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When doctors first look at sutureless anastomosis devices created by new technologies, the most frequent comment is how amazingly easy it is to create a vascular anastomosis and, as a direct consequence, they believe anybody could play the role of the cardiovascular surgeon. Pessimistic c- diovascular surgeons, on their side, think that creating a machine capable of perfectly reproducing their core activity, which consists in making an- tomosis, will kill their profession. Actually, no medical specialty’s demise has been more often predicted and, at the same time, more greatly ex- gerated than that of cardiovascular surgery. According to its detractors, - ginning in the late 1980s with the angioplasty boom, continuing in the mid-1990s with the introduction of bare metal stents, and then more - cently with the introduction of drug-eluting stents, cardiovascular surgery has been on life support for nearly 15 years. This specialty’s claimed collapse has generally been attributed to recent advantages in percutaneous procedures and devices that give the oppor- nity to non-surgeon doctors to accomplish the surgeon’s work. The reality is different. Data suggest that cardiac surgery continues to survive and has not suffered the precipitous decline that was predicted. From the economical standpoint, CABG is much more of a mature market and the size of the opportunity remains impressive and relatively stable, with around 1,500,000 procedures performed annually worldwide, at a total cost approaching 2. 5 billion US$.
This book shows how new technologies and technical skills together with deeper understanding of pathophysiology of visceral and renal ischemia have contributed to significant improvements in the clinical outcomes in patients undergoing complex aortic repair involving splanchnic arteries. In recent years, aortic repair has expanded its borders, focusing more and more on the particularly challenging segments from which critical branches originate. Optimal results in this area are obtained through a multidisciplinary approach based on crucial elements such as sophisticated imaging techniques, advanced anesthesiological and pharmacological strategies, as well as updated surgical techniques and devices able to reduce ischemic injuries. The book presents problems tackled from different perspectives, by analyzing the main technical aspects of the surgical technique but also functional and metabolic issues. It also discusses concepts such as ischemic preconditioning and ischemia-reperfusion mechanisms, as well as innovative investigational approaches. In the “endovascular era”, it highlights the most recent updates in complex endovascular repair involving renal and visceral arteries, providing both practical tips and tricks and outcomes analyses. The volume also addresses specific, rarely reported problems in vascular surgery, including issues in renal transplant, oncologic surgery with involvement of splanchnic arteries and of the vena cava, and use of the deep veins in aortic surgery. This volume represents a powerful tool for both young and experienced operators who wish to approach the complex aortic pathology either by open surgery or through endovascular methods.”
The book encompasses the different concepts and designs using magnets for surgical purposes. It provides a concise yet comprehensive summary of the current status of the field that will help guide patient management and stimulate investigative efforts. The text reviews new data about interventions in all medical and surgical fields. Written by experts in their fields, topics focus on endoluminal and laparoscopic operations, techniques from vascular and GI anastomosis. The book demonstrates the use of magnets to treat a variety of diseases such as reflux, back pain, and fecal incontinence. The reader will learn how to retract and gain exposure, dissect tissue planes, achieve hemostasis, and create anastomosis in a totally different way. Physical properties of external surface and internal magnets are discussed. The authors emphasize the importance of partnering with industry leaders to develop novel surgical tools. By harnessing the power of attraction, the energy and might of magnets, Magnetic Surgery serves as a valuable resource for clinicians, surgeons and researchers in biomedical engineering interested in this form of energy and physical metal properties. In utilizing these properties, the book seeks to improve surgical outcomes of patients worldwide.
This third edition text provides a completely revised and updated new version of this unique, modern, practical text that covers the strategic evaluation, specific approaches, and detailed management techniques utilized by expert colorectal surgeons caring for patients with complex problems–whether they result from underlying colorectal disease or from complications arising from previous surgical therapy. The format follows that of both a “how to” manual as well as an algorithm-based guide to allow the reader to understand the thought process behind the proposed treatment strategy. By making use of evidence-based recommendations, each chapter includes not only background information and diagnostic/therapeutic guidelines, but also provides a narrative by the author on his/her operative technical details and perioperative “tips and tricks” that they utilize in the management of these complex surgical challenges. Distinctive to this book, is the reliance on experts in the field including past presidents of the ASCRS, as well as multiple other national and internationally recognized surgeons, to lend their personal insight into situations where data may be more sparse, but individual and collective experience is paramount to making sound decisions and thereby optimizing patient outcomes. The text includes chapters on the assessment of risk and methods utilized to minimize perioperative complications. In addition, it incorporates sections covering the medical and surgical therapies for abdominal, pelvic and anorectal disease. Moreover, the technical challenges of managing complications resulting from the original or subsequent operations is addressed. The underlying focus throughout the text is on providing pragmatic and understandable solutions that can be readily implemented by surgeons of varying experience to successfully treat complex colorectal problems. However, it also goes beyond the technical aspects of colorectal surgery and includes special sections highlighting the essence of a surgeon; covering aspects involving the medical-legal, ethical, and economic challenges confronting surgeons. Throughout the text, each author provides an ongoing narrative of his/her individual surgical techniques along with illustrations and diagrams to “personally” take the reader through the crucial steps of the procedure, and key points of patient care inherent to that topic. Additionally, where appropriate, links to online videos give the reader an up-front look into technical aspects of colorectal surgery.
