Professor Feng Youxian from the Vascular Surgery Department of Zhongshan Hospital of Shanghai First Medical College (now Fudan University School of Medicine), in collaboration with the institute's sample factory led by Engineer Chen Jia of the Shanghai Silk Factory, conducted more than 200 animal experiments. Finally, The country's first artificial blood vessels were made from special silk.

It was impossible for Kawei to use a piece of the most common silk and sew it into a long tube shape to transplant Bertha. The warp and weft density and post-processing of the weaving do not meet the requirements of blood vessels. Not only will blood leak, but the lumen itself will also be unable to be shaped, resulting in a decrease in blood patency.

Even if the production method is really put in front of him, it may be difficult to produce a qualified artificial blood vessel because the textile process is not up to standard. 【1】

Rather than waiting for death, it is better to choose other transplant methods.

"Transplanting an allogeneic aortic blood vessel." Kawei explained simply. "The operation process is actually the same as transplanting a skin flap, except that some preliminary preparations are required."

Carvey revealed his plan: "In order to complete the operation, I hope to have a complete surgical laboratory of my own in Paris. It needs to be equipped with an animal feeding area, a surgical area, an anatomy area, and sufficient reagents and Instruments, including glycerin, ether, microscopes, infusion sets, and surgical dissection tools.”

Holt sat at his desk, resting his hands on the armrests, his expression the same as usual.

"What is your surgical plan?"

Landreth struggled internally for a moment and immediately jumped out of the vortex of dignity. He was not bored enough to compete with a surgical genius in terms of surgical skills. After all, that was a real genius that even Cedillo had to submit to. Comparing with Chinese studies, Chinese culture, and understanding of Chinese medicine is my main battleground.

However, just as he was about to speak, his mind couldn't help but recall Carvey's caesarean section, skin flap transplantation, breast reconstruction, and of course other great surgeries that were not shown in Paris. And which of these surgeries are recorded in textbooks?

"Professor Landreth, what do you think of the surgery Dr. Carvey mentioned?"

"A lot of experimentation."

Kawei could only find an allogeneic transplant.

Holt confirmed the other party's attitude and really didn't know how to answer Kavi. After thinking about it, he asked: "Such a big fanfare, a laboratory and so many materials and equipment, just to save a strange girl?"

"Of course. Not just to save her."

Landreth sat aside smoking a cigarette, glanced at the experimental team brought by Kawei, and asked: "You want to do animal experiments?"

He realized that Kawei came to the association at this time to make some demands, and also wanted to see the two sparks collide with the earth. He relied on Landreth's words to dissuade Kawei from making any more troubles. Unexpectedly, the chief of surgery, who had just taken office a few months ago, had no response to the so-called abdominal aorta transplant surgery.

Autologous transplantation is definitely the safest, has no side effects, and the transfer process is very short. However, the abdominal aorta is the largest blood vessel in the body, and simply transplanting blood vessels from other locations will definitely not work. The two-in-one blood vessel made on the battlefield last year also won’t work because it cannot reach the wall thickness of the abdominal aorta and cannot withstand the turbulent blood flow and high pressure.

Thinking of this, Landreth returned to his original state, leaned back on the sofa easily, and put the pipe into his mouth again, pretending that nothing happened.

Kawei knew that Bertha's status was humble, so he changed his excuse: "What I am doing is a blood vessel transplant, or a transplant of the most important abdominal aorta in the body. The whole process includes the removal of the recipient's hemangioma, the interception of the donor blood vessel, Processing, preservation, and final anastomosis, I think, is a breakthrough that will change the landscape of surgery.”

"Oh, that's alright."

Naturally, the so-called alien body cannot be a living person. No matter whose abdominal aorta is amputated, it will be fatal. If you want to do it, you can only do it from a dead body.

"."

Landreth had never heard of such an operation and was so surprised that he took off his pipe. Although Kawei’s skin flap transplantation is the first, it is only the skin and muscles on the body surface and does not directly involve life safety. But now they are facing the aorta. Can this thing be transplanted? And he said it so lightly!

