The use of interventional endoscopy of the biliary and pancreatic ducts has increased dramatically in recent years. Although choledocholithiasis is the most common reason for endoscopic treatment, other indications include pancreatolithiasis, cholangitis, biliary pancreatitis, papillary stenosis, sphincter of Oddi dysfunction, and benign or malignant ductal strictures. The Guest Editor has assembled an issue full of expert authors to present state-of-the art information biliary and pancreatic endoscopy procedures and techniques.

Endoscopic imaging has become an important clinical tool for the diagnosis and treatment of gastrointestinal diseases and is poised to advance in a revolutionary fashion in the next few years. The articles in this issue are a result of an ASGE Imaging workshop held in early 2008. The goal of the workshop, and this issue, is to bring together clinical investigators and biophotonics engineers to help develop and clinically apply enhanced imaging technologies for the eventual benefit of patients. Articles in this issue are devoted to chromoendoscopy, autofluorescence endoscopy, reflectance spectroscopy, optical coherence tomography, laser confocal microscopy, and targeted endoscopic imaging to name a few.

Liver Transplantation: Challenging Controversies and Topics grew out of a need I perceived within the fields of transplant hepatology and liver transplantation. Liver transplantation has rightly gained recognition as an established therapy for end-stage liver disease. Few would argue that liver transplantation is one of the few truly lifesaving and life-altering treatments within medicine and surgery. Not many realize that 20 years passed from the time of the first human liver transplantation in 1963 to its acceptance as therapy by the 1983 NIH Consensus Conference on Liver Transplantation. In 2008, 25 years will have passed since the 1983 NIH conference-a mere 25 years for a field that has provided patients hope, doctors options, and to some the "gift of life. " Many issues in liver transplantation involve indications, patient selection, and outcomes after transplantation-these are standard topics, covered by textbooks of hepatology and transplantation. In contrast, the field of liver tra- plantation is young, evolving, dynamic, and issues and decisions are often controversial. Thus, Dr. Trotter and I, as well as our colleagues at the University of Colorado, felt that a text with a different focus was required, one that highlighted controversy and challenged dogma. Out of this perceived need emerged Liver Transplantation: Challenging Controversies and Topics. To meet the transplant community's need for emerging information about liver transplantation, Dr. Larry Chan, Dr. Igal Kam, and I initiated the Controversies in Transplantation Conference.

This issue aims to bring the busy gastroenterologist/endoscopist up to date with advances and future directions in gastrointestinal motility and functional bowel disorders. Articles include coverage of the esophagus and small bowel and attention is given to Smartpill technology. Gastric emptying and constipation are also covered in detail, with attention to role of surgery and particularly sacral nerve stimulation for fecal incontinence. The Guest Editor believes that the state-of-the-art information in this issue will allow clinicians to be on the cutting edge for the foreseeable future.

This book explains the concept of metabolic surgery and provides step-by-step descriptions of all the principal minimally invasive surgical techniques employed to treat morbid obesity. The approach adopted is very practical. For each procedure, indications, technical aspects, clinical management and outcomes are described and helpful tips and tricks, highlighted. Guidance is provided on the management of emergencies and potential complications, as well as on general postoperative management and long-term follow-up. The coverage also includes new frontiers of robotic and endoscopic surgery. While the focus is on surgical techniques, emphasis is placed on the need for a multidisciplinary approach, with explanation of the role of the multidisciplinary team and the bariatric center. In addition, important information is presented on the definition of morbid and severe obesity, incidence/prevalence, pathophysiology and obesity-related comorbidities. The authors are internationally acknowledged experts who present best practice know-how in the field and draw on the most recent research literature.

