This book will enable the reader to gain a sound understanding of contemporary and futuristic evidence-based interventions and assessment procedures for pelvic floor disorders. It gathers the experiences of some of the most important experts on electrical stimulation techniques, offering a multidisciplinary and problem-oriented approach organized according to therapeutic goals. Interventions are recommended that are consistent with theory and display clinical efficacy for specific disorders, including urinary incontinence or retention, fecal incontinence, constipation, pelvic pain, sexual dysfunction and neurological diseases involving the pelvic floor. All of the surgical or rehabilitative techniques requiring electrical stimulation for the treatment of these disorders are explored and essential background information is provided on functional anatomy, neurophysiology and concepts in electrotherapy. This volume will be a very useful tool for urologists, general or colorectal surgeons, gynecologists and anesthesiologists and also physiotherapists and alternative medicine practitioners (a specific chapter focuses on electroacupuncture). It will assist in their clinical practice as they seek to help the very many patients who suffer from any of the wide range of functional pelvic floor disorders.

This is the first book to cover all currently available methods to manage pre-, intra- and post-lacrimal sac stenosis. Comprehensive multidisciplinary approaches in adults and children are described. International experts provide a stepwise analysis and describe the clinical management of these patients with detailed medical and surgical treatment plans. With this guide's highly structured and reader-friendly format, the reader will be able to solve any problem that may occur with the reconstruction of a disturbed or damaged lacrimal system.

This text provides a state of the art overview of tools for guiding surgeons in the modern operating room. The text explains how many modalities in the current armamentarium of radiologic imaging have been brought to the operating room for real time use. It also explains the current use of near infrared, fluorescent, and chemo-luminescent imaging to guide minimally invasive and open surgery to improve outcome. The book is separated into two sections. The first, discusses the biologic principles that underlie novel visualization of normal organs and pathology. The currently available equipment and equipment anticipated in the near future is covered. The second section summarizes current clinical applications of advanced imaging and visualization in the OR. Novel means of visualizing normal anatomic structures such as nerves, bile duct, and vessels that enhance safety of many operations are covered. Novel biologic imaging using radio-labeled and fluorescent-labeled molecular probes that allow identification of inflammation, vascular abnormalities, and cancer are also discussed.Authored by scientists who pioneer research in optics and radiology, tool makers who use this knowledge to make surgical equipment, and surgeons who innovate the field of surgery using these new operative tools, Imaging and Visualization in the Modern Operating Room is a valuable guide for surgeons, residents and fellows entering the field.

This book offers a complete overview on non colorectal non neuroendocrine (NCRNNE) liver metastases and describes in detail the currently available therapies. Each chapter focuses on the treatment of metastases from a particular primary malignancy and also provides valuable information on incidence, natural history and diagnosis. NCRNNE liver metastases are rare entities compared with colorectal and neuroendocrine metastases, for which the treatments are well codified. While more publications have appeared on the topic in recent years, an in-depth study has to date been lacking. Furthermore, most published series are insufficiently comparable as they comprise patients with NCRNNE hepatic metastases from a variety of primary malignancies and consequently overlook differences in tumor behavior, frequency of isolated hepatic metastases, response to neoadjuvant or adjuvant therapy and interval between diagnosis of the primary tumor and the liver metastases. This book, with its more specific approach, will serve not only as an up-to-date guide to diagnosis and treatment but also as a reference on which to base future studies.

Endovascular neurosurgery is a recently introduced but rapidly evolving medical field, which uses minimally invasive interventions to treat major life-threatening vascular lesions of the Central Nervous System. Although its history counts less than 15 years of worldwide acceptance, it has rapidly displaced the traditional open neurosurgical techniques, being nowadays the first treatment choice for brain aneurysms and vascular malformations. Thus, the experience of each neuroendovascular center and performer is invaluable, offering the base for learning and teaching the new generation of interventionalists as well as for the evolvement of the method itself. This book presents the basic principles of endovascular neurosurgery starting from clinical cases. Through this close-to-clinical-reality-process, the reader will be able to more thoroughly understand the pathophysiology of the brain and spine vascular lesions as well as the decision-making strategy, related to the indications, endovascular methods and results, finding suggestions and solutions to his/her clinical questions and problems. Besides chapters devoted to CNS vascular embryology and anatomy, clinical cases organized in groups based on the treated lesions are introduced: ruptured and unruptured cerebral aneurysms of the anterior and posterior circulation, side-wall and bifurcation aneurysms, arteriovenous malformations (AVM), dural arteriovenous fistulae (dAVF), arterial stenosis and angioplasty as well as spinal vascular lesions. A separate chapter is devoted to the organization and necessary equipment of the angio room and the department offering neuroendovascular service. This volume will be of interest to neurosurgeons, interventional neuroradiologists, vascular surgeons, neurologists and ICU physicians as well as health care providers who are involved in the diagnosis and management of the vascular lesions of the brain and spine.