Anyone who has studied anatomy will know that it is almost impossible to complete it. No, it is not almost, it is impossible!

Landreth didn't know how to complain for a while, because there were so many flaws, and any textbook used in current medical schools could be used as a tool to refute.

"Since Dr. Landreth is here, President Hott must have heard about the operation. This is why I came to you."

Yes, if the surgery can really be done to this extent, it will really change the existing concept.

Skin can be transplanted, the appearance can be reconstructed, and now even blood vessels can be transplanted. Can organs be transplanted as well?

Holt didn't expect that after just six months of not seeing each other, the surgery Kawei mentioned was already far beyond his imagination.

This is not an artistic creation such as painting, music, or writing, where the author can be as imaginative as he wants without regard to the consequences. Surgery needs to be innovative and bold while trying to ensure a certain degree of rationality. Unfortunately, Holt could not feel justified in this operation.

Transplanting organs is obviously not possible. There are too many doctors who have done this kind of thing. They have tried everything from sheep gizzard pills to bull penis, and the results have not been good. The only controversial thing is probably that no one else has done much animal experimentation, and many of them just tried it a few times before going to the operating table.

"Can the operation really be successful?" He thought of an operation report he had heard before. "Professor Astley Paston Cooper once tried it before, and the patient died within half an hour."

Kawei was also stunned. He didn't expect Master Cooper to try it so early: "So many years have passed and surgical techniques have become increasingly mature. I think it's okay."

Holt laughed awkwardly.

This is Kawei, and this is his unique self-confidence. It is not just unfounded self-confidence. The key is that he does have the ability to turn the mysterious self-confidence in the eyes of others into reality.

"The abdominal aorta is here, in the retroperitoneum." Hotch hadn't done anatomy for a long time, and his knowledge was somewhat forgotten. He flipped through an anatomy book and began to try to describe the surgical steps. "How to perform complex vascular anastomosis at such a deep position? How to ensure it?" Doesn’t the anastomosis leak blood? There are countless veins, arterial branches, ureters, and nerves nearby. Nine out of ten cadavers are damaged.”

"Don't worry about my skills."

Faced with such an answer, Holt had no way to refute: "Then, before transplanting the blood vessel, you still have to cut out the hemangioma?" "Yes."

"That's the aorta. Wouldn't cutting out the hemangioma at that location cause massive bleeding?"

"Isn't it enough to use vascular clamps to clamp the blood flow from top to bottom?" Kawei said the surgical steps casually, as if he was already accustomed to the surgery. "I estimate that by the next surgery, the dissecting tumor may have moved downwards. The common iliac arteries were dilated bilaterally."

Holt imagined the operation scene and looked at the abdominal aorta in the anatomy diagram. He became more and more nervous and did not understand the key: "That is the most important artery in the body. If you cut off the abdominal aorta, the lower limbs and What about the blood supply to the kidneys?”

"Don't worry, it's the abdominal aorta, not the aorta that just comes from the heart. It basically avoids most organs, and the clamping time won't be too long, so there won't be any problems."

Kawei knew that this guy was unwilling to help, so he immediately changed his tone: "Have you retired from the front line of surgery? Why do you care about surgery? If you care about surgery so much, you might as well find some reliable surgeons for you, the Emperor." Take a good look."

After moving out to get three, Holt couldn't help but glance at Landreth sitting aside.

However, the newly appointed Chief of Surgery was sitting there with his legs crossed and smoking without even looking here. If this guy hadn't been "complaining" to him that Kawei was too domineering, and his excited look at that moment was still there in front of him, Holt would have really suspected that he had lost his memory.

Huo Te felt bitter in his heart. Since he retired and returned home to enjoy the happiness with his old president, he sat in this seat naturally and had to deal with this offending task personally.

