The international bestseller from the author of Being Mortal In these gripping accounts of true cases, bestselling author Atul Gawande performs exploratory surgery on medicine itself, laying bare a science not in its idealised form, but as it actually is - complicated, perplexing and profoundly human. This is a stunningly well-written account of the life of a surgeon: what it is like to cut into people's bodies and the terrifying - literally life and death - decisions that have to be made: operations that go wrong; of doctors who go to the bad; why autopsies are necessary; what it feels like to insert your knife into someone. 'Written as tautly as a thriller' Observer
This volume offers authoritative, evidence-based recommendations for preventing and managing complications in all current general surgery procedures. The opening sections discuss institutional risk management issues and risks common to all operations, such as wound healing problems, infection, shock, and complications in immunosuppressed patients. Subsequent sections focus on complications of specific procedures in thoracic, vascular, gastric, endocrine, breast, and oncologic surgery, as well as organ transplantation and pediatric surgery. For each procedure, the authors discuss surgical goals, expected outcomes, preoperative identification of risk factors, intraoperative technique, and postoperative risk. Numerous decision-making algorithms, drawings of techniques, and tables complement the text.
Divided into five sections focusing on perioperative, surgical, pediatric, endoscopic and laparoscopic, and miscellaneous complications, this guide supplies state-of-the-art strategies for the identification, prevention, and management of the myriad complications that can arise during urologic surgical treatment. With contributors from leading health centers across the United States, this source reviews the potential complications of the latest laparoscopic procedures, as well as those related to systemic conditions.
As Professor Owen H Wangensteen, one of the greatest academic surgeons of the 20th century, said: ?You are a true surgeon from the moment you are able to deal with your complications.? Prompt and accurate diagnosis, as well as effective treatment, of surgical complications is one of the most important elements of surgical practice. This is today more important than at any other time, since over the last 20 years we have witnessed the development of new surgical sub-specialties, the performing of complicated operations in very challenging patients, the introduction of new technologies in surgical practice and, last but not least, an increasing interest in monitoring the quality, medico-legal implications, and ethical dimensions of surgical practice and malpractice. As surgical complications have been presented briefly and sporadically in various books and only as a small part of chapters dealing with surgical techniques, there is a pressing need for a modern textbook dealing with the diagnosis, treatment, auditing, medico-legal implications and ethical problems related to surgical complications.Written by internationally known authors, the chapters deal with both the general issues regarding the surgical complications and the specific issues related to each surgical specialty. Each chapter includes: clinical presentation; diagnosis (clinical, laboratory investigations, imaging); treatment (conservative, surgical); and outcome.
Written by internationally recognized master surgeons, this book is a comprehensive, practical guide to prevention, diagnosis, and management of complications in shoulder surgery. Major sections focus on open and arthroscopic surgery, and each section includes chapters on specific procedures, such as surgery for anterior shoulder instability, surgery for posterior/multidirectional instability, rotator cuff repair, arthroplasty, fracture management, arthrodesis, subacromial decompression, acromioclavicular joint resection, and thermal capsulorrhaphy. For each procedure, the authors discuss the full range of potential complications and present their preferred approaches to prevention, diagnosis, and treatment of these problems. More than 200 illustrations complement the text.
Patients with cancer can suffer from a bewildering variety of neurologic signs and symptoms. The neurologic symptoms are often more disabling than the primary cancer. Symptoms including confusion, seizures, pain and paralysis may be a result of either metastases to the nervous system or one of several nonmetastatic complications of cancer. The physician who promptly recognizes neurologic symptoms occurring in a patient with cancer and makes an early diagnosis may prevent the symptoms from becoming permanently disabling or sometimes lethal. This monograph, an update of the first edition published in 1995, is divided into 3 sections. The first classifies the wide variety of disorders that can cause neurologic symptoms the patient with cancer, discusses the pathophysiology of nervous system metastases, the pathophysiology and treatment of brain edema and the approach to supportive care of common neurologic symptoms such as seizures, pain, and side effects of commonly used supportive care agents. The second section is devoted to nervous system metastases, addressing in turn, brain, spinal cord, meningeal and cranial and peripheral nerve metastases, describing clinical symptoms, approach to diagnosis and current treatment. The third section addresses several nonmetastatic complications of cancer and includes sections on vascular disease, infections, metabolic and nutritional disorders, side chemotherapy, radiation and other diagnostic and therapeutic procedures. The final chapter addresses paraneoplastic syndromes. The book is intended for practicing oncologists, neurologists, neurosurgeons and radiation oncologists as well as internists who treated patients with cancer. Our attempt was to write a book that would assist oncologists in understanding neurologic problems and neurologists in understanding oncologic problems. The book is also intended for physicians training to specialize in any of the above areas. It includes a practical approach to the diagnosis and management of patients with neurologic disease who are with known to have cancer or in whom cancer is suspected.