For the thousands of people affected by severe obesity, the decision to undergo weight loss surgery can be a matter of life and death. But it is not a simple procedure. That's why, for many, the decision does not come easily. To help you make the best possible choice, a dynamic team of experts have come together to share their experience, knowledge, and findings about these procedures. Merle Cantor Goldberg is one of this country's leading psychotherapists specializing in eating disorders; Drs. Cowan and Marcus have helped develop many of the techniques used in bariatric surgery, and have also taught these procedures to hundreds of other surgeons. "Weight Loss Surgery begins by asking important questions that must be considered before any decision is made. It then presents a comprehensive overview of pre-op visits, the various weight loss surgeries available, and the post-op recovery period, examining both the psychological and the physical impacts of the surgery. Weight loss surgery is not a minor procedure, but when appropriate, it can save lives. This thoughtful book offers the information you need to make the decision that's right for you.

Any surgical intervention, elective or acute, may lead to postoperative complications. Moreover, the pertaining approach - laparoscopic or open - will probably not differ in the morbidity rate after surgery. Complications that occur after a surgical intervention can be classified as major or minor. Major complications to the digestive tract after surgery imply in most of cases a leakage of an anastomosis, bleeding in the abdominal cavity or in the tract, the appearance of intraperitoneal abscesses, or surgical site infections and wound dehiscence. These complications, depending on the organ affected, upper GI, HPB tract or colorectal, are associated with high morbidity and mortality. Early suspicion and diagnosis, followed by an early and effective treatment is imperative in order to reduce the morbidity and mortality. Adequate treatment will involve a good coordination of the three disciplines involved in treatment: the surgeon, the intervention radiologist, and the gastroenterologist. Approach of these postoperative complications is changing constantly and these changes are not properly known by general and more specialized digestive surgeons daily involved in the treatment of these diseases. The proposal for this book is to offer a systematic description of the most frequent complications occurring in the three above mentioned parts of the digestive tract. In this way, the reader will have access to a practical book in which every current complication can be easily recognized, along with relevant information as guide for an adequate treatment.

This volume builds on the success of the first edition of Imaging Pelvic Floor Disorders and is aimed at those practitioners with an interest in the imaging, diagnosis and treatment of pelvic floor dysfunction. Concise textual information from acknowledged experts is complemented by high-quality diagrams and images to provide a thorough update of this rapidly evolving field. Introductory chapters fully elucidate the anatomical basis underlying disorders of the pelvic floor. State of the art imaging techniques and their application in pelvic floor dysfunction are then discussed in detail. Additions since the first edition include consideration of the effect of aging and new chapters on perineal ultrasound, functional MRI and MRI of the levator muscles. The closing sections of the book describe the modern clinical management of pelvic floor dysfunction, including prolapse, urinary and faecal incontinence and constipation, with specific emphasis on the integration of diagnostic and treatment algorithms. Written for: Practitioners and clinicians in the fields radiology, urology, proctology/colorectal surgery, gynecology, gastroenterology

General surgery consists ofa main corpus of propaedeutic elements and clinical problems, which has been modified over the years by the separate development of numerous sub-specialistic branches. Although a common basis on the physiopathology of surgical trauma and post operative complications persists, as a result of general knowledge of surgical diseases, there is no doubt that in the spheres of doctrine and application, both research and clinical medicine have distinguished themselves autonomously in many surgical fields (orthopedics, neurosurgery, cardiovascular surgery, thoracic surgery, urology, etc.). It is therefore difficult to define the present configuration ofgeneral surgery, but without question abdominal surgery occupies a position of pre-eminent importance within the general framework. We are dealing, in fact, with pathological pictures which occur in a section ofthe body ofvast proportions, in which structures, organs, and morphologically complex spaces are arranged to carry out important functions. They are, therefore, subject to considerably complex pathological alterations, such as to establish an interesting field of diagnostic discussion and an exciting training-ground for surgical activity. It can be affirmed that the diagnosis and cures ofabdominal surgical diseases constitute a test ofthe surgeon's experience. Diagnosis is often entrusted to a differential process, the results ofwhich may be confirmed today by complementary diagnostics. This, however, must be guided by predominating clinical considerations, the exaggerated use of diagnostic techniques, detached from clinical examination, being the cause of very serious errors, which can mislead decision making and human contact, which is the basis ofcorrect medical practice.

