This book has been conceived as a reference for all those who want to deepen their knowledge of technical details, design concept and interac tion of the individual modules of Zeiss operation microscopes. The sub jects of the book are classified in accordance with our intention. Special emphasis has been placed on practical hints for the user of opera tion microscopes to avoid operating errors. Parameters which are of para mount importance for surgeon and assistant such as PD and diopter set ting are therefore described in detail. The effects of wrong adjustments are indicated. The above statements also apply to the ample selection of acces sories for Zeiss operation microscopes. That is why much attention has been given to the accessories for co-observation and documentation. The most frequently used formulae are liste in the last chapter of the book, supplemented by nomograms which allow the reader to determine the most important data of a specific piece of microscope equipment without calculation. Our thanks are due to all those who assisted in preparing the manuscript, drawings and photographs, to Mrs. Ursula Gabler for making the English translation and Miss Helen Robertson for editing it, and last but not least to the Springer-Verlag for the most careful, qualified and excellent pro duction of the book."

Pelvic pain in the female patient is common in gynaecological practice, but the specialties of general surgery, urology and orthopaedics provide a significant number of patients and problems. These patients may suffer a multitude of symptoms, and only careful analysis and investigation of each individual problem by the doctor concerned will lead to correct diagnosis and management. The subject matter of this book lies in the practice of many specialties, and all are combined here in a coherent whole. This emphasises the close collaboration necessary between family practitioners, junior hospital staff and consultants. The authors are consultants who work together in a busy district general hospital, and their experience and collaboration is evident in the approach to the diagnosis and management of pelvic pain in the female. Emphasis is laid on the careful evaluation of history and examination and the correct interpretation of diagnostic investigations. Full details of radiology, ultrasound scanning, endoscopy, peritoneoscopy and bacteriological investigation are given. Full consultation between members of staff who have special experience in these investigative procedures is of paramount importance. Details of treatment for relief of pain are important to all doctors concerned with this aspect of clinical management. and this section will be of particular value. The blending of these specialties allows full consideration of the problems affecting the patients. Careful management leads to better treatment for the patient and better satisfaction for the doctor.

This book starts appropriately in considering the principles which should govern our care of the injured child and the background factors which influence fracture epidemiology. Knowing how to manage the multiply injured child and recognizing the one who has been non-accidentally injured are essential skills in our specialty. Injuries to the growth plate are not always easy to recognize and manage but, if we fail to do so, the long-term consequences may be serious. Succeeding chapters describe childhood injuries and fractures regionally. Conservative fracture management has not been forgotten amidst the plethora of newer methods of surgical fixation.

Surgery an essentially manual exercise in its early days, has progressively grown richer in complementary techniques helping the surgeon to perfect his movements and increase efficiency. This is particularly the case with digestive surgery, which has been thoroughly transformed by radiology, endoscopy and extemporaneous examinations effected during surgical intervention. Such methods make it possible for surgeons to develop subtle nuances in operative techniques and to specify indi cations more and more precisely. Ultrasonography must now be included among such techniques. It supplements them and can sometimes even replace them. For these reasons, this work devoted to the use of ultrasound by the surgeon during surgical intervention is of great interest. Two general conditions had to be met before ultrasonography could be em ployed in abdominal surgery: the method and apparatus had to be adapted to its surgical utilization, and the surgeon had to adapt to a nonsurgical technique. The first condition has been fulfilled for all purposes. Intraoperative sonograms can be generated at a very high rate and are proving to be more and more useful. The miniaturization of probes permits their application almost everywhere with opti mal results. Of course, the costs are still high, but one can expect them to decrease.

Modern surgical oncology is characterized by multimodal therapy. In recent years numerous therapeutic approaches of pre-, peri-, intra-and postoperative treatment have been in vestigated with regard to their use in combination with surgi cal intervention. It now is time to analyze and to define the state of our knowledge. For tumors of the gastrointestinal tract there are several encouraging therapeutic approaches, such as preop erative chemotherapy in esophageal and perioperative chemotherapy in colon cancer. For some special tumors, like anal carcinoma, we have clearly defined combined therapies which even now must be viewed as standard treatment. It is also time to demonstrate the results of several clini cal studies that have been conducted within the last few years that combined surgical efforts with pre- or postinter ventional chemotherapy or radiotherapy. It is necessary to evaluate whether these trials contribute to progress in onco logical therapy. The editors of this volume - surgeons at the university hospitals of Heidelberg and Zurich - must be given the mer it of achieving these goals. It was especially appropriate for the Department of Surgery in Heidelberg, in close coopera tion with the Comprehensive Cancer Center Heidelberg/ Mannheim, to prepare a review of our present knowledge of surgical oncology as it is in the tradition of attempting to combine different therapeutic approaches to cancer therapy.

