Colpiscono circa 170 mila italiani, con un trend in forte ascesa. Si chiamano Malattia di Crohn e colite ulcerosa: malattie autoimmuni, ovvero causate da un errore del sistema immunitario che si scatena contro se stesso. Perche? Come fermare questa furia distruttiva? Sono stati fatti grandi passi avanti ma molto resta ancora da scoprire e molte sono le questioni controverse: dalle cause della malattia ai metodi di diagnosi piu tempestiva, alle terapie. Le malattie autoimmuni dell'intestino colpiscono in giovane eta, tra i 15 e i 45 anni, hanno un impatto molto negativo sulla qualita della vita di chi si ammala e pongono questioni di primissimo piano: come si convive con una diagnosi di questo tipo, qual e il migliore accesso alle cure, quali le disposizioni di legge che facilitano la vita dei malati. Questo libro vuole raccontare la vita e la battaglia quotidiana delle persone colpite da queste malattie, le scelte che devono fare e gli ostacoli che si trovano ad affrontare, dal punto di vista di uno dei massimi esperti mondiali della materia, Silvio Danese, e da quello di un giovane paziente, Marco Greco, che ha trasformato la sua lotta quotidiana in una battaglia condotta a nome di tutti i malati. Gettando luce su uno dei piu straordinari misteri della medicina moderna, le malattie autoimmuni, questo volume affronta senza omissioni il grande tema sanitario dell Italia di oggi, la cronicita, la condizione sociale e medica di milioni di persone costrette a convivere con la malattia per decenni.

Paediatric gastrointestinal endoscopy has been greatly improving since its introduction and it is continuously evolving due to the tools' improvement and the specific training of the staff. Currently this technique can be performed in children of all age including preterm infants. This book illustrates the specific performance techniques of gastrointestinal endoscopy in pediatric age both with regard to diagnosis of gastrointestinal pathologies and their operative use in the upper and lower gastrointestinal tract. One of the most famous international paediatric endoscopists tells us the history of pediatric GI endoscopy, its achievements, and where it is going. Moreover in the first part of the book the preparatory stages to gastrointestinal endoscopy are widely discussed. Afterwards, specific chapters discuss the examination of the ileum with new instruments from single- and double-balloon enteroscopy, to wireless capsule endoscopy. Furthermore some authoritative authors illustrate the management of GI endoscopy in particular situations such as cystic fibrosis, gastrointestinal tumours, graft-versus host disease, and some others deal with the management of complications that can occur during endoscopic procedures. Finally a special focus is given on endoscopic ultrasound and the application of new optical techniques, fields continuously evolving both in technology tools and in diagnostic applications mainly in the paediatric age.

The world-wide problem of obesity has increased to epidemic proportions over the last several decades and continues to grow. Obesity is now a leading cause of morbidity and mortality in the western world. Due to the limited success of dieting, lifestyle changes and medical therapy, bariatric or weight-loss surgery has become increasingly important in the fight against obesity. At this time, bariatric surgery -- now commonly called metabolic surgery -- has been shown to be the most effective and durable treatment for obesity. This book provides the reader with a comprehensive, evidenced-based and updated review of all aspects relating to bariatric surgery. The introductory chapters provide a broad overview of basic concepts such as the epidemiology of obesity, its medical treatment and related psychological issues. Preoperative evaluation of the bariatric patient and selection of the most appropriate operation is thoroughly discussed. The different types of operations and their risks and benefits are examined in depth. The text also focuses on practical issues in postoperative management and nutritional follow-up. Specific attention is given to pre-pregnancy and pregnancy considerations including pregnancy outcome following bariatric surgery and the optimal bariatric-pregnancy interval. Written by international experts, this book is a valuable resource for a broad spectrum of clinicians and healthcare professionals dealing with obesity. It also serves as a pragmatic reference for all those involved in the care of bariatric or obese patients who are considering bariatric surgery. Medical and nursing students as well as residents in surgery, medicine, obstetrics/gynaecology, and family practice will also benefit from it at any stage of their training.