Designed to provide a highly visual reference for surgeons and other members of the patient management team, Atlas of Intestinal Stomas is based on the 1967 gold standard text, Turnbull and Weakly's Atlas of Intestinal Stomas. Additions include chapters on anatomy and physiology, biliary stomas, pediatric ostomies, the continent ileostomy, urostomy, laparoscopic stoma construction, stomas in trauma surgery, stomas for antegrade continence enema, percutaneous ostomies, and quality of life. There are also sections on ileostomy, colostomy, enterostomal therapy and on the management of complications of stomas such as management of the high output ostomy, enterocutaneous fistula, parastomal hernia, prolapse, and skin conditions. The Cleveland Clinic pioneered the entire practice of ostomies, beginning in 1858 and continuing to this day as the world's leading academic and clinical center. The editors and contributors are all current or former Cleveland Clinic physicians and instructors. The fundamental focus of the book is not only how to install ostomies, but how to avoid complications and how to treat complications when they arise. Atlas of Intestinal Stomas will be of great value to colorectal and general surgeons, both in practice and in training.

This book provides detailed, comprehensive and illustrative content to the surgical community in the areas of foregut oncologic surgery. The text contains an in depth review of all surgical aspects of oncologic diseases involving the stomach and esophagus. The main focus is on the minimally invasive techniques including potential complications and their management. The text also includes an online link for the videos for all minimally invasive foregut surgical procedures including animation content which provide a more comprehensive learning experience. Minimally Invasive Foregut Surgery for Malignancy: Principles and Practice is structured in a way that makes it useful at every level of training and will be of great utility to practicing surgeons, fellows in surgical subspecialty training and surgical residents.

This book is based on the latest comprehensive data about molecular mechanism of acute pancreatitis, chronic pancreatitis and pancreatic cancer. The diagnostic techniques including histology, radiology, sonography etc. are based on the sensitivity and specificity of the respective methods. Special focus is given to the indication and contraindication to surgical techniques. The book contains specific treatment modality and results for the first time after long-term outcome evaluation. There is detailed description of diagnosis and treatment, and the book is abundantly illustrated with approximately 300 color illustrations.

Robotics in General Surgery provides a comprehensive review of the current applications of the robotic platform in all the general surgery subspecialties. Additionally, for each subspecialty it serves as a procedure-oriented instruction manual in terms of technical details of procedures, including fundamentals of robot positioning and trocar placement, step-by-step description of procedures, comprehensive discussions of advantages, limitations, indications, and relative contraindications of using the robotic approach. The text also discusses the challenges and steps to overcoming these challenges in transitioning from a minimally invasive to a robotic practice/surgeon. Lastly, this volume addresses emerging technology in robotics and the impact that the robotics platform will have on not only practice of surgery, but also in the education of surgeons at all levels. Written by experts in the field of robotic surgery, Robotics in General Surgery is a valuable resource for general surgeons of all levels including residents, fellows and surgeons already in practice.

Laparoscopic Colorectal Surgery, Second Edition is fully revised and updated and reflects an authoritative, team-oriented approach to the latest state-of-the-art laparoscopic colorectal procedures and surgical techniques. Written by pioneers in the field, this text will supply surgeons with all the information necessary to accomplish advanced laparoscopic procedures. Comprehensive discussions of positioning, instrumentation, cannulas, surgical techniques, special considerations, and considerations in cancer surgery are featured for a wide variety of major operative procedures.

This new Second Edition includes updated information on laparoscopic colorectal procedures, including hand-assisted laparoscopic procedures and new chapters on the physiology of pneumoperitoneum, laparoscopic anatomy of the colon and rectum, and evidence-based discussion of outcomes. The text is complemented by over 200 line drawings created exclusively for the textbook.