The increasing prevalence of morbid obesity has led the World Health Organization to coin the descriptive term "globesity" to reflect the worldwide nature of the problem. Providing health care to these patients, especially when surgery is required, can be extremely challenging owing to the specific needs in respect of logistics, facilities, and professional expertise. Appropriate care has to date often been unachievable and unaffordable outside of established bariatric centers, but such centers themselves usually have insufficient capacity and resources to cope with the demand among the general population. This book therefore provides a wealth of guidance and helpful tips and tricks on how to deal with obese patients within a general surgery setting. Importantly, it highlights the need for global rethinking on public health as regards resource allocation and patterns and standards of care, with the ultimate goal of improving outcomes through greater affordability.

Andreas Bihlmaier describes a novel method to model dynamic spatial relations by machine learning techniques. The method is applied to the task of representing the tacit knowledge of a trained camera assistant in minimally-invasive surgery. The model is then used for intraoperative control of a robot that autonomously positions the endoscope. Furthermore, a modular robotics platform is described, which forms the basis for this knowledge-based assistance system. Promising results from a complex phantom study are presented.

This book describes the current applications of the robotic system in general surgery, focusing on the technical aspects of the procedures most commonly performed by this means. It provides a comprehensive overview of the state of the art in robotic surgery and presents the most recently available evidence as documented in the literature. The opening chapters review robotic platforms, discuss the general advantages, limitations, and strategies of robotic surgery, and identify challenges and critical elements when setting up a robotic program. The full range of applications of the robotic system is then covered, encompassing thoracic, esophageal, gastric, hepatobiliopancreatic, splenic, colorectal, endocrine, and transplantation surgery. Detailed attention is also paid to innovative applications and future trends in the robotic platform, with inclusion of a special chapter on fluorescence imaging during robotic procedures. The book closes by considering aspects related to credentialing and privileging, such as mentoring, proctoring, and teaching modules for residents and fellows. Against the background of increasing acceptance of the robotic surgery system across the globe, this book will be invaluable for all general surgeons. There is no doubt that within general surgery the system will continue to flourish on account of its undoubted technical advantages, which minimize most of the intrinsic shortcomings of laparoscopy.

Surgical robotics is a rapidly evolving field. With roots in academic research, surgical robotic systems are now clinically used across a wide spectrum of surgical procedures. Surgical Robotics: Systems Applications and Visions provides a comprehensive view of the field both from the research and clinical perspectives. This volume takes a look at surgical robotics from four different perspectives, addressing vision, systems, engineering development and clinical applications of these technologies. The book also: -Discusses specific surgical applications of robotics that have already been deployed in operating rooms -Covers specific engineering breakthroughs that have occurred in surgical robotics -Details surgical robotic applications in specific disciplines of surgery including orthopedics, urology, cardiac surgery, neurosurgery, ophthalmology, pediatric surgery and general surgery Surgical Robotics: Systems Applications and Visions is an ideal volume for researchers and engineers working in biomedical engineering.

This volume provides a comprehensive review and detailed description of surgical techniques for prostate cancer surgery. All aspects are covered, including surgical anatomy and methods of transrectal ultrasound guided prostate biopsies, step-by-step approach techniques for radical prostatectomy, and the latest data on outcomes. Furthermore, limitations as well as tips and tricks are detailed in addition to management of common complications. Lastly, with the increasing use of ablative therapy and brachytherapy, the mechanism of action as well as the keys to obtaining optimal outcomes are illustrated. Surgical Techniques for Prostate Cancer is a concise and valuable resource to surgeons that documents the different approaches to prostate cancer surgery.

Single Incision Laparoscopic and Transanal Colorectal Surgery provide a comprehensive and state-of-the art review of single incision laparoscopic and transanal colorectal surgery. The text concentrates on surgical techniques and tricks in single incision laparoscopic and transanal surgery with detailed descriptions of the techniques, as well as indications and limitations of the procedures. The newly available evidence on these procedures is emphasized and all procedures are richly illustrated with diagrams and photos. Written by experts in their fields, Single Incision Laparoscopic and Transanal Colorectal Surgery is valuable resource for general surgeons, colon and rectal surgeons, laparoscopic GI surgeons, surgical residents and fellows in training interested in these two rapidly developing fields in colorectal surgery.