Cholecystecomy is the surgical removal of the gallbladder. It is the definitive treatment for symptomatic gallstones and non-neoplastic gallbladder disease. In this book, the authors present current research in the study of the procedures, prognosis and potential complications of cholecystectomies. Topics include the techniques and indications of cholecystectomy; traditional laparoscopic cholecystectomy; iatrogenic bile duct injuries after cholecystectomy; surgical strategy for gallbladder carcinoma; cholecystectomy in patients with suspected choledocholithiasis and cholecystitis in the elderly; and single-incision laparoscopic cholecystectomy.

This classic text is much beloved by medical students and physicians-in-training throughout the English-speaking world, as its many editions indicate. It is chock full of the pearls of clinical wisdom that students and practitioners treasure, and many of these lessons apply to medicine in general. The book was well characterized by a reviewer of an earlier edition for The New England Journal of Medicine: 'If only one book about surgery could be made available to physicians from all specialties, it should probably be Silen's recent revision of Cope's Early Diagnosis of the Acute Abdomen. Since the book first appeared, it has remained the classic treatise on the initial approach to abdominal pain.' Because acute, severe abdominal pain is still a common problem whose misdiagnosis can result in quick death, each generation of beginning physicians is faced with the urgency of learning to make a diagnosis in this high-anxiety situation, and they appreciate the wise, humane, precisely detailed guidance offered by Cope and Silen. For the 22nd Edition, Dr. Silen has again updated the text in a respectful but significant way. He has added a chapter on the increasing disorder of diverticulitis, reexamines the use of analgesics, emphasizes the costs of over-testing, and updates all recommendations regarding trauma, radiologic studies, and therapeutic recommendations.

Gastrointestinal surgery is performed for a range of benign and malignant diseases in both elective and emergency settings. However, many of these operations are followed by complications, which need early detection so that they can be managed in a way that is rational, evidence-based and makes the best use of the available local resources. Complications after Gastrointestinal Surgery is an up-to-date and comprehensive reference book for practicing and aspiring gastrointestinal and general surgeons as well as for trainees and assistants. With contributions from more than 90 experts from 15 different countries, it offers a systematic description of the general aspects of surgical complications. It discusses institutional issues such as managing complications in limited-resource settings and the impact of centralisation and checklists. It also describes the ways to deal with specific post-surgery problems pertaining to different organs such as the oesophagus, the small and large intestines, pancreas and liver.

This book serves as a valuable resource for surgeons and health care providers at all stages of their career caring for patients with colorectal disease. This edition provides all newly written chapters, organized around the "pillars" of colorectal disease: perioperative (including endoscopy); anorectal disease; benign disease (including inflammatory bowel disease); malignancy; pelvic floor disorders; and a "miscellaneous" section that covers aspects both inside and beyond the operating room. Chapters are formatted to follow that of a "how to" manual as well as an algorithm-based guide to allow the reader to understand the thought process behind a proposed treatment strategy. By making use of evidence-based recommendations, each chapter includes not only background information and diagnostic/therapeutic guidelines, but also provides operative technical details and perioperative "tips and tricks" that are utilized in the management of these complex surgical challenges. Chapters also include the assessment of risk and methods utilized to minimize perioperative complications. In addition, the book incorporates sections covering the medical and surgical therapies for abdominal, pelvic and anorectal disease. Written by experts in the field from around the world, The ASCRS Textbook of Colon and Rectal Surgery 4th Edition exposes the many critical gaps in our knowledge base and inspires the next generation to answer them through thoughtful and high level scientific inquiry.

