Endoanal and endorectal ultrasound represents considerable progress in the field of anorectal imaging. Its importance in the staging of rectal and anal cancer, in identifying perianasto- motic neoplastic recurrences, in defining acute and chronic suppurative disease and in assessing sphincteral anatomical integrity, is now a confirmed reality. The evidence provided by endoanal and endorectal ultrasonography guides the colorectal surgeon in his choice among the various therapeutic approaches and helps in assessing the effects of the treatments applied. The great flexibility and high degree of reliability make this exploratory method an indispensable tool at all stages of the clinical course in the majority of patients with anorectal problems, including the fundamental follow-up stage. The publication of this excellent volume on intraanal and intrarectal ultrasonog- raphy is therefore to be appreciated, especially since it is in the form of an atlas. As we are dealing with imaging, it is particularly appropriate that it is the images that tell the story. Like all important things, this volume does not come out of nothing. It is the result of many years of skilled work by Drs. G.A. Santoro and G. Di Falco and is based on the experience of internationally renowned professional experts. The ten sections of the atlas begin with general information on ultrasonography, gradually progressing to the technical problems of the method and the aspects rela- tive to anorectal tumors.This last section leads to a review of traditional and mod- ern therapeutic possibilities.

Laparoscopy in combination with laparoscopic ultrasonography is a new staging procedure for tumors of the abdomen. The treatment of several other tumor entities, such as pancreatic and gastric cancer, lymphoma, ovarian cancer, liver malignancies, is also improved by more accurate staging. Laparoscopic staging helps prevent unnecessary laparotomies, provides much less trauma to the patient, maximum information on tumor spread, and enables palliative procedures to be performed during the staging procedure. This book provides detailed guidelines on the aim and technique of laparoscopic staging and discusses the pathophysiological aspects and risks of laparoscopic staging (such as trocar metastases) on the basis of international experience.

Enormous developments have been made in ophthalmology during the last century. Higher precision and newer instrumentation in surgery as well as better examination methods and progress in microbiology have given us access to much more information about the pathological physiology and anatomy that we are confronted with in our various fields of expertise. As we have approached a new millennium we decided to capture some of these new ideas and incorporate them into a conference where we could share our work and benefit from each others' experiences. This book is based on contributions nd presented at the "2 International Conference on Vitreoretinal Diseases" which was held in September 2002 in Vienna, Austria which focused on the retinal macula. The meeting was very fortunate to have the world's most renowned leaders in macular research attend and share their vast experience and expertise as well as their latest research and results. This meeting followed the "First International Conference on Vitreoretinal Diseases" which was held in Vienna, Austria in 1998, and focused on retinal transplantation and retinal microsurgery. nd After the great success of the "2 International Conference on Vitreoretinal Diseases" an overwhelming interest was expressed to gather all these new and innovative ideas that had been developed in a book in order to give colleagues and students access to a valu able collection of the information presented at the meeting. This international meeting was administrated by, Mrs. Tilly and Mr.

This is a unique book in that it brings together the two key investigative techniques in Gynaecology and Obstetrics, namely ultrasound and endoscopy. So often in the past they were regarded by their exponents as rival techniques but it is now recognised that they are complementary to each other. Consequently future trainees in endoscopy should become efficient in transvaginal sonography and vice versa. Ultrasound can be used to study the morphology of the pelvic organs such as the endometrium, myometrium and ovaries, and being non-invasive, safe and convenient can be repeated as often as is deemed necessary to monitor changes over time; for example in the investigation of the infertile woman the development of the dominant follicle, the maturation of the endometrium and the formation of the corpus luteum can be documented throughout the menstrual cycle while growth of ovarian cysts can be precisely measured to determine the need for surgery. A seldom-mentioned strength of the ultrasound examination is its interactive quality, for example by performing abdominal palpation during the scan, the mobility of the uterus and ovaries can be assessed. Also the images as they appear can be shown to the patient to aid understanding. Ultrasound can also determine function and the use of Doppler has been used for example to access endometrial receptivity, follicular maturity and the likelihood of malignancy in the endometrium or ovary.