Gastrointestinal Surgical Techniques in Small Animals überzeugt durch die detailreiche Beschreibung von Operationstechniken, die bei der Behandlung des Magen Darm-Trakts von Hunden und Katzen zum Einsatz kommen. Jedes Kapitel beschreibt ein Operationsverfahren in aller Ausführlichkeit, ergänzt um hochwertige Illustrationen zu jedem Operationsschritt. Tipps und Tricks für ein erfolgreiches Operationsergebnis werden vorgestellt, ebenso mögliche Komplikationen. Auf der begleitenden Website können Videoclips zu den verschiedenen Verfahren abgerufen werden. - Logischer Aufbau nach anatomischen Abschnitten. Jedes Kapitel beschreibt ein bestimmtes Operationsverfahren, die Indikationen und Kontraindikationen und gibt Entscheidungshilfen. Tipps und Tricks werden vorgestellt, ebenso mögliche Komplikationen. - Beschreibt im Detail Operationen des Magen-Darm-Trakts bei Hunden und Katzen. - Präsentiert die neuesten Erkenntnisse zu dem Fachgebiet. - Begleitende Website mit den Videoclips der verschiedenen Techniken. Gastrointestinal Surgical Techniques in Small Animals ist ein Muss für Veterinärchirurgen und Veterinärmediziner für Kleintiere.
This is the most authoritative textbook ever dedicated to the art and science of surgical coronary revascularization, with 71 chapters, organized in 9 sections, and written by over 100 recognized world experts. It covers every aspect of the surgical management of coronary artery pathology and ischaemic heart disease.
The anastomotic technique plays a predominant role in gastrointestinal surgery. A feared complication is leakage due to the sutures. Such leakage cannot be detected early; consequently, infection spreads locally and systemically. An anastomotic method is generally evaluated according to its rate of leakage, related to the localization, bur real scientific comparisons, i.e., controlled studies, are almost totally lack ing. The criteria of evaluation include the type of suture, the localization, the auxiliary technical tools, practicability, the different forms of wound healing, angiogenesis, and vascularization, among others. The postoperative criteria are complications shortly after surgery, such as bleeding, ruptures, and stenoses of the anastomosis. A standard comparison is made difficult by the variety of cytophysiological and biochemical factors that influence wound healing. In the comparison of larger series one must always take into account differences of auxiliary tools, strategies, and inhomogeneity of patients. A change of one auxiliary tool or of one strategy implies the modification of various target criteria. Often enough, however, one does not sufficiently consider the surgeon's most. important role.
Complexities in Colorectal Surgery: Decision-Making and Management provides a unique, modern, practical guide that covers the strategic evaluation, specific approaches, and detailed management techniques utilized by expert Colorectal Surgeons caring for patients with complex problems—whether they result from underlying colorectal disease or from complications arising from previous surgical therapy. The text is formatted as both a “how-to” manual as well as an algorithm-based guide allowing the reader to understand the thought process behind the proposed treatment strategies. By making use of evidence-based recommendations, each chapter will include not only diagnostic and therapeutic guidelines, but also a narrative by the author on his/her operative technical details and perioperative “tips and tricks” that they utilize in the management of these complex surgical challenges. This test includes chapters on the assessment of risk and nutritional intervention methods utilized to minimize perioperative complications. In addition, sections on medical and surgical therapies for abdominal, pelvic and anorectal disease are incorporated. Moreover, the technical challenges of managing complications resulting from the original or subsequent operations is addressed. The underlying focus throughout the text is to provide pragmatic and understandable solutions that can be readily implemented by surgeons of varying experience to successfully treat complex colorectal problems. The text also goes beyond the technical aspects of Colorectal Surgery and includes special sections highlighting the essence of a surgeon. These include chapters describing the importance of the first encounter, building patient rapport, and demonstrating confidence and competence while showing humility and avoiding arrogance. Additionally, aspects involving the medical-legal, ethical, and economic challenges confronting surgeons are covered.
This textbook provides a succinct overview of cardiac surgery, with key concepts being emphasized throughout. An abundance of illustrations, intra-operative photographs, tables as well as information boxes, aids the reader to visualise, grasp and retain difficult concepts. The inclusion of evidence-based approaches to the management of a range of cardiac surgical conditions equips the reader with an understanding of how to overcome a variety of potentially tough clinical challenges. Concise Cardiac Surgery: A Complete Guide comprehensively covers a range of techniques used in cardiac surgery. It is therefore, an ideal resource for the trainee and practising cardiac surgeon seeking a practically focused text detailing how to apply the latest techniques and evidence-based approaches in their day-to-day practice.
A practical, comprehensive guide to the special needs of infants and neonates undergoing anesthesia.