The regenerative capacity of the liver cell is almost unlimited. Therefore after acute liver damage, be it viral, toxic, hypoxic, or surgical in origin, restitutio ad integrum is the usual outcome. In two forms of liver disease, however, this is not the case: in fulmi nant hepatic failure, liver regeneration often is not fast enough to keep the organism alive; in end-stage cirrhosis, regeneration is dis turbed by a hypertrophic architecture of fibrotic tissue. For these extreme forms of liver disease and for critical situations before and after liver surgery, artificial liver support is needed. This book contains the latest results in this area of research pre sented by scientists from allover the world at an international symposium held in Celle, Germany, June 2-4, 1980. Exciting new methods like continuous membrane plasma sepa ration and liver cell transplantation into the spleen have been de veloped. The older methods of hemoperfusion and dialysis have been improved. Enzymological methods and liver transplantation have made good progress. We hope that this volume will help the clinician in his decision-making and stimulate ingenious new re search for the benefit of our liver patients."

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"

2014 BMA Medical Book Awards Highly Commended in Surgery category! General Surgical Operations is a highly-praised and comprehensive textbook of operative surgery. It is a practical manual aimed at the surgeon who is about to carry out an operation, rather than just a description of the principles suitable for an examiner. Kirk's General Surgical Operations continues to be aimed at a broad readership: the candidate preparing for the Intercollegiate FRCS in General Surgery or international equivalents; the trained surgeon faced, through necessity, with undertaking an infrequently performed procedure; and the many surgeons working in hospitals throughout the world without access to specialist services. It remains above all a practical text which will guide the surgeon in training, or one unfamiliar with a procedure, on how to perform it, but more importantly on how to manage the uncertainties which so often arise This is a 'What to do' book. Using it the reader can aspire to gain diagnostic, decision making and operative surgical competence with confidence. The book is written in a clear and direct style and providing explicit instructions using descriptive headings for easy reference. The contents covers standard routine operations in full; non-routine and rarely performed operations are included only where appropriate and in lesser detail The text includes advice on topics such as patient selection; preparation and access to the site of operation; how to accomplish the procedure; closing and aftercare Difficulties are highlighted and advice given on how to respond to unexpected findings Each procedure is fully described thus avoiding repetitions and cutting cross-references to a minimum Regular summaries of key points in the decision making process are included. This Sixth Edition is now known as Kirk's General Surgical Operations in recognition of its distinguished founding editor, Professor RM Kirk, who is now Editor Emeritus on the textbook. The new editorial team for the Sixth Edition comprises a colorectal surgeon, a vascular surgeon and an orthopaedic surgeon The contents have been restructured and radically revised into 42 chapters, the majority of which have been completely rewritten. Laparoscopic techniques have been incorporated into all relevant chapters. All the illustrations have been redrawn to improve their clarity.

Leading medical ethicists, theologists, lawyers, transplant surgeons and physicians discuss 5 major ethical topics concerning the transplantation of human organs.

Over the past few years, a wealth of new insights have been gained and put to use in basic gastrointestinal tumor research, including tumor suppressor genes, oncogenes, cell-cycle con- trol, apoptosis, adhesion receptors, signal transduction, and gene therapy. Similarly, progress has been made in preven- tion, molecular diagnosis, laparoscopic staging, and antibody- based immunotherapy, and new drugs such as thyrnidylate and topoisomerase I inhibitors have been developed espe- cially for the treatment of colorectal carcinoma. Despite this burgeoning of knowledge in both basic and clinical research, however, we have just begun to put these results into clinical practice. Therefore, the key goal of this volume is to bring together basic and clinical research findings so as to facilitate the translation of these advances into the clinical manage- ment of gastrointestinal tumors. We hope that this volume, which covers a broad spectrum of research and clinical medicine, will impart new insights and greater understanding to all those interested in the therapy of gastrointestinal tumors and will stimulate further scientific research. Berlin, January 1996 E. D. Kreuser P. M. Schlag Contents 1 I. Basic Research S. J. Meltzer The Molecular Biology of Esophageal Carcinoma 1 E. R. Greenberg Preventing Colorectal Cancer...9 M. Streit, R. Schmidt, R. U. Hi/genfeld, E. Thiel, and E. -D. Kreuser Adhesion Receptors in Malignant Transformation and Dissemination of Gastrointestinal Tumors...19 R. Kaiser, E. Thiel, and E. -D. Kreuser Human Gene Therapy in Gastrointestinal Diseases: In Vivo and In Vitro Approaches ...