Pancreatic islets make up the endocrine pancreas and they contain the only source of insulin in the body, beta cells. Hence, access to high quality preparations of pancreatic islets is fundamental for in vitro studies and to test pre-clinical applications in animal models in vivo. Access to healthy human islets is also crucial to improve transplantation procedures for diabetes. Given the susceptibility of pancreatic islets to the enzymatic digestion and mechanical stress required to obtain them, the isolation of islets is often considered as the delicate "work of a craftsman". This book, which is aimed at beginners and experts alike, is a survey of the current state-of-the-art in this field and it centres on the challenges, pitfalls and peculiarities of pancreatic islet isolation in the different species used in pre-clinical and clinical applications. It explores the similarities and differences between human islets and those from other relevant species (rodents, pigs and non-human primates), and how these influence islet isolation. The ultimate goal of this book is to improve the outcome of islet isolation and transplantation in pre-clinical and clinical applications.

This is the first time a book about laparoscopy in emergency abdominal surgery has been published. Numerous articles have been published in specific surgical journals, but, until now, there has not been a book that collates all the aspects of this little-known field. The aim of this volume is to achieve a complete and easy presentation of all the implications associated with laparoscopy in emergency abdominal surgery. The book should be a manual that can be easily consulted by digestive, general, and specialized surgeons, especially in an emergency. The authors' contributions are founded on evidence-based medicine, which give the book scientific credibility, but this is coupled with their experience of daily practice, which adds an important complementary dimension to evidence-based medicine. This is balanced by an emphasis on clarity and accessibility, because the ultimate aim of the book is educational. We hope this book will be frequently consulted, in depth, not only by specialist practitioners, but also by undergraduate students, new graduates and surgeons in training.

With remarkable progress being reported in living donor liver transplants and small bowel transplantation, the 9th Keio International Symposium for Life Sciences and Medicine was auspiciously timed. Titled "Current Issues in Liver/Small Bowel Transplantation," the Tokyo symposium brought together researchers from Japan and other parts of the world. This volume is a compilation of papers from the symposium, organized into five key areas of interest to medical professionals: Technical aspects and physiological problems in split/living donor liver transplantation; Viral hepatitis and liver transplantation; Current status and future prospects in small bowel transplantation; Liver transplantation for malignant hepatic tumors; and Novel strategies in immunosuppression. Containing the most up-to-date information on these vital issues, the book is an essential resource for all researchers and practitioners concerned with liver and small bowel transplantation.

Few clinical disciplines have been transformed so dramatically by advancements in science and technology as gastrointestinal surgery. To begin with, modern ph- macology has virtually eliminated some kinds of surgery altogether. If one were to take a peek at a typical operating room schedule in a busy hospital of the 1960s, gastrectomies of one kind or another would have constituted a large block of the major surgeries. The advent of effective H2-histamine receptor antagonists and, more + + recently, the H, K -ATPase (proton pump) inhibitors led to a precipitous decline in those procedures such that they are rarely performed today. Exciting new approaches to treating inflammatory bowel diseases and their complications-such as fistulas- with anticytokine therapy may one day have a similarly profound effect on surgery for this condition as well. Beyond pharmaceutics, advances in imaging techniques have greatly facilitated the identification and characterization of pathology in the gastrointestinal tract in a way that would have been unimaginable only a few years ago. Just to visualize the pancreas in some way was a horrendous task until abdominal ultrasound, magnetic resonance imaging, or computer tomography made it simple. The fact that the gut is a hollow organ that can be accessed through the mouth, anus, or even through the wall of the abdomen has been fully exploited with fiberoptic endoscopes that can bend around corners with ease and permit surgery to be conducted through them.

This book will incorporate a multimodality approach toward inflammatory bowel diseases. Up to date imaging methodologies will be described along with their strengths and weaknesses that will help in providing a rational diagnostic strategy for clinical, surgical and support teams working with these patients. Advances in medical and surgical treatment would be detailed and these would be useful to readers and professionals keen to implement these techniques in their own clinical practice.

Modern Management of Cancer of the Rectum is intended to provide a comprehensive overview of all aspects of rectal neoplasms. It addresses epidemiology, biology, screening and chemoprevention, the role of imaging in diagnosis, staging and prognosis, radiation therapy, medical and surgical treatment, as well as new modalities of therapy, including laparoscopy, and transanal endoscopic surgery. A greater understanding of prognostic factors, patterns of spread and natural history has occurred during the past decade; together with new diagnostic modalities this has led to significant changes in the management of patients with rectal cancer. This book will be invaluable for all those who treat rectal cancer.