This book, written by expert surgeons, offers a comprehensive and up-to-date overview of all aspects of laparoscopic cholecystectomy. Coverage includes the indications for surgery, anesthesia, surgical technique, and the prevention and management of complications, with extensive reference to the latest clinical evidence and assessment of the benefits of the laparoscopic approach, for example in terms of outcomes and day surgery. New technologies, including SILS, NOTES, robotic surgery, and miniaturized instruments, are reviewed. The learning curve and training are also extensively discussed, and an individual chapter is devoted to the views of international experts in the field. Readers will find the book to be an ideal guide to this gold standard technique, which continues to evolve some 20 years after the National Institutes of Health Consensus Conference first published recommendations regarding indications for laparoscopic cholecystectomy.

Single-access laparoscopic surgery (SALS), performed using a single transumbilical access, has recently proved to bring advantages over other forms of laparoscopic surgery due to the reduction in the number of incisions and the consequent decrease in morbidity, less blood loss and postoperative pain. Furthermore, cosmesis may be improved because incision within the umbilicus renders surgery virtually scarless. Nevertheless, as with all new surgical concepts, questions may be raised regarding safety, usefulness and appropriateness. This book analyzes the use of SALS for different indications and abdominal surgical procedures based on a careful literature review of the experience of the most important surgical teams employing this approach and also the authors' personal observations. The coverage is broad, encompassing, for example, the role of SALS in appendectomy, repair of abdominal wall defects, cholecystectomy, gastric surgery, nephrectomy, splenectomy, hemicolectomy and pancreatic, liver and gynecological surgery.

Surgical Management of Benign Esophageal Disorders: The "Chicago Approach" covers all stages of the diagnosis and treatment of the most common benign esophageal disorders in a concise and easy-to-read format.Indications, patient preparation, operative techniques, and strategies for avoiding and managing complications are included and based both on evidence-based data and the experience of the most famous esophageal surgeons in the United States and abroad. Each chapter includes a summary of the current management strategy for the disease process, and a review of current state of the art techniques provided by world leaders on esophageal disease, surgeons and gastroenterologists alike. A special emphasis is given to emerging procedures in laparoscopy, thoracoscopy, and endoscopy. Surgical Management of Benign Esophageal Disorders: The "Chicago Approach" is illustrated throughout with line diagrams that depict fundamental anatomic or technical principles and is a valuable resource for surgeons and gastroenterologists in residence and training.

Thoroughly discussing the varied elements of meniscal damage and repair, Meniscal Injuries: Management and Surgical Techniques includes the insights and expertise of over 20 leading surgeons and researchers on topics ranging from meniscal anatomy, physical examination, innovative resection and repair techniques, gene therapy, and tissue regeneration. This treatise offers wisdom aimed at assessing true surgical candidates, exploring the intricacies of meniscal composition and function, an overview of meniscal scaffolds and replacements, and patient examination pearls. Also discussed in depth is cutting edge research concerning meniscal repair enhancement, nanofiber technology as a means of meniscal replacement, and biologic agents directed toward chondral protection. All the science presented will direct the sports medicine practitioner to state-of-the-art treatment aimed at knee preservation. Meniscal repair and regeneration is a rapidly evolving science - early attempts at meniscal restoration or repair resulted in short-term gains which often sacrificed long-term joint integrity. Now, the practitioner is afforded numerous means of retaining or restoring meniscal tissue. Breakthroughs in scaffold and allograft replacement, as featured herein, offer the promise of articular cartilage preservation like never before. In addition, tissue regeneration and gene therapy techniques, featured throughout, offer a glimpse into emerging technologies aimed at preserving or replacing meniscal tissue in previously considered "hopeless" cases. As such, Meniscal Injuries will be an indispensible resource to orthopedic surgeons and sports medicine practitioners interested in providing the absolute most contemporary and evidence-based care to their patients.

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.

Attachment of dissimilar materials in engineering and surgical practice is a perennial challenge. Bimaterial attachment sites are common locations for injury, repeated injury, and mechanical failure. Nature presents several highly effective solutions to the challenge of bimaterial attachment that differ from those found in engineering practice. Structural Interfaces and Attachments in Biology describes the attachment of dissimilar materials from multiple perspectives. The text will simultaneously elucidate natural bimaterial attachments and outline engineering principles underlying successful attachments to the communities of tissue engineers and surgeons. Included an in-depth analysis of the biology of attachments in the body and mechanisms by which robust attachments are formed, a review of current concepts of attaching dissimilar materials in surgical practice and a discussion of bioengineering approaches that are currently being developed.

