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Access to the eBook is limited to the first individual who redeems the PIN, located on the inside cover of this book, at expertconsult.inkling.com and may not be transferred to another party by resale, lending, or other means. H a n d b o o k o f S u r g i c a l T e c h n i q u e A True Surgeon’s Guide to Navigating the Operating Room This page intentionally left blank H a n d b o o k o f S u r g i c a l T e c h n i q u e A True Surgeon’s Guide to Navigating the Operating Room Christopher J. Hartman, MD Assistant Professor of Urology The Smith Institute for Urology Hofstra-Northwell School of Medicine Long Island, New York Louis R. Kavoussi, MD, MBA Waldbaum Gardiner Professor and Chairman The Smith Institute for Urology Hofstra-Northwell School of Medicine Long Island, New York 1600 John F. Kennedy Blvd. Ste 1800 Philadelphia, PA 19103-2899 HANDBOOK OF SURGICAL TECHNIQUES ISBN: 978-0-323-46201-3 Copyright © 2018 by Elsevier, Inc. 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. Details on how to seek permission, further information about the Publisher’s permissions poli- cies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. his book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Notices Knowledge and best practice in this ield are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a profes- sional responsibility. With respect to any drug or pharmaceutical products identiied, 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 practitioners, relying on their own experience and knowledge of their patients, 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, contributors, or editors, assume any liabil- ity for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. Library of Congress Cataloging-in-Publication Data Names: Hartman, Christopher J., author. | Kavoussi, Louis R., author. Title: Handbook of surgical technique : a true surgeon’s guide to navigating the operating room / Christopher J. Hartman, Louis R. Kavoussi. Description: Philadelphia, PA : Elsevier, [2018] | Includes bibliographical references and index. Identiiers: LCCN 2017038058| ISBN 9780323462013 (pbk. : alk. paper) | ISBN 9780826169334 (e-book) Subjects: | MESH: Surgical Procedures, Operative--methods | Operating Rooms Classiication: LCC RD32.3 | NLM WO 500 | DDC 617.9/17--dc23 LC record available at https://lccn.loc.gov/ 2017038058 Executive Content Strategist: James T. Merritt Content Development Specialist: Meghan Andress Publishing Services Manager: Catherine Jackson Project Manager: Tara Delaney Design Direction: Bridget Hoette Printed in China Last digit is the print number: 9 8 7 6 5 4 3 2 1 To my wife, Kerri, without whose unfaltering support, love, and dedication this would not have been possible. CJH his is dedicated to my surgical mentors Bill Catalona, Ralph Clayman, Jerry Andriole, and Herb Lepor, whose voices echo in every incision made and stitch thrown. LRK This page intentionally left blank PREFACE In every technical ield, it is important to under- purpose of roles within the operating room as well as stand and master fundamentals. he surgical arts are the behaviors needed to excel. Equipment and tools are no exception to this requirement. hose wishing to be reviewed, and the rationale for use of each is described. involved in the care of patients need to be grounded Basic techniques in surgery are explained, and tips are in the culture, resources, and processes of the operat- provided to allow a new individual in the operating ing room. hus far, there have been a limited number room to assist in a meaningful way. of resources available to students that provide a com- his text ofers a concise yet comprehensive review of prehensive overview of these fundamentals. Most gain the operating room, its components, and how to excel familiarity through a “trial by ire” approach, where in surgery. We encourage you to review the online vid- there is great variability in experiences, and holes in an eos that complement this book, which demonstrate and individual’s basic education can persist for years. explain various surgical techniques in more depth. We his text was born out of a need to help students hope you enjoy the art of surgery, and we will see you in gain a cardinal knowledge of the workings of the operat- the operating room! ing room and smoothly integrate into the surgical team. his handbook covers the basic protocol and culture Christopher J. Hartman, MD of the operating room to help students understand the Louis R. Kavoussi, MD, MBA vii This page intentionally left blank