Body piercings, tattoos, and permanent make-up have become very popular as a fashion statement in recent decades. This book guides the reader through the world of body art. An overview is first provided of the history and epidemiology of tattoos and piercings. Subsequent chapters go on to examine in detail the materials and devices used in various forms of body art, and the techniques employed. All relevant risks and potential complications are clearly described with the aid of color illustrations. Special attention is paid to allergic reactions and the management of complications. The closing chapter examines the techniques and devices used for tattoo removal, with a particular focus on the use of different lasers.
Substantially revised to reflect the most recent surgical techniques and practices, this reference describes the most effective strategies to prevent, identify, and manage complications in vascular surgery-guiding surgeons through patient selection; instances of entrapment, malpositioning, and rupture; emerging endovascular treatments; and specific device-related complications.
World-renowned experts in the field guide you through the potential intra- and post-operative risks associated with the dermatologic surgeries you perform every day. You'll find cutting-edge knowledge on how to avoid and manage complications resulting from laser surgery, photodynamic therapy, hair transplantation, chemical peeling, dermabrasion, leg vein treatments, temporary fillers, permanent fillers, botulinum toxin, liposuction, blepharoplasty, facelifts and ancillary facial cosmetic surgery procedures, skin cancer surgery/Mohs' micrographic surgery, reconstructive surgery, electrosurgery, cryosurgery, nail surgery, and contact dermatitis in dermatologic surgery. The preparation of the patient, psychosocial issues, and anesthesia complications for all procedures are also covered. World-renowned experts guide you through the potential intra- and post-operative complications, preventive measures, and treatment options relating to dermatologic surgery. Comprehensive coverage of the most common dermatologic surgical procedures, including cosmetic, general, and cutaneous oncology surgeries, helps you assess the risks associated with a particular surgery and determine which option is best for your patient. Detailed evaluations of treatment options and plans equip you with the knowledge you need to confidently manage any complication. The bonus CD-ROM contains all the book's illustrations for on-the-go reference.
Risk management is a relatively new process that can sometimes evoke feelings of suspicion among clinicians. However, when used proactively, it offers the opportunity to act at the root cause of an incident to expose de? ?ci- cies in the system rather than in individuals. This process encourages a s- portive approach to patients, relatives, and staff. The overall aim should be to learn lessons rather than to attribute blame. References 1. Vincent C, Neale G, Woloshynowych M. Adverse events in British hospitals: a p- liminary retrospective record review. Br Med J. 2001;322:517–519. 2. Neale G, Woloshynowych M, Vincent C. Exploring the causes of adverse events in NHS hospital practice. J R Soc Med. 2001;94:322–330. 3. Walshe K. The development of clinical risk management. In: Vincent C, ed. Clinical Risk Management. London: BMJ Publishing Group; 2001, p. 45–60. 4. Department of Health. An Organization with a Memory. London: HMSO; 2000. 5. National Patient Safety Agency. Reporting incidents. Available at: http://www.npsa. nhs.uk/health/reporting. Assessed June 25, 2007. 6. National Con? ? dential Enquiry into Perioperative Deaths. Changing the way we operate. The 2001 Report of the National Con? ? dential Enquiry into Perioperative Deaths. London: National Con? ?dential Enquiry into Perioperative Deaths; 2001. Available at: http://www.ncepod.org.uk. Assessed June 25, 2007. 7. General Medical Council. Good Medical Practice. London: General Medical Council; 2006. Available at: http://www.gmc-uk.org/guidance/good_medical_practice/index. asp.