2. Stone extraction via the T-tube 89 3. Endoscopic method 89 4. Preparation for stone extraction 90 5. Technique 90 6. Results 91 7. Complications 91 8. Discussion 91 Index of Subjects 99 CHAPTER 1 INTRODUCTION This book was conceived as a descriptive atlas of most reliable indication for common bile duct ex routine biliary surgery i. e., cholecystectomy and ploration. The cholangioscope allows a visual ex exploration of the common bile duct. For the pro ploration of the biliary tree and permits the re ject the two authors worked together for one week moval of common bile duct calculi and other as biopsy under direct visual con at Ninewells Hospital and Medical School, Dundee procedures such on a series of patients with biliary tract disease trol. Both procedures have been described in detail especially selected for the exercise. With the con with emphasis on the practical aspects of their use. sent of the Tayside Health Board and the patients The era of blind bilary surgery is over and the concerned, all the operations and peri-operative sooner this message is received by all concerned, procedures were filmed by the photographic mem the better the outcome of biliary surgical practice bers of the team, Mr. and Mrs. Paz-Partlow. Ad overall. ditional case material has been obtained from It has not been our intention to produce a com Cedars Sinai Medical Center, Los Angeles."

This book provides a state-of-the-art update, as well as perspectives on future directions of research and clinical applications in the implementation of biomechanical and biophysical experimental, theoretical and computational models which are relevant to military medicine. Such experimental and modeling efforts are helpful, on the one hand, in understanding the aetiology, pathophysiology and dynamics of injury development and on the other hand in guiding the development of better equipment and protective gear or devices that should ultimately reduce the prevalence and incidence of injuries or lessen their hazardous effects. The book is useful for military-oriented biomedical engineers and medical physicists, as well as for military physiologists and other medical specialists who are interested in the science and technology implemented in modern investigations of military related injuries.

This thesis lays the groundwork for the automatic supervision of the laser incision process, which aims to complement surgeons' perception of the state of tissues and enhance their control over laser incisions. The research problem is formulated as the estimation of variables that are representative of the state of tissues during laser cutting. Prior research in this area leveraged numerical computation methods that bear a high computational cost and are not straightforward to use in a surgical setting. This book proposes a novel solution to this problem, using models inspired by the ability of experienced surgeons to perform precise and clean laser cutting. It shows that these new models, which were extracted from experimental data using statistical learning techniques, are straightforward to use in a surgical setup, allowing greater precision in laser-based surgical procedures.

An indispensable study guide to help surgical trainees prepare and perform for their fellowship exam.

"Examination Surgery" offers invaluable insight into the format and content of the Fellowship Examination in General Surgery.

This study guide addresses the most frequently encountered topics from the last 10 years of examinations. It helps surgical trainees organise their studies and optimise their performance in what is reputedly one of the most rigorous postgraduate exams.

The general surgery fellowship tests clinical wisdom, judgement, insight and safe practice, and "Examination Surgery's" preparation material accurately reflects what you will encounter in the exam.

Arranged to mirror the exam's individual components, "Examination Surgery" is divided into the following sections: The written papersClinical viva vocesSurgical anatomy viva voceOperative surgery viva vocePathophysiology and critical care and clinical reasoning viva voce

This Elsevier study guide is aimed at candidates preparing for the "Fellowship Examination in General Surgery of the Royal Australasian College of Surgeons." It is, however, also relevant for candidates in the UK, Ireland, Canada, South Africa and Hong Kong, plus all general surgeons, surgical residents and medical students.

The field of interventional bronchoscopy is rapidly expanding and has emerged as a new and exciting subspecialty in pulmonary medicine. To date, the impact of interventional bronchoscopy procedures has been felt in diagnosis, staging, and management of lung cancer, the most lethal cancer worldwide. Interventional Bronchoscopy: A Clinical Guide provides a state-of-the art description of interventional bronchoscopy procedures, addressing the scientific basis, indications, techniques, results, complications, and cost issues. Chapters address the current status, the advantages of new techniques and, most importantly, when to choose new techniques over the existing techniques. Each chapter will discuss the future of these procedures. Interventional Bronchoscopy: A Clinical Guide is an essential resource for a successful interventional pulmonology service and will be useful for the bronchoscopist, anesthesiologist, radiologist, thoracic surgeon and oncologist as well as practicing pulmonologists who do not perform these procedures but have to make decisions regarding appropriate referral of their patients to advanced airway centers.