In the age of the World Wide Web, informed patients continue to surprise oncologists with detailed questions about popular tumor therapies. Although minimally invasive tumor therapies (MITT) have become daily clinical practice for palliative treatment of liver tumors, the acceptance of these palliative modalities still varies enormously. This book gives an up-to-date overview of the popular techniques and clinical results of MITT, with a clarification of the actual indications including the size, tumor entities, and clinical benefits. Moreover, the book focuses on the prospectives and limitations of imaging methods used for MITT.

The future of surgery is intrinsically linked to the future of computational sciences: the medical act will be computer assisted at every single step, from planning to post-surgery recovery and through the surgical procedure itself. Looking back at the history of surgery, surgery practice has changed drama- cally with the extensive use of revolutionary techniques, such as medical imaging, laparoscopy, endoscopy, sensors and actuators, and robots. This trend is dependent on the use of computer processing, computational method, and virtualization. Computational surgery will not only improve the ef?ciency and quality of surgery, but will also give new access to very complex operations that require extreme precision and minimum intrusion. Such examples are today's inoperable cancer tumors that have invaded critical tissues or nervous centers. In order for this milestone to be reached quicker and more ef?ciently, surgeons will have to become very familiar with computing methods, such as image analysis, augmented re- ity, and/or robotics. It will be critical for surgeons to assimilate computers in their training, understand how computers work, understand the limitations/advantages of these computer tools, and be able to interpret computer imaging and simulations.

Responding to the growing demand for minimally invasive procedures, this book provides a comprehensive overview of the current technological advances in image-guided surgery. It blends the expertise of both engineers and physicians, offering the latest findings and applications. Detailed color images guide readers through the latest techniques, including cranial, orthopedic, prostrate, and endovascular interventions.

Microsurgery for Fertility Specialists is an invaluable resource for physicians who specialize in the surgical treatment of male and female infertility. This practical text explains the basics of microsurgery and provides detailed operative descriptions of surgical procedures such as vasectomy reversal, sperm retrieval, tubal reanastomosis, and penile surgery. An exceptional cadre of reproductive specialists shares valuable knowledge of the current state of microsurgery, its role in infertility procedures, and the latest advances in the field --including some non-infertility microsurgical techniques. The book is an essential educational guide for those with a more advanced knowledge of microsurgical practice as it includes chapters that will help them mentor residents and fellows, and inspire future generations of reproductive surgeons.

Gastrointestinal bleeding is an age-old problem. The original description of g- trointestinalbleedingmayhavebeenfromGalenandhisworkconnectingdyspepsia andmelanoticstool. Thechangesinourmanagementofgastrointestinalbleeding overthecenturieshavebeendrivenbynaturalalterationsinthespectrumofdiseases, expanding our understanding of these diseases and the never ending advances in technologyandpharmacologythathaveoccurredrelativetoGIdiseases. Academic interestingastrointestinalbleedingpeakedinthelasthalfofthetwentiethcentury withtheexpandingroleofsurgery,thediscoveryofacid-basedpepticulcerthe- pies,andtheriseof?exibleendoscopyandculminatedinthedescriptionofh. pylori as a causative agent for ulcer disease. More recently there has been a decrease incidenceinbleedingdiseasesofthegutandthereforeadecreasinginterestinthe scholarlywritingaboutthesediseases. Therehasnotbeenamajortextbookwritten aboutgutbleedinginover10yearsandthereforetheintentionofthistextbookisto ?llthatvoidbyprovidingareviewofacomprehensiveapproachtouppergut,mid, andlowergutbleeding. CliniciansatDukeUniversitywhohaveacommoninterestinthegastrointes- naltracthavecollaboratedintheconstructionofthistext. Thisefforthasbrought together surgeons, gastroenterologists, and radiologists, to carefully chronicle the presentation, diagnosis, and management of modern day causes of gastrointes- nal bleeding. These co-authors concentrate on some of the latest innovations in the endoluminal and minimally invasive techniques that characterize the current approaches to these diseases. Emphasis has been placed on capsule endoscopy, double-balloon endoscopy, laparoscopic peptic ulcer surgery, and angiographic diagnosis and management techniques. The text has been written in such a way thatthereadercanquicklyreviewaspeci?ccauseofGIbleedingpriortomanaging ofsuchapatient. Weexpectthistextwillbeusedwiththesameimmediacyasthe diseasespresent. Wehopethatthistextprovidesafoundationforlearningformedicalstudents, interns,residents,andpractitionerswhoencounterthesecriticallyillanddif?cultto managepatients. Durham,NC,USA AuroraD. Pryor Durham,NC,USA TheodoreN. Pappas Durham,NC,USA MalcolmStanleyBranch v Acknowledgment TheeditorswouldliketothankMs. VirginiaCashforherhelpinthepreparation andcoordinationofthetext. vii Contents Part I Upper GI Bleeding Stabilization of Patients Presenting with Upper Gastrointestinal Bleeding. ..3 ErrolL. BushandMarkL. Shapiro Urgent Workup for Upper Gastrointestinal Bleeding...13 LorettaErhunmwunseeandSandhyaA. Lagoo-Deenadayalan Management of Esophageal Variceal Bleeding ...23 KekiBalsaraandLisaPickett Management of Dieulafoy's Lesions ...31 SerainaK. Faes,BrianR. Untch,ClaireEdwards,JohnTurner, MartinPoleski,andDouglasS. Tyler Management of Bleeding Peptic Ulcer Disease ...39 JamesC. PadussisandTheodoreN. Pappas Management of Unusual Sources of Upper GI Bleeding...65 ElisabethTracyandJanetTuttle-Newhall Mallory-Weiss Syndrome...79 JacobN. SchroderandMalcolmS. Branch Management of Bleeding Small Bowel Tumors...85 KeriE. LunsfordandAuroraD. Pryor Management of Bleeding from the Bile Duct ...103 CarlosE. MarroquinandBridgetM. Marroquin Management of Bleeding from the Pancreas...

