Surgical Pitfalls. Preparation and Fractionation

881 Pages·2009·106.955 MB·English

by  Stephen R.T. Evans, MD, FACS (Eds.)

Section Editors: Steven K. Libutti, MD, FACS
Chief
A. Alfred Chahine, MD, FACS Tumor Angiogenesis Section
Associate Professor of Surgery and Pediatrics Surgery Branch, National Cancer Institute
The George Washington University School of Medicine Professor of Surgery
Program Director Uniformed Services University of the Health Sciences
General Surgery Residency Bethesda, Maryland
Georgetown University Medical Center
Washington, DC M. Blair Marshall, MD, FACS
Associate Professor of Surgery
Edward E. Cornwell III, MD, FACS, FCCM Georgetown University School of Medicine
LaSalle D. Leffall Jr Professor Chief
Chairman of Surgery Division of Thoracic Surgery
Howard University Hospital Department of Surgery
Washington, DC Georgetown University Medical Center
Washington, DC
Gerard M. Doherty, MD
NW Thompson Professor of Surgery Leigh A. Neumayer, MD, MS
University of Michigan Professor of Surgery
Head University of Utah School of Medicine
Section of General Surgery Huntsman Cancer Institute
University of Michigan Health System Salt Lake City, Utah
Ann Arbor, Michigan
Richard F. Neville, MD
Eugene F. Foley, MD Chief
Professor of Surgery Division of Vascular Surgery
Section of Colon and Rectal Surgery Medical Director
Department of Surgery Non-invasive Vascular Lab
University of Wisconsin School of Medicine and Georgetown University Hospital
Public Health Washington, DC
Madison, Wisconsin
Shawna C. Willey, MD, FACS
Lynt B. Johnson, MD, MBA Associate Professor
Professor Georgetown University
Georgetown University Director
Chief of Transplantation Surgery Betty Lou Ourisman Breast Health Center
Vice-Chairman Lombardi Comprehensive Cancer Center
Department of Surgery Washington, DC
Georgetown University Hospital
Washington, DC
1600 John F. Kennedy Blvd.
Ste 1800
Philadelphia, PA 19103-2899
Surgical pitfalls: prevention and management ISBN: 978-1-4160-2951-9
Copyright © 2009 by Saunders, an imprint of Elsevier Inc.
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Notice
Knowledge and best practice in this fi eld are constantly changing. As new research and experience
broaden our knowledge, changes in practice, treatment and drug therapy may become necessary or
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The Publisher
Library of Congress Cataloging-in-Publication Data
Surgical pitfalls : an evidence-based approach to prevention and management / [edited by] Stephen R.T.
Evans ; section editors, A. Alfred Chahine . . . [et al.].—1st ed.
p. ; cm.
Includes bibliographical references.
ISBN 978-1-4160-2951-9
1. Surgical errors. I. Evans, Stephen R. T. II. Chahine, A. Alfred.
[DNLM: 1. Intraoperative Complications—prevention & control. 2. Evidence-Based
Medicine. 3. Medical Errors—prevention & control. 4. Risk Factors. 5. Risk Management.
6. Surgical Procedures, Operative—adverse effects. WO 181 S961 2009]
RD27.85.S87 2009
617′.9—dc22 2008034840
Publishing Director: Judith Fletcher
Acquisitions Editor: Scott Scheidt
Developmental Editor: Sarah A. Myer
Project Manager: Mary B. Stermel
Design Direction: Steven Stave
Marketing Manager: Brenna Christensen
Working together to grow
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Printed in China www.elsevier.com | www.bookaid.org | www.sabre.org
Last digit is the print number: 9 8 7 6 5 4 3 2 1
To my loving wife Karen, who every day
fuels the fi re of love in my heart and
makes every moment together pure joy.
