'This is history with a surgeon's touch: deft, incisive and sometimes excruciatingly bloody' The Sunday Times 'Utterly eccentric and riveting' Mail on Sunday 'Eye-opening and, frequently, eye-watering . . . a book that invites readers to peer up the bottoms of kings, into the souls of rock stars and down the ear canals of astronauts' The Daily Telegraph How did a decision made in the operating theatre spark hundreds of conspiracy theories about JFK? How did a backstage joke prove fatal to world-famous escape artist Harry Houdini? How did Queen Victoria change the course of surgical history? Through dark centuries of bloodletting and of amputations without anaesthetic to today's sterile, high-tech operating theatres, surgeon Arnold van de Laar uses his experience and expertise to tell an incisive history of the past, present and future of surgery. From the dark centuries of bloodletting and of amputations without anaesthetic to today's sterile, high-tech operating theatres, Under the Knife is both a rich cultural history, and a modern anatomy class for us all.

International surgical meetings with thousands of participants speaking a dozen different languages tend to be frustrating for the individual who comes with the hope of learning about progress in his fields, but who additionally would like to be able to ex change ideas on controversial topics and to meet competent people with whom to discuss specific problems. In the "one-way" ses sions in which long papers are presented, details or specific points may be missed. Differing views often are not adequately discussed, because the meeting and its participants are pressed for time. The 44 breakfast and luncheon sessions, covering different topics of interest to the practicing surgeon, were mainly planned to overcome these classical "congress handicaps" and also to do away with the anonymous atmosphere of such a large congress. Slides and formal papers were banished from these sessions. The outcome of these very lively and pleasant discussions taking place around small well-dressed tables was unexpected by most participants. A chairman and several panel members shared their repast, caloric and intellectual, with some 10-30 congress par ticipants. The result was in each instance a lively, informative intimate discussion, very different from the anonymous atmo sphere of a large meeting. In the hope of preserving these ex changes, the chairmen were requested immediately the session finished to "distill the essence" of the 90-minute exchange into a summary captured on tape."

Written by internationally acclaimed specialists, Peripheral, Head and Neck Surgery expands on surgical procedures for the neck, head, hands and feet. Chapters provide pertinent and concise procedure descriptions creating a book that is both comprehensive and accessible. 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 photographs that depict anatomic or technical principles. Forming part of the series, Surgery: Complications, Risks and Consequences, this volume Peripheral, Head and Neck Surgery provides a valuable resource for all general surgeons and residents in training. Other healthcare providers will also find this a useful resource.

The number of patients with occlusive peripheral vascular disease of the lower ex- tremities is still growing as rapidly as the number of patients with coronary heart disease and cerebrovascular disease. Due to the increase in average life expectancy during the last few decades, more patients now need surgical vascular reconstruc- tion. This actually means a demand for more centers specializing in vascular surgery and equipped with intensive care facilities, since the number of patients with cardio- vascular and bronchopulmonary complications is increasing as well. In addition, the number of patients needing repeated vascular surgery has been growing. Therefore, the search for simple procedures to recanalize the arterial lumen which could be performed under local anesthesia is no surprise. Unfortunately peripheral vascular disease is still frequently treated by amputations. In 1967, the fIrst report in German on percutaneous recanalization of arteries with thrombotic occlusions and stenoses appeared in Rontgenfortschritte. The meth- od described in this report had been published by Dotter and Judkins in 1964. Today, 10 years after their report, more data have been systematically collected on this method in Europe than in the United States, where it was developed. Possibly an explanation of this state of affairs is that nonsurgical treatment is favored more in Europe than in the United States. The scientifIcally based angiology established by Ratschow served as the foun- dation for the development of diagnostic work-up and therapy in other directions beyond the questions of operability and surgical results.

