Laparoscopy is a new frontier of the surgical technique, which recently gained more and more popularity and credit upon the surgical teams, also in Urology. The reason stays in the reduced invasivity and in the advances on the techniques of "video-assisted surgery." More recently the retroperitoneal access to laparoscopy surgery ("retroperitoneoscopy" or "retroperitoneal laparoscopy") opened a new surgical approach to several diagnostic and operative procedures for a large number of urogenital tract diseases. The applications in pediatric and in adult age and the technical challenges are widely debated at the moment. The volume gathers contributions by internationally renowned authors and is a complete overview of the technique. The book addresses urologists, general and abdominal surgeons, pediatric urologists and pediatric surgeons who are interested in minimally invasive procedures and particularly in retroperitoneal laparoscopy.

It is estimated that the functionally significant body of knowledge for a given medical specialty changes radically every 8 years. New specialties and "sub-specialization" are occurring at approximately an equal rate. Historically, established journals have not been able either to absorb this increase in publishable material or to extend their readership to the new specialists. International and national meetings, symposia and seminars, workshops, and newsletters suc cessfully bring to the attention of physicians within developing spe cialties what is occurring, but generally only in demonstration form without providing historical perspective, pathoanatomical corre lates, or extensive discussion. Page and time limitations oblige the authors to present only the essence of their material. Pediatric neurosurgery is an example of a specialty that has de veloped during the past 15 years. Over this period neurosurgeons have obtained special training in pediatric neurosurgery and then dedicated themselves primarily to its practice. Centers, Chairs, and educational programs have been established as groups of neuro surgeons in different countries throughout the world organized themselves respectively into national and international societies for pediatric neurosurgery. These events were both preceded and fol lowed by specialized courses, national and international journals, and ever-increasing clinical and investigative studies into all aspects of surgically treatable diseases of the child's nervous system.

This survey explores both the established procedures and the frontiers of laparoscopic surgery, while examining several controversies that have evolved in recent years. Also addressed are topics such as two-handed surgical technique, intracorporeal suturing, intricate dissection, control of large vessels, the operating room of the future, cost considerations, and regulatory issues. June 1998 / 0-387-98338-4 / $150.00

For more than 30 years, the highly regarded Secrets Series (R) has provided students and practitioners in all areas of health care with concise, focused, and engaging resources for quick reference and exam review. Anesthesia Secrets, 6th Edition offers practical, up-to-date coverage of the full range of essential topics in the practice of anesthesiology. This bestselling resource features the Secrets' popular question-and-answer format that also includes lists, tables, pearls, memory aids, and an easy-to-read style - making inquiry, reference, and review quick, easy, and enjoyable. The proven Secrets Series (R) format gives you the most return for your time - succinct, easy to read, engaging, and highly effective. Fully revised and updated throughout, including protocols and guidelines that are continuously evolving and that increasingly dictate best practices. New chapters on Electrocardiogram Interpretation, Cardiac Physiology, Vasoactive Agents, Volume Assessment, Blood Pressure Disturbances, Mechanical Ventilation Strategies, Perioperative Point-of-Care Ultrasound and Echocardiography, Neuraxial Techniques, Peripheral Nerve and Trunk Blocks, Patient Safety, and Medical Ethics. Top 100 Secrets and Key Points boxes provide a fast overview of the secrets you must know for success in practice and on exams. Features bulleted lists, mnemonics, practical tips from leaders in the field - all providing a concise overview of important board-relevant content. Portable size makes it easy to carry with you for quick reference or review anywhere, anytime. Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.

Gastrointestinal Surgery: Pathophysiology and Management is an invaluable reference text for surgeons and surgical trainees. Written entirely by Dr. Haile T. Debas, Dean of School of Medicine and former Professor and Chairman, Department of Surgery, at the University of California, San Francisco, this book provides the unified approach only found in a single-authored text. Based on the three pillars of understanding particular disease processes -- fundamental anatomy and physiology, pathopysiology, and clinical correlations -- surgical treatment of GI disease is presented as the means to correct abnormal physiology and restore health. Using an integrated approach of basic science and clinical practice, Dr. Debas allows the student of surgery to gain a solid understanding of disease processes that minimizes the need for rote memorization. Thirteen lavishly illustrated chapters cover the GI system as well as gastrointestinal peptides and peptide-secreting tumors, abdominal trauma, the abdominal wall, surgery for morbid obesity, the liver, spleen, retroperitoneum, and perioperative care. Dozens of summary tables throughout each chapter condense "essentials" for quick reference. Comprehensive discussions of clinical disorders review the surgical treatment options. With 400 illustrations and tables, including hundreds of anatomical line drawings commissioned exclusively for this textbook, Gastrointestinal Surgery provides a clinical and therapeutic approach to surgical diseases which will prove invaluable to the surgical trainee and the practitioner preparing for recertification.

