Management of Musculoskeletal Injuries in the Trauma Patient summarizes the most current concepts and clinical practices for the management of the patient with musculoskeletal traumatic injuries. The text covers optimal time frames for stabilization of orthopedic injuries and strategies to mitigate systemic injury while minimizing damage due to pelvic, spine and long bone trauma. The volume covers the gamut of traumatic axial and extremity injuries, including cervico-lumbar-thoracic spine injuries, spinal cord injuries, long bone fractures with special emphasis on the femoral shaft, pelvic and acetabular injuries, open fractures, mangled extremities, upper extremity injuries, combination and severe soft tissues injuries and periarticular fractures. These are discussed in the context of isolated injury and combined with orthopedic injuries of the brain, abdomen, chest and other musculoskeletal injuries. Written by internationally recognized experts, Management of Musculoskeletal Injuries in the Trauma Patient is a valuable resource for orthopedic surgeons.

Robotic surgery has revolutionised how surgeons think about minimally invasive surgery in the new century. No longer is robotic surgery only for science fiction novels. Robots can now be used for all types of minimally invasive procedures. In many cases, they bring benefits in ergonomics, visualisation, and precision of action. While the current generation of robots is limited, the future is boundless. This book explores common general surgical procedures with the use of the da Vinci (R) surgical system, describes patient selection, surgical tech, robotic instrumentation and positioning and also guides the general surgeon in understanding robotic surgery and implementing it in their practice.

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.

Written entirely by surgical urologists, Surgical Management of Urolithiasis: Percutaneous, Shockwave and Ureteroscopy presents a comprehensive overview of the past, present, and future of surgical techniques, with a focus on educating urologists on the full spectrum of stone procedures. In addition to the technical issues, detailed complications are described. Basic as well as advanced techniques are presented in both a didactic and visual mode with representative endoscopic images and radiographs. Recent advancements which are not routinely a core component of surgical training programs are also covered in detail. Compact and extensively illustrated, Surgical Management of Urolithiasis: Percutaneous, Shockwave and Ureteroscopy is a unique and valuable resource in the field of surgical urolithiasis, essential both for those currently in training and for those already in clinical practice.

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

The purpose of this book is twofold: First, it provides an up-to-date overview of the field of surgical oncology for surgeons in training. Particular attention is devoted to the principles of surgery, but important aspects of radiation and medical oncology are also discussed. Furthermore, diagnostic, staging, and treatment algorithms are presented that will offer invaluable assistance in management decision making. The second aim of the book is to offer a comprehensive reference source on the role of surgery in curative and palliative management for medical and radiation oncologists (in practice and in training) and other healthcare professionals involved in the care of cancer patients. The full range of cancer types is covered in a practical, multidisciplinary approach, and additional chapters are devoted to pediatric malignancies, the role of new surgical technologies, and surgical emergencies. "

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.

The majority of the obese population still does not take advantage of the available surgical possibilities. Clinical research should be oriented towards less invasive procedures that could be accepted by the mainstream. In 2012, most non-invasive bariatric techniques are still not standardized or sufficiently assessed, but they are being constantly upgraded. The purpose of this book is to spark a discussion between experts from around the world, and to gather relevant information on new technologies that will make it possible to enlarge the vision of bariatric care to a growing number of morbid obese and non-morbid obese patients.

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.

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.

Gastric cancer has been one of the great malignant scourges affecting man kind for as long as medical records have been kept. Until operative resection pioneered by Bilroth and others became available, no effective treatment was feasible and death from cancer was virtually inevitable. Even with resection by total gastrectomy, the chances of tumor eradication remained small. Over recent years, however, the situation has been changing. Some changes have resulted from better understanding of the disease, early detec tion, and better management techniques with applied clinical research, but the reasons for other changes are poorly understood. For example, the incidence of gastric cancer is decreasing, especially in westernized societies, where it has fallen from one of the most common cancers to no longer being in the top five causes of cancer death. Still it remains the number one killer of adult males in Japan and Korea. Whether the reduced incidence in western societies is a result of dietary changes or methods of food preservation, or some other reason, is as yet uncertain. Improvements in outcome have been reported from mass screening and early detection; more refined techniques of establishing early diagnosis, tumor type, and tumor extent; more radical surgical resection; and resection at earlier stages of disease."

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.

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.

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.

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.

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.

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.

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.

Pediatric Urology: Evidence for Optimal Patient Management provides pediatric urologists the information needed for state-of-the-art patient care. Chapters are organized around pertinent clinical questions within major areas of pediatric urology, answered using the best available data while also reporting areas for which there is poor evidence. The text includes randomized controlled trials and prospective observational studies, tables that summarize important studies, and figures that illustrate algorithms with best options for management and their expected results. With an easy to use format not found in other volumes, Pediatric Urology: Evidence for Optimal Patient Management is an indispensible and unique resource for experienced pediatric urologists, pediatric surgeons, general urologists with an interest in pediatric urology, as well as fellows and residents in training.

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.

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.

It is an honour and a pleasure to welcome you all at this 20th annual International Symposium on Blood Transfusion in the Netherlands. This year you celebrate its 20th anniversary and I congratulate the Staff of the Blood Bank Noord Nederland and especially Dr. Smit Sibinga for this great achievement. As most of you know, the name of the person of Dr. Smit Sibinga is unbreakably con nected with the annual symposium in Groningen which he has organized each year from the very start, 20 years ago. The reputation of any symposium depends heavily on the quality of the lectures. I think it is not possible to organize 20 symposia in a row if the topics lack actual relevance and the speakers are not of excellent reputation. Dr. Smit Sibinga has proven to have a keen eye for selecting interesting themes and eminent speakers. Although a lot of different topics have been dealt with in the past 20 years, which each attracted the attention of a different group in the field of blood transfusion, it is not surprising that after a tradition of 20 years several speakers but also a lot of attendees are not for the first time in Groningen to participate in this event. It gives the symposium a unique atmosphere of intimacy. It is not hard to admit that most of the newer developments in transfusion medicine take place outside the Netherlands."

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."