Stephen Evans, MD
Contributors
Christopher J. Abularrage, MD Sara A. Bloom, MD
Fellow in Vascular Surgery, Massachusetts General Chief Resident, Department of Surgery, Georgetown
Hospital, Boston, Massachusetts University Hospital, Washington, DC
Infrainguinal Revascularization Axillary Surgery
Reid B. Adams, MD Benjamin Braslow, MD
Professor of Surgery, Division Chief, Surgical Oncology, Assistant Professor of Surgery, University of Pennsylva-
and Chief, Hepatobiliary and Pancreatic Surgery, Univer- nia School of Medicine; Director of Emergency Surgical
sity of Virginia Health System, Charlottesville, Virginia Service, Hospital of the University of Pennsylvania,
Enterectomy Philadelphia, Pennsylvania
Damage Control: Abdominal Closures
Mark S. Allen, MD
Professor and Chair, Division of General Thoracic David A. Bruno, MD
Surgery; Consultant, Division of General Thoracic Chief Resident, Department of Surgery, Georgetown
Surgery, Mayo Clinic, Rochester, Minnesota University, Washington, DC
Pneumonectomy Resection and Reconstruction of the Biliary Tract
Stephen L. Altman, Esq, JD Joseph F. Buell, MD, FACS
Partner, Hamilton Altman Canale & Dillon, LLC, Professor of Surgery and Director of Transplantation,
Fairfax, Virginia University of Louisville, Louisville, Kentucky
Legal Considerations Laparoscopic Liver Resection
Rupen Amin, MD John Byrne, MB, BCh, BAO, MCh, FRCSI(Gen)
Research Fellow, Georgetown University School of Attending, Albany Medical Center Hospital, Albany,
Medicine, Washington, DC New York
Pancreaticoduodenectomy Aortic Surgery
Andrea Badillo, MD A. Alfred Chahine, MD, FACS
Resident in General Surgery, The George Washington Associate Professor of Surgery and Pediatrics, The
University, Washington, DC George Washington University School of Medicine;
Graham Patch Repair Program Director, General Surgery Residency,
Georgetown University Medical Center,
Catherine Bertram, JD
Washington, DC
Partner, Regan Zambri & Long, PLLC, Washington, DC
Imperforate Anus and Hirschsprung’s Disease; Congenital
Legal Considerations
Diaphragmatic Hernia
Parag Bhanot, MD
David C. Chang, PhD, MPH, MBA
Assistant Professor of Surgery, Georgetown University
Assistant Professor of Surgery, Department of Surgery,
Hospital, Washington, DC
Johns Hopkins School of Medicine, Baltimore,
Open Inguinal Hernia Repair with Plug and Patch
Maryland
Technique; Laparoscopic Incisional Hernia Repair
Evaluating Trauma Literature
Joseph A. Blansfi eld, MD
Zandra Cheng, MD
Clinical Assistant Professor of Surgery, Temple
Breast Surgeon, Anne Arundel Medical Center Breast
University School of Medicine, Philadelphia; Associate,
Center, Annapolis, Maryland
Department of Surgical Oncology, Geisinger Medical
Breast Biopsy and Breast-Conserving Surgical
Center, Danville, Pennsylvania
Techniques
Isolated Limb Perfusions and Extremity Amputations
Mark D. Cipolle, MD, PhD, FACS
Kenneth J. Bloom, MD
Medical Director, Trauma Program, and Member of
Clinical Professor of Pathology, Keck School of Medicine;
Staff, General Surgery, Christiana Care Health System,
Chief Medical Offi cer, Clarient, Inc., Aliso Viejo, California
Wilmington, Delaware
Image-Guided Breast Biopsy
Central Vein Catheterization
viii CONTRIBUTORS
Bryan M. Clary, MD Kiran K. Dhanireddy, MD
Associate Professor of Surgery, and Chief, Hepatobiliary Transplant Fellow, UCLA Medical Center, Los Angeles,
Surgery, Duke University Medical Center, Durham, California
North Carolina Distal Pancreatectomy
Trisectionectomy
Gerard M. Doherty, MD
Edward E. Cornwell III, MD, FACS, FCCM NW Thompson Professor of Surgery, University of
LaSalle D. Leffall Jr Professor and Chairman of Surgery, Michigan; Head, Section of General Surgery, University
Howard University Hospital, Washington, DC of Michigan Health System, Ann Arbor, Michigan
Management of Thoracic Trauma; Management of Thyroid Surgery