When one deals with cancer, the hepatobiliary malignancies present a chal lenge to the oncologists that can be characterized as a series of unsolved clinical and biological dilemmas. Liver metastases from colorectal and other gastrointestinal malignancies, hepatocellular carcinoma, cholangiocar cinoma, and gall bladder cancer present an array of problems but have two features in common. These are high morbidity and mortality with an overall poor result from treatment. Why is it that hepatobiliary cancer carries with it such a dismal prognosis? First of all, these diseases present, for the most part, in an advanced state. To this point in time the oncologist has had no help from early diagnosis or screening. Only the occasional patient followed by ultrasound or a tumor marker has the disease diagnosed in an asymptomatic state. By the time these diseases become symptomatic, curative treatment options have usually disappeared. Evolution has placed the liver in a protected position in order to avoid injury to the soft parenchyma. As with many other internal organs, the nerve supply is extremely limited. These two anatomic features result in a great lack of early warning signs of cancer.

It is estimated that the functionally significant body of knowledge for a given medical specialty changes radically every 8 years. New specialties and "sub-specialization" are occurring at approximately an equal rate. Historically, established journals have not been able either to absorb this increase in publishable material or to extend their readership to the new specialists. International and national meetings, symposia and seminars, workshops and newsletters, successfully bring to the attention of physi cians within developing specialties what is occurring, but generally only in demonstration form without providing historical perspective, patho anatomical correlates, or extensive discussion. Page and time limitations oblige the authors to present only the essence of their material. Pediatric neurosurgery is an example of a specialty that has developed during the past 15 years and over this period, neurosurgeons have ob tained special training in pediatric neurosurgery and then dedicated them selves primarily to its practice. Centers, Chairs, and educational pro grams have been established as groups of neurosurgeons in different countries throughout the world organized themselves respectively into national and international societies for pediatric neurosurgery. These events were both preceded and followed by specialized courses, national and international journals, and ever-increasing clinical and investigative studies into all aspects of surgically treatable diseases of the child's ner vous system."

This volume provides in a conveniently accessible package a comprehensive collection of accurate and timely information on the management of patients with diarrhea, both in pediatric age and in the adult. As medical knowledge has recently expanded in this area, this volume is full of new practical, clinically useful material for the busy clinician. Illustrations are emphasized to permit rapid acquisition of practical information that is not readily available in the major texts. Each chapter is concise, concentrating on "clinical pearls," and new advances in diagnostic and therapeutic technology. Each chapter discusses the relative costs of diagnostic and therapeutic options to permit financial considerations to be taken into account in the decision making process. Additional unique features include, summaries of key points, recommendations, and indications for requesting GI subspecialty consultation. Providing a comprehensive but practical overview of the issues surrounding the diarrheal diseases, this volume will prove of great value and utility to gastroenterologists, surgeons, internists, primary care physicians.

Liposuction began as a contouring procedure but has evolved into the treatment of obese patients, gynecomastia, ptosis, macromastia, and even patients who have complications from heart disease or diabetes. Other disorders such as axillary sweat hypersecretion, lipomas, and angiomas are also potential disorders that may be treated with liposuction.

Physicians performing liposuction must be adequately trained and experienced in the potential and actual complications before attempting to perform liposuction. Patient safety is the most important aspect of all surgeries, but especially of cosmetic surgery, which is an elective procedure.

New technology helps improve results but experience, care, and skill of the cosmetic surgeon is necessary to obtain optimal results that satisfy the patient.

The contributors to this book have spent time and effort presenting the cosmetic and plastic surgeon as much information as possible on the techniques and uses of liposuction for cosmetic and non-cosmetic surgery purposes.

Abdominal Wall Hernias is the most up-to-date, comprehensive reference available on all aspects of hernia repair. It includes state-of-the-art approaches to conventional open repairs using tissue-to-tissue techniques, the use of prosthetic mesh, minimally invasive approaches, the repair of recurrent and massive hernias, pertinent anatomy, basic science, and emerging biomaterials. The authors present a full spectrum of procedures to enable readers to gain a broad knowledge of the multifaceted repair of hernias. Richly illustrated, this book is a vital resource for all general surgeons and surgeons-in-training.