Of the joints of the body commonly afflicted by serious pathology the knee is the most accessible. Because it is so accessible drastic treatment may be undertaken prematurely and incorrectly. This does not threaten life but may cause permanent morbidity. Dr Stoker has set about examining this joint in depth as a radiologist. As a direct result the surgeon will be helped to make a correct diagnosis and avoid pitfalls, by a diagnostic procedure that is of little inconvenience to a patient. Arthrography is not new but a fresh appraisal is timely. This is not to suggest that there can be any slackening in clinical examination, or that other methods of examination do not have a place. But there are knee joint problems, particularly in teenage girls, in which a clinical diagnosis is very difficult, but must be made exactly. Arthrography must be accepted as a very useful method of examination of the knee joint and an essential one in certain circumstances. More radiologists should be interested in undertaking this examination and surgeons should ask for it. E.L. Trickey, F.R.C.S.

The application of the caval catheter in emergency medicine and intensive care has today become routine. Generally, even in severe shock this route of access to the cardiovascular system is available in order to apply life saving volume substitution. It also permits longterm infusions in modern intensive care, particularly continuous administration of high-osmolarity solutions in par enteral nutrition. In both fields it represents one of the most important diagnostic parameters of circulatory disorders, enabl ing the registration of central venous pressure. Its undeniable advantages are counterbalanced by the dangers inherent in all invasive methods. Since sufficient experience and precise sta tistics are now at our disposal, the time has come for a provisional survey. While a few years ago it was considered mandatory to propagate the central venous access in order to advance new therapeutic and diagnostic methods, it is now necessary to recon sider and reformulate indications for its use. In this task it is essential to weigh the expected advantages against the possible complications in each and every case of catheter application. Cri tical scrutiny must include evaluation of techniques, approaches, and finally catheter materials; this paper presents the results of such a survey. The physician is hereby given the opportunity of being completely informed of evaluating the validity of his standard procedures. VIm, April 1977 C. BURRI F. W. AHNEFELD Table of Contents I. Introduction. . . . . . . . . 1 II. Indications for Caval Catheter 3 A. Caval Catheter in Emergency Situations 3 B."

Offering the most comprehensive collection of head and neck pathology specimens available in one reference, Gnepp's Diagnostic Surgical Pathology of the Head and Neck, 3rd Edition, is a must-have resource for pathologists in training and practice. This abundantly illustrated volume covers both common and rare disease entities of the entire head and neck area, with particular emphasis on differential diagnosis and diagnostic problems and pitfalls. Detailed text and a highly visual format help you improve turnaround time when diagnosing a specimen and facilitate clear communication of prognosis and therapeutic management options to surgical/medical colleagues. Covers key topics such as molecular aspects of disease, especially in reference to targeted therapy and personalized medicine; the latest classification and staging systems for head and neck diseases and disorders; and immunohistochemical features that help ensure diagnostic accuracy. Discusses new diagnostic biomarkers and their utility in differential diagnosis, as well as newly described variants and new histologic entities. Includes a new chapter on eye pathology. Incorporates new criteria as established by the 2017 World Health Organization classification of Head and Neck tumors and the 2017 World Health Organization classification of Endocrine organ tumors. Provides clinicopathologic correlations throughout to give you all the information you need to formulate a complete diagnostic report. Features more than 1700 full-color illustrations that capture the pathologic appearance of the full range of common and rare neoplastic and non-neoplastic lesions. 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.

In this book are published papers presented at the first meeting about tomodensito metry (Computer Tomography) which the CEPUR organized in Luxembourg in March 1977. CEPUR (College d'enseignement post-universitaire de Radiologie) is an international medical association having as its main aim the promotion of courses in advanced radiology. Several sections deal with the subspecializations, one of which is Com puter Tomography. Thanks to the fruitful cooperation of several University Hospitals (Ancona, Leuven, Montpellier, Bruxelles, Strasbourg), the two-day meeting organized by Dr. Capesius in Luxembourg covered a certain number of aspects of clinical tomodensitometry in the brain as well as in the trunk. We hope that this volume will be the first of a series dealing with the actual problems in clinical radiology. Leuven/Bruxelles/Strasbourg A. BAERT L. JEANMART A. WACKENHEIM Contents I. Introduction to the Technology of Computer Tomography K. Ungerer. With 18 Figures ... 2 II. Head Sellar Region: Normal and Pathologic Conditions. U. Salvolini, F. Menichelli, and U. Pasquini. With 40 Figures ...... 14 Empty Sella and Pituitary Gland. J.L. Dietemann and A. Wackenheim. Wi th 3 Figures . . . . . .... . ., 38 Midline Lesions. D. Baleriaux-Waha, L.L. Mortelmans, M. Dupont, and L. Jeanmart. With 17 Figures ....... .. 39 Ventriculocisternal Pathology in Children. D. Touitou. With 9 Figures . . . . . . . . . . . . . . .. ....... 47 Endocranial Calcifications. J.H. Vandresse, G. Cornelis, and A."