Main focus of the new book will be the description and discussion of rat and mouse models for organ transplantation. Various microsurgical techniques will be presented which allow transplantation of functional organs in syngeneic systems. In particular, the extremely difficult methods necessary for organ transplantation in mice will be presented and evaluated. Besides these practical aspects the book will also cover the theoretical sides of organ transplantation like the immunobiology of allotransplantation. Special emphasis will be given to the resurgent field of xenotransplantation. The results from xenograft models developed in the recent years using rats or mice will be reviewed and their impact on future human xenotransplantation will be discussed.

The comparison of established methods in surgery is necessary in order to evaluate the advantages or disadvantages of each. We have therefore tried to include discussions of all the problems which arise in the treat ment of long-gap esophageal atresia. The long-term results of different types of colonic interposition, of different "stretching" procedures, and of simple staged surgery seemed especially worthy of discussion. It was also important to describe the role of complications caused by special pathology of the trachea in esophageal atresia and their management. Second, new problems continue to arise with regard to the prenatal diagnosis of malformations. These new aspects will continue to exert an influence on our surgical field. Malformations pose severe problems for parents, the growing fetus, and the doctors and are lasting burdens on our task. PETER WURNIG, Vienna Contents I. Long-gap Esophageal Atresia Current Surgical Strategies in Long-gap Esophageal Atresia with Regard to Endoscopy Anastomosis. D. BooB and J. Kotlarski. With 7 Figures .......................... 1 Long-gap Esophageal Atresia: Experience with Kato's Instru mental Anastomosis, with Cervicothoracic Procedure and P- mary Anastomosis, and with Retrosternal Colonic Interposition. W. Ch. Hecker. With 6 Figures . . . . . . . . . . . . . . . . .. 9 Esophagus Replacement by Free, Autologous Jejunal Mucosa Transplantation in Long-gap Esophageal Atresia. H. Halsband. With 10 Figures ......................... 22 The Outcome of Colonic Replacement of the Esophagus in Ch- dren. A. Ahmed and L. Spitz. With 3 Figures ........ 37 Gastric Tube Esophagoplasty. K. D. Anderson. With 1 Figure 55 The Significance of Tracheal Stenosis in Esophageal Atresia."

A clinician's guideline for intra-abdominal infections written by experts in the field.

- A manual to help physicians to quickly recognize and better understand the pathogenesis of intra-abdominal
infections
- Includes several high-quality black and white and color photographs from real-life clinical cases
- Adheres to a simple format to serve as essential and quick reference guide for all non-surgical residents and physicians

The first edition of Surgery of the Hip loint has had certain measures of success. Its cover won the Outstanding Award for art at a publishers trade show. A year later it was translated into Spanish for exposure to the vast world of the Spanish speaking peoples. As I traveled through Europe, it was repeatedly a pleasant surprise to have the book recognized as an authorita tive reference. This was a great tribute to the experts whose diligent efforts made it all possible. Apparently the book has stood the test of time to judge from the many inquiries and constructive comments made toward urging us on to write a second edition. It was not an easy task to gather another cadre of authorities to update our knowledge of the hip joint. People who have earned respected positions in their field are unavoidably burdened with a busy schedule, so a chapter in this text must be appreciated as coming from someone devoted to giving up some of his precious time for the sake of sharing his knowledge with peers and students."