He picked up the coffee cup on the desk and stopped as soon as he put it to his mouth: "I also know that His Majesty the Emperor is not in good health. I have always wanted him to undergo surgery, but he always feels that it is dangerous."

"The operation is scheduled to take place after the World Expo, and I will stay in Paris for the rest of this period."

Kawei did not hide the fact that Nasan asked him for surgery. In the eyes of the surgeon, Nasan's bladder stone should have been operated on long ago, and asking Kawei to do it could indeed maximize the success rate. But what he said just now was not to show off his identity, but more like a reminder.

"Stay in Paris. Stay in Paris?"

When they said this, Holt suddenly realized that his vision was too short-sighted, and couldn't help cursing himself for being stupid in his heart. If such a person stayed in Paris for such a long time and was given such a good opportunity, there was no reason for him to extrapolate.

No matter what the results of the experiment or the results of the surgery are, just look at the content of the project. There should be topics and figures. If he succeeds, he will be able to help him. If he fails, it will be because of Kawei's fault and has nothing to do with him. At that time, there will be hard work without any credit, and you can still earn a wave of favors.

Holt lowered his face and stared at the newspaper on the desk, fearing that Kavi would see the change in his expression.

This was an animal experiment led by Kawei, and it was a large blood vessel transplant that no one dared to touch. Such a person did not return to Vienna, nor did he go to London, let alone his hometown of Lombardy. He stayed in Paris.

What does this mean?

It shows that Paris is still the center of surgery in the world, and even geniuses like Carvey have to come here to do research.

"President Holt? What's wrong?"

"Oh, nothing, nothing."

Holt couldn't help but wonder at his previous reaction. Why should he oppose him? Why should you persuade him? I wanted to beg him to come to Paris before but couldn't, but now I just want to provide some hardware support: "There is no problem with the experimental site, and the equipment and medicines can be supplied, but the experimental subjects may not be so easy to find."

"You don't need to worry about this, President, I'm already looking for someone."

Kawei didn't say anything clearly, but made a list of the materials he just requested and handed it over: "Just give it as mentioned above. It may cost a lot of money. I will fill in the holes as soon as possible."

"Money?" Holt smiled, proudly, "Since the research was done in Paris and you received the Legion of Honor, the money can be deducted from the association's budget."

Kawei didn't expect that his attitude would change so quickly, and he was a little surprised: "This is worth tens of thousands of francs."

Holt waved his hand and told him not to mind: "Every year, the association has a lot of research budget. Instead of giving it to those third-rate doctors to squander it on boring topics, it is better to give it to you. That little girl can also settle down well. , but you don’t have to stay in the ward all day.”

"But?" Kawei knew he had a request and wasn't too surprised.

"But our young doctors here may come to participate in the experiment." Holt said, "I hope you won't refuse."

This is indeed the case.

For tens of thousands of francs in exchange for a few months of teaching opportunities, Kawei is not making a profit, and of course he is not losing money.

In his eyes, country differences should not affect medical communication, and teaching is also an important part of his efforts. Furthermore, after going back to Vienna several times and investing money in many projects, the savings in his hand became less abundant. If you really pay Holt in full now, you will have to owe someone else a favor if you encounter other troubles.

"Okay, it would be nice to have some help." Kawei agreed.

When the conversation was almost over, Holt remembered that there was one more thing that had not been settled: "By the way, do you have the experimental subject I just mentioned?"

"It's already being done. It should be done in the next two days."

"What animal did you choose? Rabbit? Sheep? Or pig?"

Kawei shook his head: "The rabbit is too small, so the operation is difficult. The sheep and pigs are too big. The breeding area alone takes up a lot of space, and the operation is also very troublesome."

"That"

"The dog I chose," Kawei said, "has a physique right between that of a rabbit and a pig. It is not difficult to raise and operate."

"dog?"

Holt couldn't help lowering his head and stared at the newspaper again. There happened to be a report condemning the behavior of catching wild dogs on the street: "No way" [2]

(End of this chapter)