In Diabetes and Peripheral Vascular Disease, a panel of distinguished leaders in the field of medicine, podiatry, and vascular and endovascular therapy assimilate the latest literature on these issues and others for an in-depth review of the management of peripheral vascular disease. Providing an overview of the management of diabetes and diabetic foot changes as well as providing a view of cutting-edge and emerging topics in optimization of arterial status, this important title addresses pathophysiology, anatomy, diagnosis and management of diabetic peripheral vascular disease, emphasizing a multi-disciplinary approach. The first chapter of the book provides an overview of this complex disease process and discusses the teamwork required for optimal management. The chapters continue with the basic pathophysiology of diabetic atherosclerosis and a contemporary review of the management of diabetes. The genesis of diabetic foot ulceration and prevention and management strategies is covered, as is the effects of neuropathy and microvascular changes in the diabetic foot. In addition, Diabetes and Peripheral Vascular Disease covers the microbiology of diabetic foot infections, the role of endovascular interventions and vascular surgery as well as the management of the complications of these procedures, the process of amputation for those patients who have progressed beyond a limb salvage situation, and the effects of diabetes on the cerebrovascular system as well as its implications in patients with aortoiliac disease. An invaluable addition to the literature on diabetes and peripheral vascular disease, the book will be of great interest internists, family practitioners, surgeons, podiatrists, wound care specialists, and vascular specialists. Students, residents, and fellows in surgical and medical specialties should also find this book of significant value and interest.

This atlas draws on a multidisciplinary approach to provide a comprehensive overview on endocrine disorders of the head and neck, with particular emphasis on the role of imaging and image-guided procedures. The first section discusses the basic characteristics of the imaging methods and other techniques used for evaluation and diagnosis. The remainder of the book focuses on application of these methods in thyroid, parathyroid, and other endocrine disorders of the head and neck. The coverage is wide ranging, encompassing Graves' disease, toxic multinodular goiter, toxic adenoma, thyroiditis, non-toxic goiter, benign nodules, and the different forms of thyroid carcinoma, as well as parathyroid adenoma, hyperplasia, and carcinoma and paragangliomas. Informative, high-quality images are provided by international experts in endocrine disorders, including endocrinologists, pathologists, radiologists, nuclear medicine physicians, and surgeons, who also discuss sample cases and provide syntheses of the relevant scientific literature.

Modern imaging methods have made it possible to detect breast cancer at an earlier stage than in the past. Nevertheless, a large majority of suspicious findings at screening subsequently prove to be benign. It is therefore important to be able to identify benign lesions in a manner that is reliable, tissue sparing, patient friendly, and cost-effective. More than 70% of breast biopsies can now be performed using minimally invasive procedures that meet these criteria. This book examines in detail vacuum-assisted minimally invasive breast biopsy systems (ATEC, EnCor, Intact, Mammotome and Vacora), stereotactic systems, MRI-guided procedures, and ductoscopy. Further chapters are devoted to the pathology of the breast tissue obtained using these procedures, their limitations, the implications of recent advances in breast imaging, and the results of cost-benefit analyses. The closing chapter provides a systematic review and meta-analysis of recent data.

Cardiac surgical procedures are among the most common and most complicated forms of surgery worldwide and the postoperative period is characterized by complex challenges. Among the factors determining ultimate clinical outcome, postoperative critical care is of major importance. This book adopts a clinical approach in explaining and analyzing the course of clinical care in patients undergoing cardiac surgery. Since the postoperative clinical status is directly influenced by preoperative and intraoperative factors, the early chapters briefly examine preoperative issues and the intraoperative course of cardiac surgery, with particular attention to anesthesia and the process of cardiopulmonary bypass. Subsequent chapters primarily address the critical care of patients by means of an organ-oriented approach, which will enable the reader to use the text as a "cookbook" of cardiac intensive care. This book is intended for use in daily practice by cardiac surgeons, cardiac anesthesiologists, intensivists and cardiac intensive care nurses.

