Oxford Handbook of Operative Surgery

960 Pages·2017·0.67 MB·English

by  Anil Agarwal

OXFORD MEDICAL PUBLICATIONS
Oxford Handbook of
Operative Surgery
ii
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Oxford Handbook of
Operative
Surgery
Third edition
Edited by
Anil Agarwal
Consultant General and Colorectal Surgeon,
University Hospital of North Tees,
Stockton on Tees, UK
Neil Borley
Consultant Colorectal Surgeon,
Cheltenham General Hospital, UK
Greg McLatchie
Professor of Surgical Sciences, University of Sunderland;
Consultant Surgeon, Lister Hospital, Stevenage, UK
1
iv
1
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First Edition published in 1996
Second Edition published in 2006
Third Edition published in 2017
Impression: 1
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v
Dedication
AKA
For Charu, Mitali, and Kunal
NB
For Alexander, Christopher, and Jennifer
GRM
For Ross, Cameron, Ailidh, Claire, and Calum
vi
vii
Preface to the
third edition
‘The story always old and always new’
The Ring and the Book
It is twenty years since the first edition of Operative Surgery was published.
At that time trainees were apprentices in surgery and the emerging con-
sultant was a varied creature in terms of skill and experience, but had the
advantage of many hours of exposure to surgical procedures.
By contrast, when the second edition appeared ten years later, the
number of training hours had been considerably reduced while training
had become more formalized to ensure the standardization of surgical
excellence by regular attendance at educational and surgical skills courses.
Further, the specialty of general surgery gradually gave way to specialized
surgical units including emergency surgery.
As a result this third edition covers the operations listed in the intercol-
legiate surgical curriculum for each of the ten surgical specialties. It has been
extensively updated and rewritten in keeping with the advances of the last
ten years.
Trainees in their early years, while sampling a number of surgical special-
ties, will find in the handbook a detailed description of common operations
at which they will assist and ultimately perform. For the specialty-s pecific
intermediate and final stages of training a range of operations that trainees
will perform is concisely described. In addition, medical students and house-
men will find the descriptions useful during their surgical attachments as will
specialist senior nurses and nurse assistants.
A section of ‘tips and tricks’ is included to add the wisdom of years of
experience.
We hope the handbook meets individual needs and will continue to
impact on the subsequent production of highly- skilled and well- trained sur-
geons both now and in the future.
AKA
NB
GRM
viii
viii
Preface to the
second edition
The text and increased numbers of contributors reflect the changes that
have occurred in general surgery over the past ten years. It is unlikely that
in the future we will encounter General Surgical Units. They will be replaced
by specialized departments catering for specific areas of surgical expertise.
These changes will also fashion future editions of this text in that almost
every chapter will become a handbook in itself and the training of surgeons
become significantly changed.
GRM
DL
North Tees and Hartlepool NHS Trust
April 2006
Preface to the
first edition
This book is a practical guide for the surgeon or surgical trainee about to
perform or assist at an operation. The procedures described are those
commonly carried out in general, urological, and orthopaedic surgical prac-
tice with an introduction on perioperative management and anaesthetics.
These should also prove of interest to operating department nurses, assis-
tants, and students of medicine. Indications for, and complications of, pro-
cedures are given but more extensive descriptions of these can be found in
surgical text books to which the reader should refer.
We emphasize that the book is not for the first-t ime operator, nor does
it embrace the philosophy of ‘see one, do one, teach one’. Anyone aspiring
to be a surgeon must acquire the basic skills of safe knot- tying and familiarity
with surgical instruments. Only by witnessing, assisting at, and then per-
forming many procedures within the structure of a formal surgical training
course can the trainee develop the skill, judgement, and the ability to select
patients correctly—t he recipe for safe surgery.
GRM
Hartlepool
DJL
Stockton on Tees
1996
ix
Contents
Contributors x
Symbols and abbreviations xiii
1 General surgery  1
2 Upper gastrointestinal surgery  65
3 Hepato- pancreato- biliary (HPB) surgery  119
4 Colorectal surgery  139
5 Breast surgery  239
6 Endocrine surgery  279
7 Paediatric surgery  313
8 Vascular surgery  373
9 Transplantation  425
10 Urology  441
11 Plastic and reconstructive surgery  503
12 Cardiothoracic surgery  581
13 Neurosurgery  645
14 ENT  705
15 Oral and maxillofacial surgery  825
16 Orthopaedics  935
Index 1011