The thrust forward into small dimensions with the aid of high magni- fication (6-40 power) under the operating microscope marks an important development in almost all fields of surgery. Neurosurgery, ophthalmology and otorhinolaryngology have already integrated the binocular mono- scope as an indispensable tool into their armamentarium. General surgery is also making increasing use of it-as is the case with transplantations of autogenous free intestinal grafts. A great "victory march of microsurgery", however, appears to be taking place in plastic and reconstructive surgery. Reimplantation of arms, hands, and especially digits are hardly thinkable today without the possibility of high magnification. New microsurgical anastomosing techniques (interfascicular neurorrhaphy) have also improved the func- tional results after nerve injuries. Time-consuming reconstructive proce- dures, such as the transfer of a distant flap with its physical and psycho- logical burden, are being increasingly replaced by free flaps transplanted by microvascular suture techniques-the most popular free flap being the groin flap in which the superficial circumflex iliac artery and vein is reanastomosed to the recipient vessels. Nevertheless, the writer was sceptical when Dr. TSCHOPP set about with his ambitious plan to transplant a free autogenous rib graft in combination with its adjacent intercostal musculature. The evidence of the results obtained has given the lie to my scepticism. Dr. TSCHOPP has not only succeeded in securing the complete arterial and venous supply to the musculoskeletal graft at the recipient site but has also managed to preserve the functioning entity of nerve and muscle.

The premier exam-prep guide for surgery-with 800+ board-style practice questions with detailed answers and rationales Based on general surgery's cornerstone text, Schwartz's Principles of Surgery, this unmatched study guide provides everything they need to ace your exams-whether you're a resident or a practicing surgeon seeking recertification. Developed by the top minds in modern surgery, Schwartz's Principles of Surgery ABSITE and Board Review, 11th Edition delivers the most current, authoritative perspectives on surgical practice. Each practice question is accompanied by answers and comprehension-building rationales, ensuring complete understanding of the material. Answers are keyed to the latest edition of Schwartz's Principles of Surgery providing only the studying only relevant, applicable material from the most authoritative source possible. Features *300 photos and illustrations *Updated chapters-all aligned with the latest American Board of Surgery Qualifying Board Examination blueprint *Questions reflect those most likely to appear on the American Board of Surgery in-training exam and the surgery board exam *Excellent prep for both written and oral boards

1. A guide to managing paediatric surgical patients in a remote and rural setting 2. Includes guidance on differences in presentation and problems relating to the Tropical environment 3. A key resource in understanding paediatric surgical patients needs when being managed remotely

This monograph is a summary of observations collected over the past ten years on vagal denervation of the stomach and the functional pathology of the vagotomized stomach. It is primarily a continuation of the work we (Holle and Heinrich, 1954) began with fundectomy - the prototype of proximal dener vation of the stomach. This was the starting point for the develop ment of selective proximal vagotomy (SPV). Between 1961 and 1964 the SPY technique was developed to the extent that it could be applied clinically from January 1,1964. Like most clinical innovations, the development took place in several stages. A report on the first 235 surgical cases (1961-1967) appeared in 1968 in F. Holle's Special Surgery of the Stomach, pp. 508-509, and in 1969 in Surgery of the Stomach and Duodenum by Harkins and Nyhus, 2nd edition, pp. 629-634. Since that time it has been possible to demonstrate on the basis of 1200 operated cases as well as animal experiments that the new technique we introduced represents a successful, nonresecting surgical treatment of gastric and duodenal ulcers. It is important to have a long series of clinical cases from the same source, because it is not until a large number of individual observations have been collected concern ing complications of diagnosis, indications and technique that is it possible to analyse the relationships between them.