Pancreatic and Duodenal Injuries; Traumatic Brain
Jessica S. Donington, MD
Injury; Managing Injuries to the Spleen
Assistant Professor, Department of Cardiothoracic
Derrick D. Cox, MD Surgery, New York University, New York, New York
Chief Resident, General Surgery, Georgetown Chest Wall Resections
University Hospital, Washington, DC
Brian J. Duffy, MD
Open Inguinal Hernia Repair with Plug and Patch
The George Washington University; Research Fellow,
Technique
Children’s National Medical Center, Washington, DC
Aimee M. Crago, MD, PhD Pectus Excavatum
Fellow, Surgical Oncology, Memorial Sloan Kettering
Quan-Yang Duh, MD
Cancer Center, New York, New York
Professor of Surgery, University of California, San
Preoperative Pitfalls; Gastrectomy with Reconstruction
Francisco; Attending Surgeon, Veterans Affairs Medical
Dale A. Dangleben, MD Center, San Francisco, California
Assistant Program Director, General Surgery Residency, Laparoscopic Inguinal Hernia Repair
and Member of Staff, General Surgery, and Trauma/
David T. Efron, MD
Surgical Critical Care, Lehigh Valley Hospital,
Assistant Professor of Surgery, Johns Hopkins School of
Allentown, Pennsylvania
Medicine; Director of Trauma, Division of Acute Care
Central Vein Catheterization
Surgery: Trauma, Critical Care, Emergency and General
R. Clement Darling III, MD Surgery, The Johns Hopkins Hospital, Baltimore,
Professor of Surgery, Albany Medical College; Chief, Maryland
Division of Vascular Surgery, Albany Medical Center Management of Thoracic Trauma; Management of
Hospital, Albany, New York Pancreatic and Duodenal Injuries
Aortic Surgery
Martin R. Eichelberger, MD
Elizabeth A. David, MD Professor of Surgery and Pediatrics, The George
Resident, General Surgery, Georgetown University Washington University; Attending Surgeon, Children’s
Hospital, Washington, DC National Medical Center, Washington, DC
Arterial Catheterization; Laparoscopic Nissen Pectus Excavatum
Fundoplication
Rebecca Evangelista, MD
James E. Davies, MD Assistant Professor of Surgery, Georgetown University
Assistant Professor, Department of Cardiothoracic Medical Center; Staff Surgeon, Veterans Affairs Medical
Surgery, University of Iowa, Iowa City, Iowa Center, Washington, DC
Pneumonectomy Open Gastrostomy Feeding Tube Placement and
Percutaneous Endoscopic Gastrostomy Tube Placement;
David Deaton, MD
Open Jejunostomy Tube Placement
Assistant Professor, Georgetown University; Chief of
Endovascular Surgery, Division of Vascular Surgery, Stephen R. T. Evans, MD, FACS
Department of Surgery, Georgetown University Robert J. Coffey Professor and Chairman, Department
Hospital, Washington, DC of Surgery, Georgetown University Medical Center,
Endovascular Interventions Washington, DC
From Error to Perfection: The Process of Surgical
Demetrios Demetriades, MD, PhD
Maturation; Teaching Technical Skills—Errors in the
Professor of Surgery, University of Southern California
Process; Preoperative Pitfalls; Arterial Catheterization;
School of Medicine; Director of Trauma and Critical
Chest Tube Insertion; Paracentesis; Laparoscopic Nissen
Care, Los Angeles County and University of Southern
Fundoplication; Laparoscopic Esophagomyotomy with Dor
California Medical Center, Los Angeles, California
Fundoplication; Gastrectomy with Reconstruction
Management of Penetrating Neck Injury
CONTRIBUTORS ix
Eleanor Faherty, MD Kelly Garrett, MD
Staff Surgeon, and Captain, United States Air Force, Chief Resident, Albany Medical College, Albany, New York
Malcolm Grow Medical Center, Andrews Air Force Left Colectomy: Open and Laparoscopic
Base, Maryland
Ankur Gosalia, MD
Open Gastrostomy Feeding Tube Placement and
Assistant Professor of Anesthesiology, Temple
Percutaneous Endoscopic Gastrostomy Tube Placement;
University, Philadelphia; Attending Anesthesiologist,