This book is a unique work devoted to the subject of disordered defaecation. It contains chapters written by experts in the field of ano-rectal physiology and management of disordered defaecation. The various contributions present personal views and special clinical experience of individuals. There are some personal views which we felt should be commented upon and a few areas where the experience of others has been included into the text. For the sake of completeness of each chapter, a slight overlap in some cases was inevitable. We hope the book will serve as a useful collection of opinions on a subject which until recently has been largely ignored by the medical profession. The editors Major contributors H. O. ten Cate Hoedemaker Department of Surgery, University Hospital, Rijnsburgerweg 10,2333 AA Leiden, The Netherlands G. Coremans Department ofInternal Medicine, University Hospital Gasthuisberg, Here- straat 49, 3000 Leuven, Belgium S. Fasth Department of Surgery II, Sahlgrenska Hospital, S-413 45 G6teborg, Swe- den H. G. Gooszen Department of Surgery, University Hospital, Rijnsburgerweg 10, 2333 AA Leiden, The Netherlands J. A. Gruwez Department of General Surgery, University Hospitals KU, Brusselsestraat 63,3000 Leuven, Belgium M. M. Henry Department of Gastroenterology, Central Middlesex Hospital, Acton Lane, London NWlO 7NS, United Kingdom M. R. B. Keighley Department of Surgery, The General Hospital, Steelhouse Lane, Bir- mingham B4 6NH, United Kingdom J. H. C. Kuypers Department of Surgery, University Hospital St. Radboud, Geert Groote- plein Zuid 14,6500 HB Nijmegen, The Netherlands Ph. B.

Endoscopic Sinus Surgery examines the surgical techniques for tackling nose and sinus disease. With the advent of multi-angled endoscopes, better optical instruments and imaging techniques, the impact of endoscopic sinus surgery has been greatly increased in recent years as it considers the problem at its root cause. The book combines a clear, practical text with extensive visual material and many colour illustrations. All aspects of functional endoscopic sinus surgery are covered including an assessment of the technique and a detailed account of both morbid and endos copic anatomy which are important to an understanding of the techniques involved. Post-operative care, complications (and how to avoid them) and radiology of the sinuses are also covered. This is an accessible and practical book for the novice which will broaden diagnostic skill and improve patient care. The many tips included will also aid established surgeons.

Thyroid carcinoma is an uncommon malignan ing the available non-human lines, as models cy. In the vast majority of patients, if treated for cell cycle studies and oncogene/anti appropriately, it is associated with a benign oncogene regulation, because they are unaware clinical course. Why then does it hold a con of the often fundamental dichotomy between tinuing fascination for so many physicians? thyroid malignancy and prognosis. Third, the The answer is probably directly dependent very nature of the benign clinical course has suggested to the major health research fund on the very benign nature of most thyroid ing agencies that thyroid cancer is not worthy maligllancies. While there are terrible excep of study in a time of scarce resources. tions, the follicular and papillary thyroid can Nothing could be further from the truth. cers behave in a way quite alien to "common" This gratifying clinical course is the very reason neoplasia, since they grow and metastasize why the study of human thyroid cancer has the slowly. We believe that if only we could under potential for contributing further to our fun stand such a transformed state, we would be able to learn a great deal about the normal and damental understanding of malignancy and, abnormal regulation of the cell cycle and im perhaps more importantly, the mechanisms by prove our understanding of cancer. which the human body can resist neoplastic However, recent advances in the biology of cells."

Every year, in the United States and the third world combined, 13.3 million boys and 2 million girls are circumcised. Whether because of perceived medical, cultural, or religious necessity, most of these parents feel they have no alternative but to allow their children to undergo this surgery. Sparking intense debate, the circumcision of children is a highly controversial and complex phenomenon that touches a variety of sociological areas, such as religious beliefs, identity issues, medical conceptualizations, fear, and superstition. The contributors to this volume comprise an international panel of experts in the fields of medicine, psychology, law, ethics, sociology, anthropology, history, theology, and politics. In 18 chapters they discuss the history of circumcision; document the physical and psychological consequences of circumcision; present the latest anatomical discoveries about the male prepuce; analyze the role of circumcision in various traditions; reveal the medical industry's investment in the practice; describe current legislative efforts to protect children from circumcision; and outline effective, culturally sensitive methods that are being implemented today to safeguard the human rights of at-risk children. For its insights into this troubling aspect of culture, Understanding Circumcision: A Multi-Disciplinary Approach to a Multi-Dimensional Problem is a critically important contribution to the growing body of literature on this subject.