This book attempts to combine many different threads into a comprehensible whole. Since the subject is the Gamma Knife and the author is a neurosurgeon, the field of clinical interest is restricted to intracranial pathology. The discipline of radiosurgery now applies to patients who may reasonably be referred by internists, neurologists, otolaryngologists, endocrinologists and several others. Some of the topics, touched upon, such as stereotaxy and the construction of a radio surgical instrument are unfamiliar to the majority of medical men. Other topics, such as those pertaining to the reactions between radiation and living tissue, are not exactly unfamiliar and yet, for most of us, they are not comfortable areas of expertise: in that we have some basic knowledge but not enough to draw conclusions and interpret. In particular, it is not easy to answer the very sensible questions that patients ask, when being considered for this particular form of treatment. The author has attempted to describe the basic relevant phenomenology in terms that should be readily understandable to a non-specialist physician. To do this, he has been heavily dependent on the expertise of a number of mathematically sophisticated collaborators, who have checked his manuscript. They are named in the acknowledgments section. The relevance of the different sections of this book will naturally be assessed differently, according to the experience and interest of the reader. To simplifY access to the information that is required, the book is divided into three main sections.

An International Conference on "Neurosurgical Training and Reserach" was held in Munich from October 6 - 9, 1996, under the auspices of the EANS, and organized by H.-J. Reulen and H.-J. Steiger. Experts from different countries and neurosurgical organizations have collected information on the present status of resident training in neurosurgery and the mechanisms involved with the training. Various aspects, the recruitment process, the criteria used for selection, the contents and structure of a program, the continuous quality control, exposition to the art of research, fellowships and subspeciality training, etc. have been covered. The present book contains this material and thus provides a unique and comprehensive source of information on the complex of modern neurosurgical training. " ... The beauty of this work is that it puts in one place the many varied aspects of a neurosurgical training program that one needs to be aware of ... should be required reading for the faculty of any academic training program as well as for others who may have a misconception of what residency training is ... an excellent book for any program director or active faculty member. It should be required reading for all faculty members before the next round of resident interviews ..." Neurosurgery "... well edited, published to a high standard and will naturally be of interest to those specifically involved in the areas of selection and training ... a useful text for aspirants to surgical training posts ..." British Journal of Neurosurgery

Filling a gap in the anatomical and ENT literature, the authors show the various approaches to the middle ear which allow safe surgical manipulations, such as through the tympanic membrane or the Eustachian tube.

In the 5 years since the publication of Urologic Laparoscopy by the Japanese Society of Endourology and ESWL, the field has moved on apace, particularly technologically. It is with an eye on the need to disseminate the latest information on this progress that this collection has been assembled, highlighting the most recent advances in laparoscopic urologic oncology surgery. With treatment options becoming ever more complicated, it is essential to keep the prime objectives in mind - improved quality of life for the patient, minimal complications, early convalescence, and a better end result. In our effort to cover a broad range of techniques from renal cyst decortication to robotic laparoscopic camera control, we are in debt to surgeons at the forefront of treatment, not only in Japan but worldwide, and to manufacturers who are constantly innovating in their equipment. The contributors are enthusiastic in their expertise, as shown in the quality of the material they have produced.

Recent Advances in Coloproctology provides a thorough overview of modern developments in the surgical treatment of disorders of the lower intestine including ulcerative colitis/severe acute colitis, Crohn's disease, carcinomas, haemorrhoids and anal incontinence. Recognizing that the surgeon does not work in isolation, the book also integrates recent progress in imaging techniques for the anal canal and rectum, and highlights medico-legal considerations in separate chapters. Aimed at current practitioners and trainees, Recent Advances in Coloproctology discusses key concepts that will assist general surgeons and colorectal consultants in their management of patients with a broad spectrum of anorectal and colonic disorders. With a problem-oriented slant, this book is essential reading for all those with interest in coloproctology.