The book encompasses the different concepts and designs using magnets for surgical purposes. It provides a concise yet comprehensive summary of the current status of the field that will help guide patient management and stimulate investigative efforts. The text reviews new data about interventions in all medical and surgical fields. Written by experts in their fields, topics focus on endoluminal and laparoscopic operations, techniques from vascular and GI anastomosis. The book demonstrates the use of magnets to treat a variety of diseases such as reflux, back pain, and fecal incontinence. The reader will learn how to retract and gain exposure, dissect tissue planes, achieve hemostasis, and create anastomosis in a totally different way. Physical properties of external surface and internal magnets are discussed. The authors emphasize the importance of partnering with industry leaders to develop novel surgical tools. By harnessing the power of attraction, the energy and might of magnets, Magnetic Surgery serves as a valuable resource for clinicians, surgeons and researchers in biomedical engineering interested in this form of energy and physical metal properties. In utilizing these properties, the book seeks to improve surgical outcomes of patients worldwide.

This comprehensive, illustrated guide presents representative general surgery, including gastrointestinal tract, hepatobiliary and inguinal hernia. Surgery is generally based on the microanatomy; however, in practice surgery involves more dynamic and floating anatomy. In the last decade, the methods have been constantly improved, shedding new light on classical anatomical science. Laparoscopic is one such methodology. All illustrations presented in this book have been drawn by the author - a pioneering surgeon - and show real-world procedures. All the methods introduced are practical and have been refined based on the precise clinical and embryological anatomy. This unique book offers readers essential insights into efficient and high-integrity surgeries in abdominal region. As such, it is a valuable resource for all gastrointestinal surgeons.

The first edition laid out the foundation with laparoscopic and robotic surgery utilizing the Da Vinci SI platform. Since then, many new advances in equipment and surgical techniques are becoming more popular. This second edition expands upon laparoscopic and endoscopic techniques and robotic surgery with the use of the new Da Vinci XI platform. This book bridges the gap between the practicing community of surgeons and the surgical innovators and provides a foundation for all classic and new techniques in minimally invasive colorectal surgery. By enhancing the surgical toolbox, the surgeon is able to progress from the novice to the master. Rather than describing the entire operative procedure by an individual author, this book compares operative steps of various technical difficulties throughout different chapters, thereby allowing the surgeon to tailor surgery to patient and surgeon`s own comfort level and experience. Chapters are written by a myriad of renowned experts in the field and discuss the major advances in advanced laparoscopic and endoscopic, robotic, and transanal minimally invasive surgical techniques. Great emphasis is placed on transanal total mesorectal excision (TaTME), which is dramatically changing the surgical approach to rectal resections. The second edition of Advanced Techniques in Minimally Invasive and Robotic Colorectal Surgery serves as a valuable resource to general surgeons, colon and rectal surgeons, minimally invasive surgeons, as well as residents and fellows.

This book presents current evidence in an Enhanced Recovery Programme context, and provides a common sense approach to using the array of available analgesia techniques appropriately in major abdominal surgery. Current pain relief options are discussed, many of which have been described only in the last ten years. Topics covered range from the now widespread use of portable ultrasound machines to an appreciation of the value of some older drugs in a new context. Analgesia for Major Abdominal Surgery is aimed at anesthetists, acute pain teams, and acute pain nurses, as well as colorectal, hepatobiliary, urological and gynecological surgeons.

The editors aim to provide the definitive guide for healthcare professionals on functional disorders of the gastrointestinal tract and pelvic floor, and the treatments used within the current healthcare context. This book will help the reader to access and understand relevant information within a variety of clinical settings and scenarios. It will be relevant and useful to a variety of disciplines (e.g. Physicians, Nurses, Physiotherapists) who work within the field of gastrointestinal care. This book will be written by a team from the worlds' most well established colorectal specialist hospital, presenting a definitive guide to care of the patient group.

Self-expandable stents were initially placed for the treatment of cardiovascular diseases but now play an integral role in the relief of benign and malignant obstruction of the gastrointestinal tract and biliary system. Self-Expandable Stents in the Gastrointestinal Tract will familiarize the reader with the indications, techniques, and outcome following placement of expandable metal stents within the gastrointestinal tract. The volume covers all aspects of expandable stents including their composition, tissue responses, and placement techniques. In addition, placement using endoscopic and radiologic techniques is discussed. Unique illustrations allow the reader to gain knowledge that will improve their ability to care for their patients. The volume will serve as a comprehensive reference for all aspects of expandable stents. Self-Expandable Stents in the Gastrointestinal Tract will be extremely useful for physicians in the field of gastroenterology, endoscopy, and radiology, as well as gastrointestinal and thoracic surgeons whether they are in training or practice.