Open Jejunostomy Tube Placement; Lateral
Western Pennsylvania Hospital, Pittsburgh, Pennsylvania
Pancreaticojejunostomy (Puestow) Procedure;
Anesthesia for the Surgeon
Supraclavicular Lymph Node Biopsy
Vicente H. Gracias, MD
Elizabeth D. Feldman, MD
Associate Professor of Surgery, and Chief, Surgical
Assistant Professor, Georgetown University,
Critical Care, University of Pennsylvania School of
Washington, DC
Medicine, Philadelphia, Pennsylvania
Mastectomy
Damage Control: Abdominal Closures
Felix G. Fernandez, MD
Jay A. Graham, MD
Cardiothoracic Fellow, Barnes-Jewish Hospital, Washington
Resident, Department of Surgery, Georgetown
University School of Medicine, St. Louis, Missouri
University, Washington, DC
Thymectomy and Resection of Mediastinal Masses
Laparoscopic Surgery; Right Hepatectomy; Left Hepatectomy
Richard E. Fine, MD
Philip C. Guzzetta, Jr., MD
Clinical Associate Professor, Department of Surgery,
Professor of Surgery and Pediatrics, The George
University of Tennessee College of Medicine—
Washington University; Pediatric Surgery Chief Resident
Chattanooga Unit, Chattanooga, Tennessee; Director,
Program Director, Children’s National Medical Center,
Breast Care Continuum Program, Wellstar Kennestone
Washington, DC
Hospital, Marietta, Georgia
Malrotation, Volvulus, and Bowel Obstruction
Image-Guided Breast Biopsy
Adil H. Haider, MD, MPH
Thomas M. Fishbein, MD
Assistant Professor of Surgery, Division of Trauma/
Professor, Department of Surgery, Georgetown
Critical Care, Johns Hopkins School of Medicine,
University; Director of Small Bowel and Pediatric Liver
Baltimore, Maryland
Transplant Program, Georgetown University Hospital,
Traumatic Brain Injury; Managing Injuries to the Spleen
Washington, DC
Distal Pancreatectomy; Resection and Reconstruction of Elliott R. Haut, MD, FACS
the Biliary Tract Assistant Professor of Surgery and Anesthesiology and
Critical Care Medicine, Division of Acute Care Surgery:
James FitzGerald, MD
Trauma, Critical Care, Emergency and General Surgery,
Attending Surgeon, Washington Hospital Center,
Department of Anesthesiology and Critical Care
Washington, DC
Medicine, Johns Hopkins School of Medicine; Director,
Ileostomy
Trauma / Acute Care Surgery Fellowship, The Johns
Eugene F. Foley, MD Hopkins Hospital, Baltimore, Maryland
Professor of Surgery, Section of Colon and Rectal Evaluation and Acute Resuscitation of the Trauma Patient
Surgery, Department of Surgery, University of
Mary Hawn, MD, MPH
Wisconsin School of Medicine and Public Health,
Associate Professor of Surgery, and Chief, Section of
Madison, Wisconsin
Gastrointestinal Surgery, University of Alabama at
Hemorrhoidectomy; Anal Fistulotomy
Birmingham, Birmingham, Alabama
Hugh M. Foy, MD Open Primary and Mesh Repairs
Professor of Surgery, and Head, Wind River College,
Richard F. Heitmiller, MD
University of Washington School of Medicine;
Associate Professor of Surgery, Johns Hopkins Medical
Attending Surgeon, Harborview Medical Center,
Institutions; J.M.T. Finney Chairman of Surgery, Union
Seattle, Washington
Memorial Hospital, Baltimore, Maryland
Teaching Technical Skills—Errors in the Process
Esophageal Surgery
Charles M. Friel, MD
Earl Hodin, MD
Associate Professor of Surgery, and Chief, Section of
Attending Surgeon, Children’s National Medical Center,
Colon and Rectal Surgery, University of Virginia,
Washington, DC, and Inova Fairfax Hospital, Falls
Charlottesville, Virginia
Church, Virginia
Low Anterior Resection; Abdominal Perineal Resection
Inguinal and Umbilical Hernias
with Colostomy
x CONTRIBUTORS
Arsalla Islam, MD James Laredo, MD
Assistant Instructor, GI Endocrine Surgery Division, Assistant Professor, Division of Vascular Surgery,
Department of Surgery, University of Texas Department of Surgery, Georgetown University;