Anemia, a frequent complication of cancer and its treatments, produces unwanted symptoms and significantly impairs metabolic and physiologic functions, as well as patients' activity, quality of life and even life expectancy. In its new Second Edition, this book presents current knowledge on anemia in cancer and its treatment with Recombinant Human Erythropoietin (rhEPO). Expanded, updated and newly added chapters describe scientific and clinical aspects of anemia, and give diagnostic and therapeutic recommendations on use of rhEPO. This is an essential source of information for radiotherapists, medical oncologists, hematologists, internists, pediatricians, surgeons, specialists in transfusion and laboratory medicine, and pharmacologists.

Since their first application in 1982, Totally Implantable Venous Access Devices (TIVADs) have become increasingly important in the clinical practice, as more intensive chemotherapy and parenteral treatments have come into use. At this time, there is objective evidence that TIVADs are a safe, effective strategy for long-term venous access; they play a significant role throughout the management of the oncology patient, as they are needed in the initial phases for active treatments as well as in the last stages for palliative measures, making possible repeated administration of chemotherapeutic vesicant agents, nutrients, antibiotics, analgesics, and blood products. According to a number of prospective studies, use of TIVADs is associated with a significant complication rate (10% to 25% of all patients). Evidence-based data support that most complications are directly related to inappropriate technique of placement and/or nursing care, sometimes leading to TIVAD loss, significant morbidity, increased duration of hospitalization, and additional medical cost. A group of world-renowned experts - both in the clinical and research fields - contributed to this volume, whose aim is to provide clinicians, nurses and medical students with a multidisciplinary, full update on these devices, as long term central venous access can no be longer considered a routine matter, and serious complications can be maintained at a very low level only if strict adherence to a well-defined protocol of surgical technique and of catheter care is maintained.

Head and neck pathology is increasingly becoming an attractive field for the new generations of pathologists, fully aware that in the era of specialization the information contained in the treatise of general surgical pathology, although extremely valuable to create the basis of their knowledge, does not provide in its full picture the specific knowledge required to meet current diagnostic and prognostic requirements. The book Pathology of the Head and Neck presents in a single volume the most pertinent and updated information needed by the interested readers. Its contents have been divided into ten chapters. The first one covers the spectrum of precursor and neoplastic lesions of the squamous epithelium. It is followed by chapters devoted to nasal cavities and paranasal sinuses, oral cavity, maxillofacial skeleton and teeth, salivary glands, nasopharynx and Waldeyers ring, larynx and hypopharynx, ear and temporal bone, neck and neck dissection, as well as eye and ocular adnexa. The authors of the different chapters have been selected among internationally recognized experts, all of them members of the Working Group on Head and Neck Pathology of the European Society of Pathology.

The Training Courses of Urological Laparoscopy is written by an international team of experts who have come together to share their experiences of training and skills acquisition in Urological Laparoscopy. Skills training and certification are needed to protect both patient and doctor from the pitfalls of uncertified practice. This comprehensive text focuses on the details of laparoscopic training within the field of urology from step-by-step guidance on the use of basic stems in the dry lab through to hints and tricks for problem solving in more complex scenarios. The Training Courses of Urological Laparoscopy is an essential text for Urologists and residents in training.

In this guidebook, international authorities review the current nonsurgical and surgical therapeutic options for dealing with Peyronie's disease. A variety of state-of-the-art research techniques is discussed. As the first medical text on the subject, this book provides an up-to-date summary of the etiology, natural history, and pathophysiology of this disease. Also discussed are the many misconceptions about Peyronie's disease.

Male Infertility: Problems and Solutions provides a summary of state of the art developments in male infertility for both new and experienced practitioners. Written in a clear, concise and readable style, this volume allows the reader to obtain rapid answers to this challenging medical issue. Special emphasis is placed on diagnostic and treatment algorithms. Topics covered include interpretation of semen analysis and advanced testing, endocrine and genetic evaluation, diagnosis of azoospermia as well as an up-to-date interpretation and analysis of the many new therapies available for the treatment of male factor infertility. Male Infertility: Problems and Solutions provides rapid acquisition of pertinent background and development of management plans through the use of concise discussion and treatment algorithms and thus will be of great value to general urologists, gynecologists, primary care providers and allied health providers who manage infertility in both men as well as women.