Congenital Malformations of the Head and Neck offers a unique conceptual and visual approach to children with congenital malformations of the head and neck. Developed by renowned leaders in the field, this title is richly illustrated with a wealth of patient photos, radiology and endoscopic images of malformations. Starting with the genetics of common congenital syndromes, Congenital Malformations of the Head and Neck goes on to comprehensively cover malformations of the ear, nose, nasopharynx, oral cavity, oropharynx, cleft lip and palate, larynx, trachea, and neck. Easy-to-read and an indispensable reference and teaching resource, this title will serve as an invaluable reference for clinicians, neurologists, pediatricians, otolaryngologists and head and neck surgeons. It should also be of great interest to fellows and residents.

Nach Schilderung der Indikation zur intraaortalen Ballonpumpen-Therapie wer- den die Daten von 12 in Hamburg mit dieser Methode behandelten Patienten vor- getragen. Bei der Hiilfte der Patienten war die Therapie beziiglich der kardialen Ausgangs- situation wirksam gewesen. Vier Kranke dieser Gruppe starben an zusatzlichen Organschaden. wie Schocklunge. Bronchopneumonie und Urosepsis. Bei zwei Patienten war die Therapie erfolgreich. sie haben iiberlebt. 289 EINFLUSSE. DIE DIE ISCHAEMIETOLERANZ DES KUNSTLICH STILLGELEG- TEN HERZENS BESTIMMEN Von P. Kalmar. N. Bleese. U. Kirsch. H. Pokar und G. Rodewald In der offenen Herzchirurgie ergibt sich bei einer Reihe von Operationen die Not- wendigkeit. das Herz kilnstlich stillzulegen. Die Ischaemietoleranzzeit eines ge- sunden normothermen Herzens liegt in der Gr613enanordnung von 60 Minuten. In der Kardiochirurgie sind aber die zu operierenden Herzen in verschiedenem Ma13e vorgeschadigt. Somit ist es erforderlich. intraoperativ die Ischaemie- toleranz des Herzens kilnstlich zu verlangern, das hei13t, den Sauerstoffbedarf zu senken oder den Abbau der energiereichen Phosphate zu blockieren. Das Erste kann durch Hypothermie, das Zweite durch Verwendung von kardioplegi- schen Substanzen erreicht werden. Experimenteile und klinische Untersuchun- gen ergaben, da13 das von KIRSCH eingeflihrte Kardioplegin wirksam die Isch- aemietoleranz verlangert (4, 5. 6. 7). Nach den Postulaten von BRETTSCHNEI- DER (!) sind bei der IschaemietOleranz folgende Faktoren von gro13er Bedeutung: vor der Ischaemie die Speicherung von Energiereserven und Reduktion des Energieumsatzes. wahrend der Ischaemie kleiner Energieumsatz und nach der Ischaemie M6glichkeiten der raschen Erholung. Eine experimenteile Untersuchung am Meerschweinchenherzen von IMHOLZ (3) zeigt, gemessen an dem Zeitpunkt des Totenstarreeintritts.

Effective leadership is critical to ensuring safety, efficiency and maximum productivity in the operating room (OR). This practical, evidence-based book unpicks the dynamics of a successful OR environment to underline the key techniques for management of policies, systems, staff members and teams. Fully updated to include recent clinical guidelines, the book provides the 'A-Z' of OR management, including sections on metrics, scheduling, human resource management, leadership principles, economics, quality assurance, recovery and ambulatory practice. New chapters include future healthcare models, emergency preparedness and budgets amongst other topics. Written by authors with unrivalled experience in the field, chapters are laid out in an easy and clinically helpful format to assist learning, and real-life case studies cover seventy-three different clinically relevant pain topics. This book is an essential guide for anyone working in the OR including anaesthesiologists, surgeons, nurses, and administrators.