Technology seems to be an integral part of modern living. Urologists have over the years embraced new technological advances for patient beneft. On some occasions, however, the initial enthusiasm in something new has failed to endure rigorous scientifc scrutiny. Thus, while being technological leaders, we urologists know better than most other surgical speci- ties that what is new is not necessarily good. This textbook is aimed at urologists and surgeons at all levels and has contributions from international experts. The topics vary from robotics to lasers to single port laparoscopy. The comprehensive chapters should be of equal interest to uro-oncologists and those involved in treating benign urological diseases. While the contents are meant to bring the reader up to date with technological advances, the authors have attempted to balance their enthusiasm with basic science, translational research, and clinical outcomes. It will be obvious that some of the s- jects mentioned here, such as nanotechnology, are still evolving, and it will be a while before they undergo clinical trials that establish their position in clinical medicine. We hope you enjoy reading this book as much as we have enjoyed creating it. London, UK Prof. Prokar Dasgupta Dublin, Ireland Prof. John Fitzpatrick London, UK Prof. Roger Kirby CA, USA Prof. Inderbir S. Gill vii Acknowledgements The editors thank all authors for their time and valuable contributions. We are also grateful to our developmental editors Joni Fraser and Barbara Lopez-Lucio.

A comprehensive review of current endovascular techniques for the treatment of cerebral aneurysms, this is a practical manual for those practicing, or intending to practice, this rapidly expanding branch of minimally invasive surgery. The authors provide descriptions based on an extensive combined experience of clinical management, technical problems, complications and recent results, and discuss the limitations and role of combined extravasular/endovascular techniques.

This publication of the papers presented at the Workshop on Laparoscopic Colorectal Surgery that took place on 27-29 November 1995 in the European Surgical Institute in Norderstedt, Germany, is effectively a snapshot of the current state of knowledge in both the theory and the practice of minimally invasive colon surgery. This snapshot is a mosaic made up of the varied ex periences of individual surgeons. After a long period in which nothing much seemed to be happening, the recent growth in the use of minimally invasive surgery or video-controlled operative procedures in surgery of the abdominal and chest cavities has been unparalleled. More difficult operations have become increasingly possible as more and more new techniques have become available. Cholecystectomy should be regarded as the pacesetter for video-controlled procedures. Under defined conditions, it has now become the standard operation. Other operative procedures such as appendicectomy, hernior rhaphy, overs ewing of a perforated gastric or duodenal ulcer, vagotomy and fundoplication, operations on the spleen or adrenal, staging operations., and thoracic surgical procedures are becoming increasingly widely performed. Minimally invasive operations on the small and large bowel are currently still at the stage of individual reports."

Exciting new developments and applications of imaging techniques have emerged over the last few years, leading to many improvements in diagnosis and staging of urologic diseases. Refinements in the technology mean that imaging now is much more precise than even five years ago, and this has significantly enhanced its application within several key fields.

As such, there are virtually no books currently available that cover the impact of these advances within urology leaving a major hole in the market. With its sound overview of the current state of affairs, and also its focus on highlighting future advances, this book would therefore find a significant audience within not only trainees, but also practicing clinicians too.

Furthermore, the whole topic of ultrasonography is a relatively overlooked one, with very few modern books tackling any specific areas of the field. This book will be up-to-date and will pay attention to the unique applications of ultrasound within each discipline.

Ophthalmic microsurgery is applied in ophthalmic pathological conditions. Ophthalmic pathology sets the landmarks for all kinds of microsurgical manipulations. Thus, in order to ensure the best surgical outcome, ophthalmic clinicians and microsurgeons have to consider the critical structures and potential complications before they start with the surgical procedure.

Written by the world famous expert G. O. H. Naumann, this excellent textbook emphasizes the ocular structures such as the nuances of morphology, surgical anatomy, and pathology.