Southwestern Medical Center, Dallas, Texas Georgetown University Hospital, Washington, DC
Adrenal Surgery Venous Surgical Pitfalls
Kamal M. F. Itani, MD David W. Larson, MD
Professor of Surgery, Boston University School of Consultant in Surgery and Assistant Professor of
Medicine; Chief of Surgery, Veterans Affairs Boston Surgery, Mayo Clinic, Mayo Medical School, Rochester,
Healthcare System, Boston, Massachusetts Minnesota
Umbilical and Epigastric Hernias Right Colectomy: Open and Laparoscopic
Patrick G. Jackson, MD Edward C. Lee, MD, FACS, FASCRS
Associate Residency Program Director, Georgetown Associate Professor of Surgery, Chief, Section of GI/
University; Assistant Professor of Surgery, Georgetown Surgical Oncology, and Vice Chairman for Clinical
University Hospital, Washington, DC Affairs, Albany Medical College, Albany,
Laparoscopic Surgery; Vagotomy and Pyloroplasty; Lateral New York
Pancreaticojejunostomy (Puestow) Procedure; Pancreatic Left Colectomy: Open and Laparoscopic
Cyst/Debridement
Stacy Loeb, MD
Lynt B. Johnson, MD, MBA Resident in Training (Urology), Johns Hopkins Medical
Professor, Georgetown University; Chief of Transplanta- Institutions, Baltimore, Maryland
tion Surgery, and Vice-Chairman, Department of Surgery, Paracentesis
Georgetown University Hospital, Washington, DC
Amy D. Lu, MD, MPH, MBA
Right Hepatectomy; Left Hepatectomy;
Associate Professor of Surgery, Albert Einstein College
Pancreaticoduodenectomy; Pancreatic Cyst/Debridement
of Medicine; Director, Renal Transplant Program,
Benjamin Kim, MD Montefi ore Medical Center, Bronx, New York
Staff Physician, Kaiser Permanente West Los Angeles Gallbladder: Cholecystectomy (Laparoscopic vs. Open)
Medical Center, Los Angeles, California
Jeffrey Lukish, MD
Laparoscopic Inguinal Hernia Repair
Associate Professor of Surgery and Pediatrics,
Lawrence T. Kim, MD, FACS and Chief, Division of Pediatric Surgery, Uniformed
Professor, Department of Surgery, University of Services University of the Health Sciences,
Arkansas for Medical Sciences; Chief, Surgical Service, Bethesda, Maryland
Central Arkansas Veterans Healthcare System, Little Tracheoesophageal Fistula and Esophageal
Rock, Arkansas Atresia Repair
Parathyroid Surgery
Robyn A. Macsata, MD
Daniel Kreisel, MD, PhD Chief, Vascular Surgery, Veterans Affairs Medical
Assistant Professor of Surgery, Pathology and Center, Washington, DC
Immunology, Washington University in St. Louis, Arteriovenous Hemodialysis Access
St. Louis, Missouri
Donna-Marie Manasseh, MD
Thymectomy and Resection of Mediastinal Masses
Co-Director of the Women’s Breast Health Center,
John C. Kucharczuk, MD Stamford Hospital Foundation, New Haven,
Assistant Professor of Surgery, University of Connecticut
Pennsylvania School of Medicine; Division of Thoracic Axillary Surgery
Surgery, Hospital of the University of Pennsylvania,
Carlos E. Marroquin, MD
Philadelphia, Pennsylvania
Assistant Professor of Surgery, Duke University Medical
Bronchoscopy: Flexible and Rigid; Esophagoscopy: Flexible
Center, Durham, North Carolina
and Rigid; Mediastinoscopy; and Anterior
Trisectionectomy
Mediastinotomy
M. Blair Marshall, MD, FACS
Paul C. Kuo, MD, MBA
Associate Professor of Surgery, Georgetown University
Professor of Surgery, and Chief, Division of General
School of Medicine; Chief, Division of Thoracic
Surgery, Duke University Medical Center, Durham,
Surgery, Department of Surgery, Georgetown University
North Carolina
Medical Center, Washington, DC
Trisectionectomy
Bronchial and Vascular Sleeve Lobectomy
CONTRIBUTORS xi
Marga F. Massey, MD, FACS Kurt D. Newman, MD
Associate, Center for Microsurgical Breast Professor of Surgery and Pediatrics, The George
Reconstruction, Charleston/Chicago/Salt Lake City, Washington University School of Medicine; Surgeon in
Charleston, South Carolina Chief, and Executive Director, Joseph E. Robert, Jr.
