Additional Information
Book Details
Abstract
The Sixth Edition of this highly regarded title for surgical trainees gives clear, concise guidance on all aspects of acquiring surgical skills to ensure operative success. The full range of surgical procedures is comprehensively reviewed in a clear ‘how-to-do-it’ style, which consolidates the skills learnt both in theatre and on training courses. This new edition has been completely updated throughout, with all the illustrations redrawn in full colour. Each chapter is introduced with a key points box, which briefly summarises the major issues that are covered. International experts from the Middle East, Australia, Asia, North America and Europe have reviewed and added their comments to the text.
- Provides guidance on the full range of surgical techniques required by all trainee surgeons.
- Concentrates on the main principles behind the use of the surgical techniques
- "Key Points" boxes throughout provide hints and tips to reinforce the main aspects of each technique.
- Now presented in full colour with all illustrations redrawn to add detail and clarity and to bring all the information fully up to date.
- A comprehensively updated text takes account of new developments in surgical techniques and equipment.
- A new final chapter on surgical craftsmanship brings the skills all together for the surgeon in the operating theatre, uniting and applying the relevant factors in the correct sequence and focussing on getting it right first time.
Table of Contents
Section Title | Page | Action | Price |
---|---|---|---|
Copyright | iv | ||
Preface | v | ||
Acknowledgements | vii | ||
Handling yourself | 1 | ||
Attitudes – the five ‘cs’ | 2 | ||
Physical Attributes | 2 | ||
Hands | 2 | ||
Stability | 2 | ||
What Is Skill? | 3 | ||
Exercises Versus Practice | 4 | ||
Haptics | 4 | ||
Transferable Skills | 5 | ||
Speed | 5 | ||
Sequence (L sequi = to follow) | 6 | ||
Skills Courses | 6 | ||
Rational Assessment Of Information | 6 | ||
References | 7 | ||
Further reading | 7 | ||
Handling threads | 9 | ||
Thread Characteristics | 21 | ||
Sizes | 22 | ||
Knots | 22 | ||
Two-handed knot | 25 | ||
One-handed knot tied with the left hand | 27 | ||
Knot tied using instruments | 31 | ||
Laying and tightening knots | 31 | ||
Tightening under tension | 34 | ||
Tying knots in cavities | 35 | ||
Ligatures | 36 | ||
Stitches | 38 | ||
Needles | 38 | ||
Stitching with a curved needle | 41 | ||
Types of stitch (Fig.3.66) | 42 | ||
Interrupted stitches | 43 | ||
Continuous stitches | 44 | ||
Handling ducts and cavities | 47 | ||
Intubation | 48 | ||
Percutaneous intubation | 48 | ||
Direct intubation | 51 | ||
Fixing catheters and tubes | 54 | ||
Dilating Ducts | 56 | ||
Bougies | 56 | ||
Balloons | 58 | ||
Other methods | 58 | ||
Endoscopic Access | 58 | ||
Rigid instruments | 60 | ||
Flexible endoscopes | 62 | ||
Display | 63 | ||
Occlusion | 63 | ||
Divided duct | 63 | ||
In continuity | 64 | ||
Control of leakage | 64 | ||
Disobliteration | 65 | ||
Repair | 68 | ||
Gastrointestinal tract | 70 | ||
Other ducts and cavities | 70 | ||
Resection | 71 | ||
Anastomosis | 71 | ||
Principles | 71 | ||
Bowel | 71 | ||
Alternative methods | 73 | ||