A thoroughly revised second edition providing the knowledge and evidence-base needed for the perioperative practitioner, clarifying the underlying principles needed for an understanding of anaesthetic, surgical, and recovery practice. This book defines the level of knowledge required for perioperative practitioners and provides a comprehensive reference to the principles and practice of modern operating department practice. Featuring a diverse range of topics, it offers a multidisciplinary overview of new techniques and technologies, changes in medico-legal requirements, changes to professional accountability, and requirements for continuous professional development. Twelve new chapters cover healthcare ethics and professional regulation, health and safety, infection prevention and control, basic patient monitoring, human factors, and perioperative care of the paediatric patient. Incorporating a new focus on the provision of evidence-based practice and holistic care in all areas of perioperative care, this invaluable book is essential reading for anyone working in this sector, in both education and practice.

The second volume of Operative Manual of Endoscopic Surgery covers some of the operative endoscopic procedures which have been introduced into clinical practice since the publication of VoI. 1. In the general section, we have included an updated chapter on instrumentation and new chapters on anaesthetic manage ment of patients undergoing endoscopic surgery and on video image and record ing. Both topics are of importance to the practice of endoscopic surgery and have not been adequately covered in the reported literature. Volume 2 deals with endoscopic procedures)nthechest and abdomen. There have been significant advances in thoracoscopic surgery duririg the past 2 years; particular reference rs made to anatomical pulmonary resections and oesophageal resections. As far as the gastrointestinal trad is concerned, we have included gastric and allied operations but have not covered the colorectal region as we believe that more evaluation is needed before definitive accounts can be written on endoscopic colorectal resections, especially for cancer. For this reason, we have decided to defer this important topic to VoI. 3, which is in preparation. The same applies to laparoscopic repair of abdominal hernias. The same layout has been adopted as in VoI. 1 of the series, with heavy em phasis on illustrative representation of the operative steps and techniques. In the diagrams on sites of trocar/cannulae, we have indicated not only the site and size but also the functional role of each port.

This work is derived from the International Symposium on Advanced Laparo-Endoscopic Surgery, reknowned for being a comprehensive program that brings together international leaders in the field to discuss the current state of practice, the emerging possibilities and the future directions for research. The program focuses on the experiences in large series which have set the standard of practice and won acceptance for laparo-endoscopic surgery in recent years; the panelists and lecturers span the field from concept to realization. The program also addresses the evaluation process by which innovations should be judged in the interest of safety, clinical efficacy and cost effectiveness to improve the delivery of surgical care in the world. The symposium clebrates the firm establishment of laparo-endoscopic surgery and the promise of the future. Together, members of the panel outline future innovations that will change the practice of laparoscopic surgery, showcasing the future of robotics, virtual reality, telesurgery, needlescopic surgery, minimally-invasive breast surgery, cryotherapy and live donor nephrectomy.Highlights include contributions by John Hunter (Endo-Gastric Surgery), Dana Anderson (Repair Common Bile Duct Injury), Jack Jackimowicz (European Laparoscopic Hernia Multi-Institutional Study), Alfred Cuschieri and John Flowers (Role of Clinical Trial for New Procedures).

Metastases determine malignancy. The main attention so far has been focused upon organ metastases. The molecular mechanisms thereof, while far from being totally elucidated, are increasingly well understood. Modern diagnostic tools now enable detection and precise localization of small lesions. In contrast, our knowl edge and diagnostic capabilities regarding metastatic spread to the'lymphatic system are rather limited. However, there have re cently been a number of interesting advances. It is the aim of this volume to submit these developments to detailed analysis. The therapeutic relevance of enhanced sensitivity in detection of lymph node metastases has to be considered in the light of in creased morbidity versus eventual prognostic improvements by modification of therapy. An interesting concept which might im prove diagnostic accuracy while reducing operative morbidity is the "sentinel node" technique. Surgical standards are lacking, however, and many fundamental questions pertaining to precise lymphatic mapping remain unanswered. Whether the sentinel node concept is of general relevance or whether it is applicable in only a few organs remains to be determined. This book offers intensive discussion of the concept from methodological and tu mor biological viewpoints. World-renowned experts with long term involvement in related basic and clinical research provide the reader with a broad survey of actual knowledge together with a critical appraisal of recent and future developments. We sincerely hope this book succeeds in providing an outlook as a reference for all clinicians on future prospects and serving and researchers in this extremely important field.