GU-ITIS is a compilation of expert creativity and opinion based upon critical review of the literature, consensus reports and the author's professional experience. Inflammation and pain caused by infectious etiologies are presented by experts in urological and gastrointestinal fields. Pain syndromes specific to the pelvic floor or genitourinary system are discussed from several perspectives. The book also includes chapters addressing iatrogenic causes of GU inflammation. Management by means of pharmacological, surgical or alternative methods are likewise presented within the context of specific disease entities, as well as separate therapeutic chapters.

This manual covers all aspects of endoscopic surgery of the lacrimal drainage system. Step-by-step descriptions are provided of endoscopic dacryocystorhinostomy (DCR) and its use in revision surgery, accompanied by numerous helpful photographs and anatomical drawings. In addition, clear flow charts are included to aid in diagnostic and surgical decision making and identify surgical indications. Essential information is provided on anatomy, physiology and pathology and an individual chapter is devoted to imaging of the lacrimal drainage system. Further topics include lacrimal probes and stents, potential complications of surgery, and endoscopic DCR in the pediatric age group. This book will assist the practitioner in negotiating the steep learning curve involved in gaining the skills needed to perform endoscopic surgery of the lacrimal drainage system, which offers significant advantages in terms of avoidance of external incisions and maintenance of the lacrimal pump.

This volume provides a comprehensive, state-of-the art review of inflammatory bowel disease and its management through the use of telemedicine applications. The book reviews barriers to successful outcomes in patients with IBD and offers a rationale for how self-management and telemedicine approaches can improve care in chronic illnesses such as IBD. This volume also includes a summary of the burden of telephone encounters in patients with IBD, characteristics of frequent callers to the office, outcomes associated with high telephone use, and strategies to provide education via telephone to patients with IBD. Prior literature on implementation of teleconsultation in research and clinical practice, as well as mobile applications used to track symptoms, quality of life, diet, and medication use in IBD are also explored in the book. Written by experts in the field, Telemanagement of Inflammatory Bowel Disease is a valuable resource for gastroenterologists, surgeons, a nd other clinicians dealing with, and interested in, this novel adjunct to routine care for inflammatory bowel disease.

This atlas demonstrates all components of the body through imaging, in much the same way that a geographical atlas demonstrates components of the world. Each body system and organ is imaged in every plane using all relevant modalities, allowing the reader to gain knowledge of density and signal intensity. Areas and methods not usually featured in imaging atlases are addressed, including the cranial nerve pathways, white matter tractography, and pediatric imaging. As the emphasis is very much on high-quality images with detailed labeling, there is no significant written component; however, 'pearl boxes' are scattered throughout the book to provide the reader with greater insight. This atlas will be an invaluable aid to students and clinicians with a radiological image in hand, as it will enable them to look up an exact replica and identify the anatomical components. The message to the reader is: Choose an organ, read the 'map,' and enjoy the journey!

Uncommon tumors of the pancreas are of increasing interest for clinicians: cross imaging techniques development makes it possible to detect small lesions in the pancreatic gland of asymptomatic patients, and in the last decades a more detailed and specific pathological classification definitivelyopened an unexpected world of more or less rare pancreatic tumors. As a matter of fact, nowadays most surgical procedures deal with these so called uncommon pancreatic tumors such as cystic, endocrine and others unfrequent histotypes, and many patientsexperiencing an accidental discovery of this type of tumor need therefore a specialistic evaluation. The concept behind this volume is the need to give the correct clinical relevance to these "uncommon" tumors, that are ranked at the first place among pancreatic tumors, and that are definitively curable with a multimodal approach. Aim of the book is therefore to get clinicians closer to these pathologies, describing their complexity and the current state of the art in diagnostic, therapeutic and pathological classification strategy, thus providing them with the tools for a modern and updated clinical management of these patients.

Die längere Lebenserwartung von Dialysepatienten und die Zunahme von Diabeteserkrankungen führen dazu, dass Shuntoperationen öfter und häufig wiederholt durchgeführt werden müssen. Ausgehend von seiner langjährigen klinischen und wissenschaftlichen Arbeit auf dem Gebiet der Shuntchirurgie beantwortet der Autor Fragen zur Auswahl des individuell sinnvollsten Eingriffs und zur Beherrschung von Komplikationen. Der Band enthält über 300 detaillierte Zeichnungen zum Prinzip der einzelnen Eingriffe und zum operativen Vorgehen.