Atlas of General Surgical Techniques (Courtney M. Townsend Jr., B. Mark Evers)
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ATLAS OF GENERAL SURGICAL TECHNIQUES |
ISBN: 978-0-7216-0398-8 |
Copyright © 2010 by Saunders, an imprint of Elsevier Inc. |
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All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Permissions may be sought directly from Elsevier’s Rights Department: phone: ( 1) 215 239 3804 (US) or ( 44) 1865 843830 (UK); fax: ( 44) 1865 853333; e-mail: healthpermissions@elsevier.com. You may also complete your request on-line via the Elsevier website at http://www.elsevier.com/permissions.
Notice
Knowledge and best practice in this field are constantly changing. As new research and experience broaden our knowledge, changes in practice, treatment and drug therapy may become necessary or appropriate. Readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of the practitioner, relying on their own experience and knowledge of the patient, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the Authors assumes any liability for any injury and/or damage to persons or property arising out of or related to any use of the material contained in this book.
The Publisher
Library of Congress Cataloging-in-Publication Data
Atlas of general surgical techniques / [edited by] Courtney M. Townsend Jr., B. Mark Evers. -- 1st ed.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-0-7216-0398-8 (hardcover : alk. paper) 1. Surgery--Atlases. I. Townsend, Courtney M. II. Evers, B. Mark, 1957-
[DNLM: 1. Surgical Procedures, Operative--methods--Atlases. WO 517 A8797 2010]
RD41.A782 2010
617.0022’3--dc22
2009049217
Acquisitions Editor: Judith Fletcher
Developmental Editor: Kristina Oberle
Publishing Services Manager: Julie Eddy
Senior Project Manager: Laura Loveall
Design Direction: Louis Forgione
Artwork: Michael A. Cooley
Mike de la Flor
Peggy Firth
Victoria Heim
Alexandra Hernandez
Lauren Shavell
Jennifer Smith
Gina Urwin
Electronic Publishing Services Inc., NYC
Printed in the United States
Last digit is the print number: 9 8 7 6 5 4 3 2 1
CONTRIBUTORS
Carlos A. Angel, MD, FACS |
B. Mark Evers, MD |
Associate Professor |
Director, Lucille P. Markey Cancer Center; |
Department of Surgery |
Professor and Vice-Chair for Research |
University of Missouri—Columbia |
University of Kentucky Department of Surgery; |
Columbia, Missouri |
Markey Cancer Center Director Chair; |
|
Physician-in-Chief, Oncology Service Line |
Valerie P. Bauer, MD |
University of Kentucky Healthcare |
Assistant Professor |
Markey Cancer Center |
Department of Surgery |
Lexington, Kentucky |
The University of Texas Medical Branch |
|
Galveston, Texas |
James J. Gallagher, MD |
|
Assistant Professor of Surgery |
Edward Y. H. Chan, MD |
Department of Surgery |
Surgical Resident |
Weill Medical College; |
Department of Surgery |
Assistant Attending Surgeon |
Mount Sinai School of Medicine |
Department of Surgery |
New York, New York |
New York Presbyterian Hospital |
|
New York, New York |
Celia Chao, MD |
|
Assistant Professor |
Dennis C. Gore, MD |
Department of Surgery |
Professor |
The University of Texas Medical Branch |
Department of General Surgery |
Galveston, Texas |
The University of Texas Medical Branch |
|
John Seely Hospital |
Charlie C. Cheng, MD |
Galveston, Texas |
Assistant Professor |
|
Department of Vascular Surgery |
Baiba J. Grube, MD, FACS |
The University of Texas Medical Branch |
Associate Professor |
Galvaston, Texas; |
Department of Surgery |
Assistant Professor |
Yale University School of Medicine |
Department of Vascular Surgery |
New Haven, Connecticut |
Mainland Medical Center |
|
Texas City, Texas |
Kristene K. Gugliuzza, MD, FACS |
|
Professor, Departments of Surgery and Pediatrics |
Dai H. Chung, MD |
Alonzo Alverly Ross Centennial Chair in General |
Professor and Vice-Chair |
Surgery |
Department of Pediatric Surgery |
Program Director, General Surgery Residency |
Vanderbilt University Medical Center |
Director, Kidney and Pancreas Transplant Program |
Nashville, Tennessee |
in the UTMB Texas Transplant Center |
|
Scholar, John P. McGovern Academy of Oslerian |
Concepcion Diaz-Arrastia, MD |
Medicine |
Associate Professor and Director |
The University of Texas Medical Branch |
Division of Gynecologic Oncology |
