Farquharson's Textbook of Operative General Surgery

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The publishers wish to make clear that any views or opinions expressed in this book by individual editors, authors or contributors are personal to them and do not necessarily reflect the views/opinions of the publishers. To calculate the overall star rating and percentage breakdown by star, we don’t use a simple average. LigaSure™ and Ultracision® are electrothermal bipolar tissue sealing devices; Harmonic® coagulating shears use high-frequency mechanical vibrations in the ultrasonic range to fragment tissues and seal small vessels. The head-down b tilt (Trendelenberg) position for varicose vein and pelvic surgery and the head-up tilt for thyroid surgery are examples.

The technique, and its place in the surgery of rectal cancer, are discussed in more detail in Chapters 23 and 24.One example is the use of cross-sectional imaging, such as CT, ultrasound or MRI, to demonstrate the presence and position of pus. As the skin in most areas of the body requires the support of sutures for the healing wound for at least 7 days, these little punctate scars may be unavoidable. Ultimately it is the sole responsibility of the medical professional to make his or her own professional judgements, so as to advise and treat patients appropriately.

Ablation of abnormal electric foci in the myocardium, closure of septal defects and even some valve surgery can be undertaken by this route. Nor does it cover operating theatre safety, communication and teamworking (an area that will be indispensable in the future). This title presents all the operations which the trainee surgeon may be expected to undertake, discussing the basic techniques available and the reasons for their application. This book does not indicate whether a particular treatment is appropriate or suitable for a particular individual. An earlier tutor in the Edinburgh School of Surgery, the late lamented Ian Aird, thus prepared his wonderful Companion to Surgical Studies, which covered a broad field of surgery (omitting orthopedics, perhaps in deference to Watson Jones's classic text).

Whereas most of the developments described above have been dependent on improvements in flexible scopes and of instruments that can be passed through the small operating channels, transanal endoscopic microsurgery (TEMS) is performed through a specially designed rigid proctoscope.

Small linear cutting stapling devices have been of particular benefit in the safe division of large veins, where the length of the vein is too short to accommodate ligatures. Laparoscopic access and some general intra-abdominal principles are discussed in Chapters 13 and 14. It represents a departure from the usual physical examination teaching tools which, in their attempts to be all inclusive, tend to de-emphasize the practical nature of patient care. The ninth edition of the Farquharson's Textbook of Operative General Surgery is both a classical and a modern book. The additional scarring from sutures is avoided, but it should be noted that a subcuticular suture gives no support to the underlying tissue.The information or guidance contained in this book is intended for use by medical, scientific or health-care professionals and is provided strictly as a supplement to the medical or other professional’s own judgement, their knowledge of the patient’s medical history, relevant manufacturer’s instructions and the appropriate best practice guidelines. Interrupted skin sutures should be of a fine smooth non-absorbable material such as nylon or polypropylene (Prolene), which causes less tissue reaction than silk. It also manages to include operative situations that could present unexpectedly to a general surgeon working in a rural area or overseas with limited referral resources. Increase in bleeding is nearly always a sign that the surgeon has wandered out of the correct plane or that the underlying pathology, whether inflammatory or malignant, has itself breached the plane.

In all of these an endoluminal stent can be placed across the obstruction, under image control by the radiologist, although for some stents additional endoscopy is needed. At the end of a continuous suture (for example, closure of the abdominal wall), the surgeon is left to tie a ‘loop’ to an ‘end’, which is not ideal, especially in slippery monofilament material. It is therefore important to include as little adjacent tissue as possible in the clamp, to use the finest material consistent with security and not to leave 6 Surgery of the skin and subcutaneous tissue the cut ends longer than necessary. You can change your choices at any time by visiting Cookie preferences, as described in the Cookie notice.A non-absorbable nylon or Prolene subcuticular suture avoids the tissue reaction associated with vip. This tenth edition has been fully revised and updated, while retaining the core philosophy that has ensured its popularity over six decades-to provide an authoritative guide to operative surgery for the general surgeon in a manageable single volume. Below the knee, and on b the back, sutures are needed to prevent skin dehiscence for around 2 weeks.