This is the only guide you need to pass the MRCS Part B OSCE examination. This unique two-volume set includes comprehensive revision notes on all the areas covered in the exam; numerous practice scenarios with model answers in the format they would be encountered in the exam; and essential exam technique tips. Written by a team of editors and authors with extensive experience of the exam and all the recent changes, it broaches topics that can often trip up the candidate, including communication and history-taking skills. Revision is aided by over 130 images and illustrations, as well as boxes highlighting clinical tips and exam hints.
Volume 2 addresses the stations that exam the four specialty areas: Trunk and Torso; Limbs and Spine; Head and Neck, and Neuroscience. It covers the anatomy, physiology and pathology in each of these four speciality areas along with detailed clinical exam scenarios and a bank of likely clinical questions and model answers.

Aimed at consultant colorectal surgeons and those in training who wish to expand their practice into pelvic floor pathology- a complex and developing area of surgery- Pelvic Floor Disorders for the Colorectal Surgeon provides a modern, thought-provoking approach to pelvic floor disorders written by emerging young leaders in the field. These conditions are of high importance and interest to colorectal surgeons, but also gynaecologists, gastroenterologists and general gastrointestinal surgeons.
The layout of the text book is in 3 sections. The first provides an organizational and diagnostic approach to pelvic floor problems that is conceptual in scope, the second details the patho-anatomical and physiological entities that this diagnostic approach will bring to light and describes their management, while the third is more technical, covering key new diagnostic and therapeutic procedures and their results. The textbook aims to encourage the reader to critically analyze some of their own cherished views, and those more widely established, on colorectal pelvic floor practice.

Hepatobiliary and Upper GI Surgery reflects the overwhelming need for such a book as this specialisation proceeds apace. The book covers all the foregut except the liver, bile duct and pancreas, looking at the diverse anatomy and physiology, the functions and the disease processes. The book reflects a significant change in the management of certain conditions, as our understanding of disease has improved. Technical developments have moved surgery forward; minimally invasive surgery being the treatment of choice for most upper GI operations for benign disease. With cancers of the upper GI tract being common, and with our understanding more of the genetic profile of tumours, we have identified premalignant lesions and cancer surgery is now targeted to allow stage-appropriate therapies. This book gives a current and concise summary of all key topics within the specialty and concentrates on recent developments. Hepatobiliary and Upper GI Surgery brings together an international group of contributors, all experts in their field, to provide a text for specialists and trainees.

This book provides a useful guide for the management of complex abdominal wall problems from the perspective of a general surgeon, with sensible, practical clinical advice for the management of problems as they arise. Starting from managing the open abdomen and optimising the chances of achieving later definitive fascial closure, through to dealing with incisional and parastomal hernias throughout the abdomen. Expert guidance supported by an evidence-based review of the literature aids higher surgical trainees and consultant general surgeons who wish to expand their practice in this area. Focuses on the needs of the general surgeon Offers practical tips and advice for handling difficult cases Based on current best evidence Complemented by high quality images

This book is a compilation of endoscopic images of the upper gastrointestinal tract. The 3rd edition is enriched with high-resolution digital images highlighting the classification and staging of endoscopically relevant diseases. Serial documentation of diseases and procedures like corrosive injury, variceal obliteration, peptic ulcer etc. provides a complete, informative and interesting perspective. Rare conditions like Dieulafoy's disease and Gastric antral vascular ectasia (GAVE) have been extensively discussed along with common diseases of the GI tract. This book outlines the technique and interpretation of endoscopic images proving to be a helpful guide to endoscopy practitioners. Key Features Explores various GI tract diseases through coloured, high resolution clinical photographs. Serves as a useful reckoner for trainee endoscopists and practitioners pursuing gastroenterology or gastrointestinal endoscopy. The text is updated with tables, flowcharts, classifications and international treatment guidelines.