Component Separation for Complex Abdominal Wall Center for Surgical Care, Children’s National Medical
Reconstruction and Recurrent Ventral Hernia Repair Center, Washington, DC
Pyloromyotomy
Aarti Mathur, MD
Resident in Surgery, Georgetown University, C. Joe Northup, MD, FACS
Washington, DC Assistant Professor, University of Virginia Health
Chest Tube Insertion; Laparoscopic Splenectomy System, Charlottesville, Virginia
Laparoscopic Appendectomy
Fabio May da Silva, MD
Professor of Clinical Surgery, Universidade do Sul de Fiemu Nwariaku, MD, FACS, FWACS
Santa Catarina; Thoracic Surgeon, Secretaria do Estado Malcolm O. Perry MD Professor, and Associate Professor
de Santa Catarina, Florianopolis, Santa Catarina, Brazil and Vice Chair, Department of Surgery, University of
Bronchial and Vascular Sleeve Lobectomy Texas Southwestern Medical Center, Dallas, Texas
Adrenal Surgery
Michael McLeod, MD
Associate Professor, Michigan State University, Michael D. Pasquale, MD, FACS, FCCM
Kalamazoo, Michigan Associate Professor of Surgery, Penn State College of
Thyroid Surgery Medicine, Penn State University, Hershey; Senior Vice
Chair, Department of Surgery, Chief, Division of
Aziz Merchant, MD
Trauma/Surgical Critical Care, and Member of Staff,
Fellow, Minimally Invasive Surgery, Emory University,
General Surgery, and Trauma/Surgical Critical Care,
Atlanta, Georgia
Lehigh Valley Hospital, Allentown, Pennsylvania
Pyloromyotomy
Central Vein Catheterization; Pulmonary Artery
Angela M. Mislowsky, MD Catheterization
Chief Resident—Surgery, Union Memorial Hospital,
James F. Pingpank, Jr., MD
Baltimore, Maryland
Head, Surgical Metabolism Section, Surgery Branch,
Esophageal Surgery
National Cancer Institute, National Institutes of Health,
Bruno Molino, MD Bethesda, Maryland
Director, Division of Trauma, Liberty Health—Jersey Isolated Limb Perfusions and Extremity Amputations
City Medical Center, Jersey City, New Jersey
Dahlia Plummer, MD
Damage Control: Abdominal Closures
Vascular Fellow, Georgetown University, Washington, DC
Gitonga Munene, MD Carotid Endarterectomy
Chief Resident Physician, Georgetown University
Todd A. Ponsky, MD
Hospital, Washington, DC
Assistant Professor of Surgery, Case Western Reserve
Gastrectomy with Reconstruction
University; Assistant Professor of Surgery, Division of
Russell J. Nauta, MD, FACS Pediatric Surgery, Rainbow Babies and Children’s
Professor of Surgery, Harvard Medical School; Vice- Hospital, Cleveland, Ohio
Chairman, Surgery, Beth Israel-Deaconess Medical Wilms’ Tumor and Neuroblastoma
Center; Chairman of Surgery, Mount Auburn Hospital
David M. Powell, MD
and Harvard Health Services, Cambridge, Massachusetts
Associate Professor of Surgery and Pediatrics, The
General Laparotomy
George Washington University; Attending Surgeon,
Edward W. Nelson, MD Children’s National Medical Center, Washington, DC
Professor of Surgery and Division Chief of General Pectus Excavatum
Surgery, University of Utah School of Medicine,
Brian Reuben, MD
Salt Lake City, Utah
Chief Resident, General Surgery, University of Utah,
Prolene Hernia System—Hernia Repair
Salt Lake City, Utah
Richard F. Neville, MD Component Separation for Complex Abdominal Wall
Chief, Division of Vascular Surgery, and Medical Reconstruction and Recurrent Ventral Hernia Repair
Director, Non-invasive Vascular Lab, Georgetown
T. A. Rothenbach, MD
University Hospital, Washington, DC
Staff Surgeon, Pediatric Surgery Inc., The Children’s
Carotid Endarterectomy; Infrainguinal
Hospital at Saint Francis, Tulsa, Oklahoma
Revascularization
Congenital Diaphragmatic Hernia
xii CONTRIBUTORS
Shawn D. Safford, MD Scott J. Swanson, MD
Assistant Professor of Surgery, Uniformed Services The Eugene W. Friedman Professor of Surgical
