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Performing a surgical operation could be compared to na- gating inside the human body. Two essential requirements are necessary for a successful apprenticeship: ? A perfect understanding of the roadmap, the anatomy ? Regular training with expert surgeon teachers showing str- egies, tactics, manoeuvres, and gestures to make the journey safe, efficient and fast For decades this was the way taken by apprentice-surgeons and also by surgeons already in practice concerned about upd- ing their knowledge. For years their only travelling companions were books, drawings, and pictures. However, printed medium cannot satisfactorily and properly reproduce the movements of a manoeuvring surgeon. In open surgery, only the two first - sistants can precisely capture by direct vision what is happ- ing in the depth of the operating field. Therefore, the duration of apprenticeship is long and restricted to a small number of people per teacher. The introduction of movie cameras into the operating rooms improved the quality of surgical education. But filming in open surgery is not so easy. The cameraperson has to be well trained to catch good takes in the depth of a pit between the heads, shoulders, and fingers of the surgeon and assistants. Most of the time, those constraints disturb the op- ator's manoeuvres, altering their pedagogical value. With the introduction of laparoscopic surgery (LS), using a video camera providing images in real time on a television screen, everything changed.
The second volume of Operative Manual of Endoscopic Surgery covers some of the operative endoscopic procedures which have been introduced into clinical practice since the publication of VoI. 1. In the general section, we have included an updated chapter on instrumentation and new chapters on anaesthetic manage ment of patients undergoing endoscopic surgery and on video image and record ing. Both topics are of importance to the practice of endoscopic surgery and have not been adequately covered in the reported literature. Volume 2 deals with endoscopic procedures)nthechest and abdomen. There have been significant advances in thoracoscopic surgery duririg the past 2 years; particular reference rs made to anatomical pulmonary resections and oesophageal resections. As far as the gastrointestinal trad is concerned, we have included gastric and allied operations but have not covered the colorectal region as we believe that more evaluation is needed before definitive accounts can be written on endoscopic colorectal resections, especially for cancer. For this reason, we have decided to defer this important topic to VoI. 3, which is in preparation. The same applies to laparoscopic repair of abdominal hernias. The same layout has been adopted as in VoI. 1 of the series, with heavy em phasis on illustrative representation of the operative steps and techniques. In the diagrams on sites of trocar/cannulae, we have indicated not only the site and size but also the functional role of each port.
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