The aim of this Atlas is to present the three-dimensional arrangement of the liver structures, which should be familiar to those who diagnose and treat diseases of the liver, particularly in an era when the methods of diagnostic imaging and surgical treatment are becoming increasingly sophisticated. For this purpose a series of corrosive preparations of the blood vessels and bile ducts of the liver was made and photographed. In addition to the normal situations, many frequent and rare variations are shown. The Atlas also shows some blood vessels that have not been adequately described or are not well-known in the reference literature, but are nevertheless of great importance in performing segmental liver resections.This Atlas takes a fresh approach to the subject. The method used allows the size, three-dimensional arrangement and structure of the blood vessels and bile ducts of the liver to be preserved. The majority of photographs were taken from the direction from which surgeons see the liver during an operation. This, together with the schematic presentations complementing most of the photographs, gives a further instructional value to the work. With colour photographs and explanatory text, the Atlas forms a basic guide to orientation inside the liver parenchyma, to understanding and diagnosing certain pathological processes and to planning surgcial procedures.

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.

This must-have manual for surgical residents and vascular surgery trainees is copiously illustrated with more than 250 original line drawings. The author presents in a step-by-step fashion the techniques for all common vascular reconstructions, basics of exposure and access, as well as invaluable technical pearls and tips. The text provides the surgical trainee with the opportunity to review and practice the necessary vascular reconstructions before entering the operating room. The illustrations and clear instructions make this a manual that is referred to again and again throughout the surgical residency.

Since RUTHERFORD MORISON left us with the concept of the Omentum being the 'abdominal policeman', clinicians have tacitly assumed that they know sufficient about the structure and function of this organ. However interest in the omentum and its relationship to clinical surgery has recently been develop ing. This book examines all aspects with special reference to surgery and should provide a welcome impetus in research and clinical practice. The editors and contributors have produced a book which is comprehensive and well illustrated and contains detailed refer ences to the important original sources - so essential in a work of this nature. It is written for those who wish to share the delight of acquiring knowledge - even about a comparatively humble organ - as well as for practical surgeons. Both will find ample information to arouse their interest and expand their surgical horizons in exciting ways of which they will almost certainly not have dreamt. I welcome a book of this calibre on a subject which deserves our increasing interest. I delight in the fact that it is dedicated to my friend and colleague MARTIN ALLGOWER.

Cancer is one of the major health problems of our time and liver cancer is responsible for over one million deaths per year world-wide, making it the fourth most common cause of death from cancer. Surgical resection of the tumour(s) is the treatment of choice and offers the only chance of prolonged survival. Yet the best attempts are often frustrated by either advanced or co-existent disease that renders the patient non-resectable. This book tackles the many options available to doctors and patients in an attempt to combat this desperate disease.

Pancreatic Disease: Basic Science and Clinical Management summarises the state of the art in basic science and clinical management of pancreatic disease. This book provides a clear and up-to-date review of the advancing areas in clinical pancreatology and clinical research related to the pancreas. Written by leading experts in the field, this comprehensive review directs the interested reader towards important and current published source material. Covering all aspects of pancreatic disease, contributions are included from pancreatic surgeons and medical pancreatologists on pancreatic cancer, acute pancreatitis and chronic pancreatitis. Special features include a systematic review of the evidence for the use of gemcitabine in pancreatic cancer prepared for the National Institute of Clinical Excellence (NICE), the UK body charged with evaluating new drug treatment. Gemcitabine has FDA approval. There are several contributions dealing with the management of pancreatic neuroendocrine tumours. This book will be useful to gastroenterologists, internists and surgeons, and specialist clinicians with an interest in pancreatic disease. Trainees in medical and surgical pancreatology will find it a companion to supplement standard textbooks.

Apart from the articles on history and nursing, the con- ditions discussed include Mediastinal Masses in childhood seen from a Pathologist's point of view, Intrapulmonary se- questration, lymphangiomata involving the neck as well as thorax, unusual forms of Diaphragmatic Hernia and Congenital Heart Disease. Such a volume would hardly be complete with- out some references to Oesophageal Atresia and one article discusses The Influence Of Anatomy And Physiology On The Ma- nagement Of Oesophageal Atresia.