A hernia is defined as a protusion or projection of an organ or a part of an organ through the body wall that normally contains it. The risk for inguinal hernia is highest among Caucasian males. Other risk factors include a history of another hernia, advanced age, abdominal wall injury, history of abdominal aortic aneurysm and smoking. Inguinal hernias have a variety of clinical presentations ranging from a finding of a painless bulge in the groin region on routine physical examination to emergent, life-threatening presentations due to bowel strangulation. Most hernias can be diagnosed on physical examination as a bulge in the groin while coughing or straining. The definitive treatment of all hernias, regardless of their origin or type, is surgical repair. The authors of this book examine the risk factors, prognosis and management options for inguinal hernia.

Since general surgeons first started performing laparotomies in the late 1880's, acquired hernias and abdominal wall defects have become a surgical disease of their own. Many surgeons have made it their life's work to develop surgical techniques, design hernia meshes or utilise biologic tissue for repair of these abdominal wall defects. Hernias are defined as a defect in the normal architecture of the abdominal wall muscuolo-aponeuroic structure. They are subdivided into congenital or acquired hernias. The ventral or incisional hernia defects are rare due to the failure of normal healing of the incision after a laparotomy. The approach to the initial repair may be quite straightforward in the patient with a simple fascial defect who is otherwise healthy. As the size of the defect gets beyond 4 cm, or the patient has a significant co-morbid disease, other considerations must come into play. The component separation technique for abdominal wall reconstruction has brought many new young surgeons to focus their skills toward improving it. With the advances in critical care and peri-operative resuscitation together with knowledge of the abdominal compartment syndrome, surgeons are addressing very complicated ventral hernias. They commonly have significant loss of domain, tissue loss due to infection or tumour, or an entero-atmospheric intestinal fistula. The combined information in this text will help the surgeon identify the right surgical technique for the right patient. The focus of the text is the evaluation, prevalence, surgical techniques, and outcomes of patients undergoing complex ventral hernia repairs. The use of preoperative evaluation imaging is reviewed. The multiple etiologies of hernia and abdominal wall defects are mentioned. The surgical repairs utilising tissue repairs, both synthetic and biologic mesh are reviewed, and the component separation is discussed in detail. New endo/laparoscopic component separation techniques are also described. This text will become a must-have for every surgeon who takes care of patients with complex ventral hernias.

A hernia is the protrusion of an organ or the fascia of an organ through the wall of the cavity that normally contains it. A hiatal hernia occurs when the stomach protrudes into the mediastinum through the oesophageal opening in the diaphragm. This book presents topical research in the study of the types, symptoms and treatment of hernias. Topics discussed include minimally invasive repair of inguinal hernia in children; surgical approach to parastomal hernia and risk factors for incisional hernia after severe secondary peritonitis.

Laparoscopic Surgery of the Abdomen is intended to give the practicing surgeon or trainee an in-depth analysis of the technical aspects of the most commonly performed laparoscopic procedures, their indications, contraindications, and complications. Included are strategies to prevent complications as well as ways to handle them once they occur. Heavily illustrated, the book breaks new ground in visualizing operative procedures and problems. Seven sections, comprising the core curriculum of accepted procedures in laparoscopic surgery, present gallbladder disease, common bile duct exploration, hernia, colon diseases, anti-reflux procedures, acute abdomen and the role of diagnostic laparoscopy, and emerging procedures on the spleen and adrenals. Recognized leaders in the field tackle each section, emphasizing what to do when and how to solve acute situations. Laparoscopic Surgery of the Abdomen is a practical, must-have resource for the general surgeon, imparting the clinical insight needed for successful performance of the core miminally invasive procedures as well as a source of useful patient information for the office practice.