The content includes: Unique features of closed system intraocular surgery in closed system and open eye surgery.- Crucial aspects of restoring the anterior chamber, includes such as the role of blood-ocular barriers and effects of paracenthesis-effects. The spectrum of potential complications in (pseudo-) exfoliation- syndromes as well as the most vulnerable cell populations.- The features of normal and pathologic wound healing in the various tissues after non-mechanical laser and mechanical interventions emergency-pathology requiring prompt surgical intervention.

Brilliant artwork and sketches are further illustrating and summarizing the complex pathology. Thus, the reader will derive great value for the daily routine when learning how the specific pathology modifies the indications and techniques of microsurgery.

The roentgenologic visualization of excretory ducts of a secreting organ is a longe-stablished diagnostic method in roentgenology. For a long time, radiologists have felt the need to establish a method for filling the excretory duct system of the pancreas with contrast material, in the way that intravenous retrograde urography is used to diagnose pathologic changes such as displacement of the renal collecting system or of the urethra. This need to establish a method became more urgent the more the pancreas resisted conventional roentgenologic clinical di- agnostic methods. From time to time in peroperative or postoperative cholangiography mostly incomplete reflux into the pancreatic duct in 10-14% was observed (Stiller, 1948; San Julian und Pascual y Megias, 1952; Wapshaw, 1955; Bergkvist und Seldinger, 1957). However, there was no possibility of obtaining reliable and complete opacification of the pancreatic duct. Peroperative Pancreaticography It was in 1951 when Leger and Arway achieved this goal, though only by surgery. It should be mentioned that, when performing their first peroperative examination, these French surgeons already had the impression, that cannulation of the pancreatic duct was easier than cannulation of the common bile duct. This observation has been con- firmed by hundreds of examinations after ERPC had been established for several years; however, up till now this phenomenon has not been sufficiently explained. During the following years, peroperative pancreaticography develop- ed into a routine examination, above all by Doubilet et al.

This heavily revised third edition gives an essential textbook which provides a comprehensive guide to robotic surgical techniques in urology. Extensively updated chapters cover general aspects of surgery such as aspects of operating room preparation and anesthesia. Instructions on how to use a variety of the latest techniques for procedures associated with the kidney, prostate, bladder and testicle are covered. Detailed information on how to improve outcomes, avoid potential complications and pitfalls is also provided. Instructive video clips assist the reader in being able to visualize how to enhance their methodologies further. Robotic Urologic Surgery is a detailed up-to-date resource that includes contributions from leading robotic urologic surgeons from around the world. It assists readers in refining their surgical technique and improving their patient care. Therefore, it is a critical resource for all practicing and trainee physicians involved in the care of these patients.

There are numerous textbooks detailing almost every aspect of the different laparoscopic procedures. However, in this era of evidence-based medicine, a text focusing on the controversies - from the laparoscopic as well as the general surgeon's point of view - is missing.

This book is not intended to be yet another textbook of laparoscopy; instead, its main purpose is to address unsettled issues of controversy. This will significantly enhance evidence-based knowledge of this developing field, stimulate thinking and discussions in rounds and meetings, assist surgeons in their decision making and stimulate further research.

This book is not aimed only at laparoscopic surgeons - with their steadily increasing number - but also at general surgeons and surgical trainees. It will define and sharpen points of controversy by internationally recognized authors, and thus provide 'state of the art' quality to each topic.

This detailed atlas illustrates the anatomical structures of the upper basal cisterns, their topography and relationship to other intra- and extradural structures. The author expands his well-established efforts to convey his outstanding neuroanatomical knowledge to the basal cisterns. His famous anatomical drawings are based upon anatomical preparations, cadaver dissections and intraoperative pictures, in order to point out important aspects concerning microsurgical and endoscopic approaches to these parts of the brain.