Galveston, Texas |
Department of Obstetrics and Gynecology |
|
Baylor College of Medicine |
|
Houston, Texas |
|
v
vi C O N T R I B U T O R S
David N. Herndon, MD |
Jacqueline A. Lappin, MD, FRCSI, FACS |
Chief of Staff |
Assistant Professor of Surgery and Director of |
Director of Research |
Pancreas Transplantation |
Shriners Hospitals for Children—Galveston; |
Department of Surgery |
Professor of Surgery |
University of Texas Health Science Center and |
Jesse H. Jones Distinguished Chair in Burn Surgery |
Memorial Hermann Hospital; |
The University of Texas Medical Branch |
Assistant Professor of Surgery |
Galveston, Texas |
Department of Surgery |
|
St. Luke’s Episcopal Hospital and Texas Children’s |
Glenn C. Hunter, MD, FRCSC, FACS |
Hospital |
Professor |
Houston, Texas |
Department of Surgery |
|
University of Arizona; |
Jong O. Lee, MD |
Staff Surgeon |
Assistant Professor |
Department of Surgery |
Department of Surgery |
Southern Arizona VA Healthcare Service |
The University of Texas Medical Branch; |
Tucson, Arizona |
Staff Surgeon |
|
Shriners Hospitals for Children—Galveston |
Margie A. Kahn, MD |
Galveston, Texas |
Associate Professor |
|
Department of Obstetrics and Gynecology |
David B. Loran, MD |
Tulane University School of Medicine |
Thoracic, Vascular, and General Surgery |
New Orleans, Louisiana |
Meadville Medical Center |
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Meadville, Pennsylvania |
Lois A. Killewich, MD, PhD |
|
Professor and Chief, ad Interim |
William J. Mileski, MD, FACS |
Section of Vascular Surgery |
Professor |
Department of Surgery |
Chela and Jimmy Storm Distinguished Professor |
The University of Texas Medical Branch |
Chief of Trauma Services |
Galveston, Texas |
Department of Surgery |
|
The University of Texas Medical Branch |
Thomas D. Kimbrough, MD |
Galveston, Texas |
Professor |
|
Department of Surgery |
William H. Nealon, MD |
The University of Texas Medical Branch |
Professor and Vice Chairman |
Galveston, Texas |
Department of Surgery |
|
Vanderbilt University; |
Tien C. Ko, MD |
Associate Surgeon-in-Chief |
Jack H. Mayfield, MD Distinguished Professor in |
Department of Surgery |
Surgery |
Vanderbilt University Hospital |
Vice Chairman for Harris County Hospital District |
Nashville, Tennessee |
The University of Texas Health Science Center at |
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Houston |
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Chief of Surgery at Lyndon B. Johnson General |
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Hospital |
|
Houston, Texas |
|
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C O N T R I B U T O R S |
vii |
Colin D. Pero, MD |
Courtney M. Townsend, Jr., MD |
Clinical Assistant Professor |
Professor |
Department of Otolaryngology—Head and Neck |
John Woods Harris Distinguished Chairman |
Surgery |
Department of Surgery |
University of Texas Southwestern Medical School |
Robertson-Poth Distinguished Chair in General |
Dallas, Texas; |
Surgery |
Department of Otolaryngology—Head and Neck |
The Unversity of Texas Medical Branch |
Surgery, Facial Plastic and Reconstructive Surgery |
Galveston, Texas |
Baylor Regional Medical Center |
|
Plano, Texas |
Michael D. Trahan, MD |
|
Surgeon |
Anna M. Pou, MD, FACS |
Martha Jefferson Surgical Associates |
Professor and Program Director |
Charlottesville, Virginia |
Otolaryngology—Head and Neck Surgery |
|
Louisana State University Health Sciences Center, |
Kenneth J. Woodside, MD |
New Orleans |
Assistant Professor of Surgery |
New Orleans, Louisana |
Division of Transplant and Hepatobiliary Surgery |
|
Department of Surgery |
Lori Cindrick Pounds, MD, FACS RVT |
University Hospitals Case Medical Center |
Peripheral Vascular Associates |
Cleveland, Ohio |
San Antonio, Texas |
|
|
Joseph B. Zwischenberger, MD |
Taylor S. Riall, MD, PhD |
Johnson-Wright Professor and Chairman |
Associate Professor |
Department of Surgery |
Department of Surgery |
University of Kentucky College of Medicine |
The University of Texas Medical Branch |
Lexington, Kentucky |
Galveston, Texas |
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Arthur P. Sanford, MD, FACS |
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Associate Professor |
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Department of Surgery |