This volume focuses on the biomechanical modeling of biological tissues in the context of Computer Assisted Surgery (CAS). More specifically, deformable soft tissues are addressed since they are the subject of the most recent developments in this field. The pioneering works on this CAS topic date from the 1980's, with applications in orthopaedics and biomechanical models of bones. More recently, however, biomechanical models of soft tissues have been proposed since most of the human body is made of soft organs that can be deformed by the surgical gesture. Such models are much more complicated to handle since the tissues can be subject to large deformations (non-linear geometrical framework) as well as complex stress/strain relationships (non-linear mechanical framework). Part 1 of the volume presents biomechanical models that have been developed in a CAS context and used during surgery. This is particularly new since most of the soft tissues models already proposed concern Computer Assisted Planning, with a pre-operative use of the models. Then, the volume addresses the two key issues raised for an intra-operative use of soft tissues models, namely (Part 2) "how to estimate the in vivo mechanical behavior of the tissues?" (i.e. what are the values of the mechanical parameters that can deliver realistic patient-specific behavior?) and (Part 3) "how to build a modeling platform that provides generic real-time (or at least interactive-time) numerical simulations?"

The field of minimally invasive surgery (MIS) has now taken centre stage in modern clinical practice. With ever changing technologies in the field of MIS, such as robotics, there is now the need to train the surgeon to the next degree. Training by simulation, whether virtual, hybrid, or real, allows the surgeon to rehearse, learn, improve or maintain their skills in a safe and stress free environment.

"Simulation Training in Laparoscopy and Robotic Surgery" gives a true insight into the latest educational and learning techniques for new technologies in surgery. Written by an international team of experts, this illustrated text provides advice on specialised team training, non technical skills and simulation.

"Simulation Training in Laparoscopy and Robotic Surgery" is an important training aide for surgeons and residents interested in developing skills in this field.

"

Advances: H. Duffau: Subpial dissection and subcortical mapping with vasculature and white matter pathways preservation in surgery for brain (low grade) gliomas. - F. Scholtes, G. Brook, D. Martin: Spinal cord injury and its treatment: current management and experimental perspectives. - M. Sindou, M. Messerer, J. Alvernia, G. Saint-Pierre: Percutaneous Biopsy through the Foramen Ovale for Parasellar lesions: Surgical anatomy, Method and Indications. - Technical Standards: C. Raftopoulos, F. Waterkeyn, E. Fomekong, T. Duprez: Percutaneous pedicle screw implantation with robotic intraoperative 2D/3D fluoroscopy for refractory low back pain. I. Zemmoura, S. Velut, P. Francois: The choroidal fissure: anatomy and surgical implications. I. Timofeev, T. Santarius, A.G. Kolias, P.J.A. Hutchinson: Decompressive craniectomy operative technique and perioperative care. - S Fauser, J Zentner: Management of complex cortical dysplasia in epilepsy

"