This book represents the proceedings from a conference that took place in Dallas in the spring of 1999 which was entitled "Pediatric Gender Assignment - A Critical Reappraisal". Some participants rightfully argued that the conference really focused on the issue of pediatric gender assignment, and that reassignment was not applied in most cases. Their comments were reflected in the title of this monograph. This multidisciplinary meeting was sponsored by a conference grant from the National Institutes of Health, and a broad inquiry into this complex topic took place from many points of view. Basic scientists offered insight into mechanisms of sexual differentiation of the gonads, physical phenotype and imprinting of the central nervous system. Endocrinologists reviewed their experience in diagnosis and management, surgeons described traditional as well as innovative approaches, and there was strong representation from the ethical and behavioral sciences. In putting together such a panel, it was essential that we identify a cast of speakers who could address their viewpoints with strong convictions, and yet not let their passions render the meeting counter productive. We were not disappointed. While many differing points of view were firmly expressed by the panelists and audience, all viewpoints were accorded the respect they deserved. The concept behind the meeting and this book really originated in 1997 shortly after Diamond and Sigmundson published their long term follow up study of the John/Joan case.

The advent in the 1960s of the unique and exciting new form of energy called laser brought to medicine a marvelous tool that could accomplish new treatments of previously untreatable disorders as well as improved treat ment of mundane problems. This brilliant form of light energy is many times more powerful than the energy of the sun yet can be focused microscopically to spot sizes as small as 30 microns. Lasers can be directed into seemingly inaccessible areas by mirrors or fiberoptic cables or can be directly applied into sensitive areas such as the retina without damage to intervening structures. There has been a rapid proliferation in the use of lasers in all surgical specialties. Starting with bold ideas and experiments of "thought leaders" in each specialty, the application of lasers has evolved into commonplace usage. Beginning with the era when laser presentations and publications were an oddity, now nearly all specialty areas have whole sections of meetings or journals devoted exclusively to laser usage. Laser specialty societies within a specialty have developed and residency training programs routinely instruct trainees in laser techniques. Basic science and clinical experimentation has supported laser knowledge. Laser usage has also become international. Newer wavelengths and accessories have added to the armamentarium of laser usage. Despite the rapid growth in laser interest, no single source exists to instruct the many new laser users in proper, safe, and effective use of this new modality."

Professor Philip Bromage From the earliest stirrings of modern surgical anesthesia, novice surgeons struggling to learn from the living what there was a strong intuitive feeling that anesthesia of part they were denied an opportunity to learn from the dead_ of the body would be better for the patient than complete But that is largely nostalgia for a past era_ Today, the visual anesthesia of the whole organism. In 1848, James Young arts and the plastics industry have united to give us superb Simpson spent some time and effort seeking this elusive teaching models and techniques that did not exist a few goal, but after a few ingenious though unsuccessful experi decades ago, and they have developed two- and three ments, he gave up the search and turned back to general dimensional surrogate cadavers that are imbued with a anesthesia as the only practical solution to surgical pain more vivid artistry than ever existed on the marble slabs relief at that time_ amid the formalin reek of our old dissecting rooms_ earl Koller's simple but brilliant application of cocaine to This book is a fresh and highly successful attempt to repair some of the bridges that were burnt with the passing of the the eye in 1884 opened the door to a whole new universe of neural anatomy and pharmacology_ Within a decade or old anatomy days_ Together, the authors have contributed"

Alessandro Condivilla of Bologna first attempted a resection of the head of the pan creas in 1898, but several decades of further trial-and-error attempts ensued before the prototype procedure of pancreatoduodenectomy (PD) was established by Whipple in 1935. In the half-century following that landmark, refinements of surgical technique, including pancreatico-and bilio-entero anastomosis as well as develop ment of new technology to support perioperative management and patient care have contributed to the decrease in mortality and morbidity rates for obstructive jaundice and pancreatic fistula. The improvement in mortality and morbidity rates associated with PD has led to an increase in the number of patients undergoing the procedure and in the number of institutions performing it. Indications for PD have also been expanded. In the early years after PD was established as a viable procedure, periampullary carcinoma was the most common indication; now PD is indicated for a number of benign and malignant diseases. Some surgeons believe that PD is the procedure of choice for certain types of chronic pancreatitis, pancreatico-biliary maljunction, and pancreatic and duodenal trauma. Other surgeons have reported the necessity of PD for lymph node dissection of gallbladder carcinoma. Consequently, the basic procedure has been greatly modi fied to accommodate the specific conditions of each disease. For patients with malig nancy, extended procedures have been developed to improve the curative resection rate and ensure complete lymph node dissection."