Gain confidence in the surgical management of female and male infertility. Authored by leading experts in operative gynecology and urology, in collaboration with the Society of Reproductive Surgeons, this valuable handbook provides readers with a comprehensive understanding of the indications, techniques, and outcomes of modern reproductive surgery. This manual presents clear step-by-step instructions illustrated with intraoperative photographs and surgical videos in order to offer patients surgical options and avoid, or improve, IVF.

of the cholecystogram. 1940 - the first anastomosis for oesophageal atresia by CAMERON HAIGHT in Ann Arbor and the first duodeno-pancreatectomy for pancreatic carcinoma, perfor med by WHIPPLE in New York. In 1943 - again WHIPPLE and his associates carried out the first porto-caval anastomosis at Columbia University and in 1945 - there followed BLALOCK'S anastomosis for Fallot's Tetralogy. In the following years the heart, as the last organ of the human body, became the chief target of surgical therapy. Most of the cardiovascular procedures, which today Fig. 4. New medical center of the Free University in West-Berlin under construction are part of the routine all over the world, originated in the United States or in Canada: in particular the spectacular successes of open heart surgery in hypothermia or extracorporeal circulation and the replacement of cardiac valves and arteries. This was the achievement of many active fellows of the American College of Surgeons with names well-known to all of us. The gradient between the surgical standards of our two countries was regrettably large after the second world war. The longtime isolation, the destruction of our cities, the loss of man-power through two world wars and the emigration following 1933 as well as a considerable brain-drain in more recent years were the main causes."

Providing safe, effective anaesthesia for patients undergoing oral and maxillofacial surgery presents unique challenges involving a wide range of complex procedures, treatments, and interventions to manage an array of pathologies. This textbook is a practical, easy to read and engaging guide to the entire perioperative management process, encompassing everything that the practitioner needs to know. It utilises a clear, step-by-step approach to managing all aspects of anaesthesia for oral and maxillofacial surgery, from routine elective procedures to emergencies, difficult airways, cancer, and pain. A contemporary, evidence based approach and the most up-to-date techniques are described, with reference to current guidelines and standards. This comprehensive second edition will empower the novice, but also support more experienced practitioners and those who may occasionally be called upon to manage emergency cases. Written by international experts in the field with many years of experience both conducting and teaching oral and maxillofacial anaesthesia, this textbook is an essential resource for all members of the multidisciplinary team who wish to improve their understanding of and confidence with anaesthesia for this surgery.

This book provides comprehensive coverage of the anatomical and physiological aspects of complex colorectal and pelvic malformations. Also described are the surgical protocols for this specialized field within pediatric surgery. The benefits of high-level collaboration between surgical services when treating these anomalies are explained, as are treatment algorithms and care of complications. Includes evaluation and management of the newborn Describes surgical interventions of the newborn, and when a primary repair versus a staged approach is required Explains the value of laparoscopy and deciding in which cases to use it Looks at the importance of a transition program to adulthood Pediatric surgeons worldwide and the teams in which they work will benefit from this well illustrated and comprehensive work.

The introduction of antibiotics has practically eliminated infection of the paranasal sinuses as source of intracranial infeetions. Thoracic surgery has nearly eradieated a for merly fairly frequent source of abseess of the brain, namely infections of the lung, such as lung abscess, bronchiectasia and lung gangrene. Gunshot wounds of the head are of course a very important course of brain abseess and meningitis, but in civilian practice fortunately rare. Complieated fractures of the vault and fractures of the base of the skull are at present the most important source of intraeranial infection, and are likely to increase in importance due to ever increasing frequeney of motor accidents. Metastatic brain abscess originating from a foeus of infection of the tonsils or from other lesions anywhere in the body are on the whole rare. This source of infection must be considered to be of minor importance. These faets are clearly reflected in Dr. IRSIGLER'S monograph. There is an abundance of material of traumatic abscesses both due to gunshot wounds and to pcaee-time acci dents involving the vault, the base of the skull and the paranasal sinuses, which is exten sively documented by case histories and weil chosen illustrations.