Mobile bowel, edge to edge, single layer, interrupted stitches | 73 | ||
Edge to edge, single layer, continuous stitches | 73 | ||
Fixed bowel, single layer, interrupted stitches | 74 | ||
Two-layer anastomosis | 75 | ||
Variations | 75 | ||
Other ducts | 75 | ||
Bowel Transfer | 76 | ||
Sphincters | 77 | ||
Myotomy | 77 | ||
Sphincterotomy | 78 | ||
Sphincteroplasty | 79 | ||
Sphincter repair | 79 | ||
Sphincter reversal | 79 | ||
Acquired Channels And Cavities | 79 | ||
Sinus | 79 | ||
Fistula | 80 | ||
Stoma | 81 | ||
Cysts | 81 | ||
Abscesses | 81 | ||
Handling blood vessels | 83 | ||
Percutaneous Puncture | 84 | ||
Veins | 84 | ||
Arteries | 86 | ||
Percutaneous Cannulation | 87 | ||
Veins | 87 | ||
Arteries | 87 | ||
Percutaneous Catheterization | 88 | ||
Seldinger technique | 88 | ||
Endovascular Surgery | 89 | ||
Sutures | 90 | ||
Expose and Control (see also Ch. 10.) | 92 | ||
Incision | 93 | ||
Veins – Direct Procedures | 93 | ||
Varicose veins | 94 | ||
Arterial replacement with vein | 95 | ||
Arteries – Direct Procedures | 96 | ||
Incision and closure | 96 | ||
Direct catheterization | 96 | ||
Embolectomy | 96 | ||
Vein patch | 96 | ||
Arterial Anastomosis | 97 | ||
End-to-end anastomosis | 97 | ||
End-to-side anastomosis | 99 | ||
Microvascular Surgery | 99 | ||
Basic technique | 100 | ||
Reference | 102 | ||
Handling skin | 103 | ||
Structure | 103 | ||
Healing | 104 | ||
Open wounds | 104 | ||
Wound Management | 105 | ||
Wound closure | 106 | ||
Analgesia | 106 | ||
Incision | 106 | ||
Excision | 108 | ||
Skin lesions | 108 | ||
Intradermal or subcutaneous cyst | 108 | ||
Closure | 109 | ||
Simple linear | 109 | ||
Subcuticular stitch | 110 | ||
Closing defects | 112 | ||
Grafts | 113 | ||
Split-skin graft | 114 | ||
Full-thickness graft | 116 | ||
Flaps | 116 | ||
Z-plasty | 116 | ||
Transposition flaps | 117 | ||
Myocutaneous and compound flaps | 117 | ||
Free Tissue Transfer | 118 | ||
Tissue Expansion | 118 | ||
Aesthetic Procedures | 118 | ||
Liposuction | 118 | ||
Lipoplasty | 118 | ||
Clostridium botulinum | 118 | ||
Breast procedures | 118 | ||
References | 118 | ||
Handling connective and soft tissues | 119 | ||
Percutaneous Diagnostic Procedures | 120 | ||
Aspiration of fluid for cytology | 120 | ||
Needle biopsy | 120 | ||
Open biopsy | 121 | ||
Connective Tissue | 122 | ||
Areolar tissue | 122 | ||
Aponeuroses | 122 | ||
Tendons | 123 | ||
Ligaments | 124 | ||
Nerves | 124 | ||
Skeletal Muscle | 125 | ||
Cartilage | 125 | ||
Mucoperiosteum | 126 | ||
Breast | 126 | ||
Lymph Nodes | 126 | ||
Sentinel node biopsy | 127 | ||
Abdominal Wall | 127 | ||
Midline abdominal incision | 127 | ||
Gridiron incision | 129 | ||
Hernia | 129 | ||
Abdominal Contents | 130 | ||
Bowel | 130 | ||
Liver | 130 | ||
Spleen | 130 | ||
Pancreas | 131 | ||
Urological System | 131 | ||
Kidney | 131 | ||
Ureter | 131 | ||
Bladder | 131 | ||
Testis | 131 | ||
Penis | 131 | ||
Gynaecological System | 131 | ||
Uterus | 131 | ||
Ovaries | 132 | ||
Cardiorespiratory System | 132 | ||
Lung | 132 | ||
Heart | 132 | ||
Endocrine System | 132 | ||
Brain And Spinal Cord | 132 | ||
Handling bone and joints | 133 | ||
Bone | 133 | ||
Physical Characteristics | 133 | ||
Exposure | 134 | ||
Steadying | 134 | ||