Distinguishing between CVDs, e. g. , hemangiomas and vascular malformations, often presents special problems. The clinical symptoms can be misleading and di- agnosis requires complete and careful evaluation of the patient's history and in some cases further diagnostic measures. A clear histologic classification is limited to cases in which a surgical resection is indicated and the minimally invasive therapy is no longer possible. However, the diagnosis should be made in a very early stage as the different types of congenital vascular disorders require different types of management. While hemangiomas should be treated in their very early stages, the treatment of some vascular malformations can be postponed until the diagnostic and therapeutic measures are of acceptable risk for the patient. References 1. Belov S, Loose DA, Weber J (1989) Vascular malformations. Einhorn, Reinbeck (Periodica Angiolo- gica 16), pp 19-30 2. Berlien HP, Cremer H, Djawari D, Grantzow R, Gubisch W (199311994) Leitlinien zur Behandlung angeborener GefaBerkrankungen. Paediatr Prax 46: 87-92 3. Finn Me, Glowacki J, Mulliken JB (1983) Congenital vascular lesions: clinical application of a new classification. J Pediatri Surg 18 (6): 894-900 4. Grantzow R, Schmittenbecher PP, Klima-Lange D, Spreng G (199011991) Problematik der Therapie von Riesenhamangiomen. Paediatr Prax 41: 311-320 5. Jacobs AH, Walton RG (1976) The incidence of birthmarks in the neonate. Pediatrics 58 (2): 218-222 6. Philipp e, Poetke M, Berlien HP (199311994) Klinik und Klassifikation angeborener GefaBerkrank- ungen.

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.

Who owns your sex organs? Different cultures today and in different epochs have given a variety of answers to this question. It may seem self evident that every individual owns and has sovereignty over his or her own body parts, such as the head, legs, nose, stomach, pancreas, and other body parts. The sex organs, however, seem to be an exception. Even though they are as much an integral part of the individual as a leg or a liver, the sex organs are unique in that many cultures have established laws and taboos over the use and even the mere display of the sex organs. Thus, certain cultures have placed constraints over the individual's ownership of his or her sex organs and actively regulate and restrict the individual's access and use of those organs. In other cultures, the question of ownership of the sex organs is more decisively answered. In any culture where circumcision to any degree of either the male or female is practiced, permitted, encouraged, or even merely tolerated, it is clear that the individual is not considered to own his own sex organs. In the United States today, the medical establishment has created an is considered acceptable and desirable that anyone for environment where it any reason can authorize or execute the amputation of the foreskin from a male child's penis."

In 2006, when my colleague Andrea Renda proposed multiple primary malignancies (MPM) as the subject of the Biennial Report to the 2008 Congress of the Italian - ciety of Surgery, I, together with the Steering Committee, quickly agreed. Recent progress in our understanding of the etiopathology of these neoplasms has led to - novative and significant progress on the clinical level. Importantly, the incidence of the onset of two or more tumors in the same patient suggests a more than casual - lationship. Furthermore, the occurrence of MPM derives from several different me- anisms-viral, iatrogenic, immunologic, environmental, and hereditary-such that any form of treatment must take into account the etiology of these tumors. After an epidemiological introduction, this monograph analyzes various aspects of multitumoral syndromes based on the experience of the Department of Surgical Sciences, along with that of other clinical departments of the University Federico II of Naples. In the discussion of inherited tumors, reference is made to the series of patients treated at the Department of Surgery at the University of Siena. The many topics that comprise this volume range from carcinogenesis to diagnostic strategies, and from epidemiology to innovations in imaging and endoscopic techniques. Among the clinical aspects, particular emphasis is given to sporadic and hereditary syndromes, as these patients are frequently treated by general surgery departments.

This book provides detailed guidelines to any physician treating patients with emergency vascular disorders. These might include ruptured abdominal aortic aneurysms, acute limb ischemia, vascular trauma, iatrogenic vascular injuries and complications to vascular surgery. The book provides an introduction to vascular surgical operations and focuses on how to manage patients. Numerous figures illustrate the particular points in vascular techniques and diagnostic problems in the emergency situation. This is an indispensable guide for all surgeons dealing with vascular emergencies.

Surgery of the Esophagus and Stomach provides an illustrative, instructive, and comprehensive review that depicts the rationale of basic operative principles essential to surgical therapy of the esophagus and stomach. The chapters provide pertinent and concise summaries of how to deal with various esophagus and stomach disorders, spanning benign and malignant problems and minimally invasive procedures. Stages of operative approaches with relevant technical considerations are outlined in an easily understandable manner. Complications are reviewed when appropriate for the organ system and problem. The text is illustrated throughout by line drawings and photographs that depict anatomic or technical principles. A concise, handbook-sized reference work, this book is a valuable resource for all general surgeons and residents in training.

This book is an organized approach to understanding bone growth and disease. It integrates anatomic and radiologic knowledge of enchondral and membranous bone growth and emphasizes the similarities of the physis and acrophysis in development. The artwork, jointly produced by artist and author, illustrates the concepts described. The identification of abnormality is aided by the explanations of the causes in terms of pattern recognition.