University of the Health Sciences, Bethesda, Maryland Oncology, Mount Sinai School of Medicine; Chief,
Tracheoesophageal Fistula and Esophageal Atresia Repair Division of Thoracic Surgery, Mount Sinai Medical
Center, New York, New York
Ali Salim, MD
Lobar Resections
Program Director, General Surgery Residency, Cedars-
Sinai Medical Center, Los Angeles, California Lorraine Tafra, MD
Management of Penetrating Neck Injury Director, The Breast Center, Anne Arundel Medical
Center, Annapolis, Maryland
Rovinder S. Sandhu, MD, FACS
Breast Biopsy and Breast-Conserving Surgical Techniques
Clinical Assistant Professor of Surgery, Penn State
College of Medicine, Penn State University, Hershey; Amit D. Tevar, MD, FACS
Medical Director, Adult Transitional Trauma Unit, and Assistant Professor, University of Cincinnati, Cincinnati, Ohio
Member of Staff, General Surgery, and Trauma/Surgical Laparoscopic Liver Resection
Critical Care, Lehigh Valley Hospital, Allentown, Mark J. Thomas, MD
Pennsylvania Assistant Professor, University of Cincinnati, Cincinnati, Ohio
Central Vein Catheterization; Pulmonary Artery Laparoscopic Liver Resection
Catheterization
Trevor Upham, MD
Babak Sarani, MD Surgical Resident, Department of Surgery, Georgetown
Assistant Professor of Surgery, University of University Hospital, Washington, DC
Pennsylvania; Attending Surgeon, Division of Pancreatic Cyst/Debridement
Traumatology, Emergency Surgery, and Surgical Critical
Daniel Vargo, MD
Care, Hospital of the University of Pennsylvania,
Associate Professor of Surgery, Division of General
Philadelphia, Pennsylvania
Surgery, Department of Surgery, University of Utah,
Anesthesia for the Surgeon; Graham Patch Repair
Salt Lake City, Utah
John E. Scarborough, MD Component Separation for Complex Abdominal Wall
Assistant Professor of Surgery, Department of Surgery, Reconstruction and Recurrent Ventral Hernia Repair
Duke University Medical Center, Durham, North Carolina
Diana M. Weber, MD
Trisectionectomy
Surgeon, Presbyterian Hospital, Albuquerque, New Mexico
Bruce Schirmer, MD Laparoscopic Splenectomy; Supraclavicular Lymph
Stephen H. Watts Professor of Surgery, University of Node Biopsy
Virginia Health System, Charlottesville, Virginia
Todd S. Weiser, MD
Laparoscopic Gastric Bypass
Assistant Professor, Mount Sinai School of Medicine;
Joseph B. Shrager, MD Attending, Mount Sinai Medical Center, New York,
Professor of Cardiothoracic Surgery, Stanford University New York
School of Medicine, Stanford; Chief, Division of Lobar Resections
Thoracic Surgery, Stanford University Hospital, Tamica White, MD
Stanford; Staff Surgeon, Palo Alto Veterans Affairs
Thoracic Surgeon, Surgical Specialists of North Jersey,
Health Care System, Palo Alto, California
Englewood, New Jersey
Cervical Tracheal Resection and Reconstruction
Vagotomy and Pyloroplasty
Anton N. Sidawy, MD, MPH Shawna C. Willey, MD, FACS
Professor of Surgery, Georgetown and George Washington Associate Professor, Georgetown University; Director,
University Schools of Medicine; Chief, Surgical Service, Betty Lou Ourisman Breast Health Center, Lombardi
Veterans Affairs Medical Center, Washington, DC Comprehensive Cancer Center, Washington, DC
Arteriovenous Hemodialysis Access Mastectomy
Niten Singh, MD Alexander Wohler, MD
Assistant Professor of Surgery, Uniformed Services Fellow in Cardiothoracic Surgery, Mount Sinai Medical
University of the Health Sciences, Bethesda, Maryland; Center, New York, New York
Chief, Endovascular Surgery, Madigan Army Medical Laparoscopic Esophagomyotomy with Dor Fundoplication
Center, Tacoma, Washington
James C. Yang, MD
Venous Surgical Pitfalls; Endovascular Interventions
Assistant Professor, Uniformed Services University of
William H. Snyder, MD the Health Sciences; Senior Investigator, Surgery