To date, more than three thousand brain and skull base tumors, along with various vascular problems, have been treated by using advanced, fully endoscopic, minimally invasive surgical techniques. In this book, Dr. Hrayr K. Shahinian, director of the Skull Base Institute, compiles these techniques. The book is highly specific and amply illustrated. The step-by-step operating room procedures provide a definitive guide to the difficult yet essential art of skull base surgery.

MRI-Guided Focused Ultrasound Surgery will be the first publication on this new technology, and will present a variety of current and future clinical applications in tumor ablation treatment. This source helps surgeons and specialists evaluate, analyze, and utilize MRI-guided focused ultrasound surgery - bridging the gap between phase 3 clinical trials and the expansion to the clinical practice - by exploring fundamental principles and future clinical applications using this new therapeutic method.

In "Revision Sinus Surgery" the world's most prominent rhinologists illustrate their experience in diagnosing and managing recurrent sinus disease and skull base lesions. Starting with preoperative planning and medical management, these challenging cases are well-illustrated with the relevant surgical techniques. This invaluable resource is designed to prevent complications and improve the outcomes of revision sinus surgeries. Both practicing and in-training otolaryngologists can use this comprehensive volume as an all-in-one source for the evaluation and management of recurrent sinus disease and skull base pathology.

In this thoroughly revised second edition of the frequently downloaded manual, The SAGES Manual of Quality, Outcomes, and Patient Safety. A panel of experts update and expand their survey of the many factors that influence quality in the world of surgery, surgical outcomes, and threats to patient safety. Among the highlights include a section devoted to threats to quality and outcomes and safety, such as surgeon wellness and burnout, disruptive behavior, second victims, the surgeon with declining skills, and maintaining quality in the setting of a crisis. Another all-new section focuses on surgical controversies, such as whether or not to use robotic surgical technology and whether or not it influences surgical outcomes; whether or not routine cholangiography reduces the common bile duct injury rate; whether or not having a consistent operating room team influences surgical outcomes, and whether a conflict of interest truly influences surgical quality. Further, this manual updates chapters on surgical simulation, teamwork and team training, teleproctoring, mentoring, and error analysis. State-of-the-art and readily accessible, The SAGES Manual of Quality, Outcomes, and Patient Safety, Second Edition will offer physicians strategies to maintain surgical quality in a rapidly changing practice environment the tools they require to succeed.

Written by renowned experts from Australia, Canada, the United States, Asia, and Europe, Telesurgery explains technical issues, digital information processing, and provides collective experiences from practitioners in different parts of the world who perform a wide range of telesurgery applications. This includes transatlantic telesurgery and telesurgery for urology, brachytherapy, Heller myotomy, etc. There are numerous graphics and clinical photographs throughout, which illustrate and illuminate the text well, providing high-quality visual reference material.

Telesurgery lays the foundation for the globalization of surgical procedures, making possible the ability of a surgeon located in one part of the world to operate on a patient located in another.

The second half of the twentieth century saw vascu- agree or disagree, but will be stimulated to question lar surgery develop from a necessity for hemostasis their surgical management and explore possible - to a mature reconstructive art. However, this was ac- ternatives. companied by increasing patient expectations and The only certainty of the future is that it will bring the introduction of the alternative techniques of dila- change. An essential requirement for facing that tation and stenting. These factors have helped sur- change is multidisciplinary teamwork, and within geons to focus attention on the need for clinical audit that framework to define the roles of endovascular and to define clearly the limitations and standards of and invasive procedures, as well as the place of m- excellence that should be achieved in the specialty. ical management in the prevention and modification Vascular disease remains an extensive problem in of vascular disease.

Incisional hernia surgery has witnessed important advances over recent years, not only as far as the pathophysiological and etiopathogenetic aspects are concerned, but also from a technical point of view. This book provides an update on incisional hernia surgical techniques. It includes chapters on synthetic prostheses, biomaterials and robotics. Surgeons, surgical residents, and medical students will find the information in this volume very useful in their daily practice.