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Loyola University Medical Center |
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Maywood, Illinois |
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Michael B. Silva, Jr., MD |
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The Fred J. and Dorothy E. Wolma Professor of |
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Vascular Surgery |
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Professor of Radiology |
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Director |
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Texas Vascular Center; |
|
Department of Vascular Surgery |
|
The University of Texas Medical Branch |
|
Galveston, Texas; |
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Department of Vascular Surgery |
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Mainland Medical Center |
|
Texas City, Texas |
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PREFACE
“An education in medicine involves both learning and learning how; the student cannot effectively know, unless he knows how.”
—EXCERPT FROM ABRAHAM FLEXNER,
“Medical Education in the United States and Canada,” 1910.
The fundamental core knowledge of general surgery remains the cornerstone of all surgical disciplines. Over the last decades, we have witnessed a proliferation of surgical specialties. The majority of graduating residents elect to pursue additional training in highly specialized fields of surgery. However, a sound foundation in general surgical techniques and principles is critical for success in these areas. Therefore, an atlas describing common general surgical procedures in a clear and concise fashion is an essential complement to current surgical textbooks to ensure that the student not only “learns how” but, most importantly, “knows how.” With that said, putting together a surgical atlas is a daunting challenge. Coordinating schedules of busy surgeons and medical illustrators is, at times, akin to herding cats. So, why expend the time and effort to put this together?
For one, we have been privileged to edit the Sabiston Textbook of Surgery for the last three editions. This text provides a comprehensive compendium on the physiology, diagnosis, and treatment of surgical diseases, yet we are limited in the ability to describe the operative procedures in any detail. A good textbook must provide the basic knowledge to ensure that the student “learns” the material. However, it is vastly different from an atlas which teaches the student “how.” Textbooks that have tried to be a comprehensive text as well as an atlas have usually failed on both accounts. Therefore, this surgical atlas series provides an important and necessary complement to the Sabiston Textbook of Surgery (Saunders).
The illustrations have been meticulously drawn by medical illustrators who share the same philosophy of art design. Illustrations are drawn in detail from the perspective of the operating surgeon, yet the drawings are simple enough that the reader is not distracted with extraneous colors or overly complicated design. The essential steps of the procedure are illustrated with an emphasis on surgical anatomy. Each concludes with three to five “pearls” or pitfalls from master surgeons with years of experience. Recognizing that many general surgical procedures are now performed laparoscopically, we have illustrated steps of both the open and the minimally invasive techniques where applicable. Except for the approach and the instruments, the basic tenets of the dissection and attention to detail are common to both techniques.
Finally, we were inspired to produce this atlas series based on our interactions over the years with numerous talented and hard-working surgical residents who need a concise reference to study and review prior to entering the operative suite. This atlas is meant to provide these trainees with the essential steps in performing common general surgical procedures. We recognize that the atlas is not all-inclusive. In the interest of space, we have omitted some procedures which are less commonly performed by the general surgeon in practice. However, we believe that this atlas provides a great start.
COURTNEY M. TOWNSEND, JR., MD
B. MARK EVERS, MD
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