Professor of Surgery, Department of Surgery, University Branch, National Cancer Institute, National Institutes of
of Texas Southwestern Medical Center, Dallas, Texas Health, Bethesda, Maryland
Adrenal Surgery Management of Soft Tissue Sarcoma
Preface
It is on our failures that we base a new and different and better success.
—Havelock Ellis
As a profession, surgeons are exceedingly reluctant to view in the introductory section on the process of surgical
publicize our errors. Whether they are errors in judgment maturation.
or intraoperative technical errors, they are usually kept to During this fi rst edition we have attempted to be as
ourselves or become semi-public when presented formally comprehensive as possible in describing all major pub-
at the usual Morbidity and Mortality conferences held lished intraoperative complications and intraoperative
weekly at all hospitals by surgeons throughout the country. errors that are made in our decision making. As previously
It is quite clear, however, that the Morbidity and Mortal- stated, however, surgeons are reluctant not just to talk
ity conference proves to be the most educationally pro- about our mistakes, but certainly loathe publishing
ductive conference for all surgeons because of how much them. In preparation for our second edition we are actively
we learn from our own errors as well as the errors of soliciting cases with substantial intraoperative or radio-
others. graphic confi rmation and documentation of the specifi c
Surgical Pitfalls has been a work in progress for many errors and complications that have occurred with the
years and is targeted not just at surgeons in training but intent of making the second edition even more compre-
at surgeons of all levels of expertise. Our hope is that this hensive and truly an “Encyclopedia of Error” or the
will lead to signifi cant error prevention and improve and “Textbook of Morbidity and Mortality.”
enhance error training through surgical residencies. We I would like to thank all of our extremely talented con-
have therefore constructed this book to include all of the tributing authors for their tremendous time and effort put
major specialties in surgery. in to this fi rst edition. It is certainly much easier to write
This book is unique in its intent to identify intraopera- an operative procedures textbook on how to do an oper-
tive errors that occur at specifi c steps during both simple ation; it is far more diffi cult to write a procedures manual
and complex operations, but more importantly identifying on how NOT to do an operation. I greatly thank our
how to prevent the error, the consequences of the error contributors for their patience as we moved through this
if they occur, and lastly, how to repair or correct the error sometimes arduous process. We have adhered to a tem-
once it has happened. The book covers over 80 major plate which we hope that the reader will fi nd exceedingly
operative procedures in addition to discussing common useful and user-friendly. In addition to our contributing
errors, especially errors in preoperative decision making authors I would like to extend a heartfelt thanks to our
based upon individual organ systems and risk stratifi cation staff at Elsevier, including Scott Scheidt, Sarah Myer, and
that should be considered in preoperative assessment and our publishing director, Judy Fletcher. They have shared
evaluation of all patients. Additionally, errors made in the passion, excitement and energy that we all have for
teaching technical skills are reviewed, errors in communi- this fi rst edition and have made the job all that much
cation that lead to medical legal issues, and lastly an over- easier.
Stephen R. T. Evans, MD, FACS