Biopsy | 134 | ||
Cutting | 135 | ||
Hand saw | 135 | ||
Gigli saw | 135 | ||
Powered saws | 135 | ||
Osteotome | 136 | ||
Chisel | 136 | ||
Cutting forceps | 137 | ||
Rongeurs | 138 | ||
File | 138 | ||
Drilling | 138 | ||
Fixing | 139 | ||
Screws | 139 | ||
Stitching | 141 | ||
Wiring | 142 | ||
Plates | 142 | ||
External fixators | 144 | ||
Intramedullary fixation | 144 | ||
Bone grafts | 146 | ||
Amputation | 146 | ||
Joints | 147 | ||
Cartilage | 148 | ||
Ligaments | 148 | ||
Tendon Insertion | 148 | ||
Handling dissection | 149 | ||
Organize | 149 | ||
Expose | 150 | ||
Dissection Methods | 151 | ||
Sharp | 151 | ||
Blunt | 152 | ||
Instrumental | 154 | ||
Layered or Solid Tissues? | 154 | ||
Tissue Planes | 155 | ||
Solid Tissues | 157 | ||
Imaging | 157 | ||
Dissecting | 157 | ||
Diseased Tissues | 158 | ||
Neoplasms | 159 | ||
Aids to Dissection | 159 | ||
Anatomy | 159 | ||
Palpation | 160 | ||
Haemostasis | 160 | ||
Find a safe starting point | 160 | ||
Tension | 160 | ||
Dissecting around structures | 161 | ||
Needles | 162 | ||
Fluid infiltration | 162 | ||
Transillumination | 162 | ||
Probes and catheters | 162 | ||
Dyes | 162 | ||
Marker stitch | 163 | ||
Intraoperative ultrasound scanning | 163 | ||
Flexibility | 163 | ||
Priorities | 163 | ||
Reference | 163 | ||
Handling bleeding | 165 | ||
Haemorrhage | 165 | ||
Prevention | 165 | ||
Aids | 166 | ||
Elevation | 166 | ||
Fluid infiltration | 167 | ||
Transillumination | 167 | ||
Tourniquet | 167 | ||
Technical aids (see also Ch. 2) | 167 | ||
Control | 168 | ||
Intracavity bleeding | 169 | ||
Intracranial Bleeding | 170 | ||
Handling drains | 171 | ||
Caution | 171 | ||
Types | 172 | ||
Packs and wicks | 172 | ||
Sheet drains | 172 | ||
Tube drains | 173 | ||
Sites | 174 | ||
Subcutaneous | 174 | ||
Subfascial and intramuscular | 175 | ||
Extraperitoneal | 175 | ||
Intraperitoneal | 175 | ||
Pleural cavity | 176 | ||
Abscesses and Cysts | 177 | ||
External Fistulas | 177 | ||
Negative Pressure Wound Healing | 177 | ||
Reference | 178 | ||
Handling infection | 179 | ||
Principles | 179 | ||
Infections | 180 | ||
Cellulitis | 180 | ||
Abscess | 180 | ||
Sirs and Sepsis | 180 | ||
Viral Transmission | 180 | ||
Universal Precautions | 180 | ||
Trauma | 181 | ||
Preoperative | 181 | ||
Operating Routines | 181 | ||
Operation | 182 | ||
Bleeding | 182 | ||
Surgical Site Infection | 182 | ||
Treating Infections | 183 | ||
Cellulitis | 183 | ||
Abscess | 183 | ||
References | 184 | ||
Handling minimal access surgery | 185 | ||
Examples | 185 | ||
Laparoscopy | 186 | ||
Access | 186 | ||
Closed pneumoperitoneum | 186 | ||
Open pneumoperitoneum | 187 | ||
Technical Aspects | 188 | ||
Closure | 189 | ||
Acquiring Skills | 189 | ||
Other procedures | 193 | ||
References | 193 | ||
Handling craft skills | 195 | ||
Physician/Surgeon | 195 | ||
Skills Courses | 196 | ||
Operating Precepts | 197 | ||
Gentleness | 197 | ||
‘Setting up’ | 197 | ||
Speed | 197 | ||
Sequence | 198 | ||
Strategy/tactics | 198 | ||
Tissue oxygenation | 198 | ||
Emergencies | 198 | ||
Error Avoidance | 198 | ||
Assisting at Operations | 199 | ||
Mentoring | 200 | ||
Ten reminders | 200 | ||
Common Sense | 200 | ||
References | 201 | ||
Index | 203 |