Surgical Anatomy and Technique: A Pocket Manual

696 Pages·2009·53.57 MB·English

by  Lee John Skandalakis

Surgical Anatomy and Technique
Third Edition
Lee John Skandalakis
John E. Skandalakis
Panajiotis N. Skandalakis
Surgical Anatomy
and Technique
A Pocket Manual
Third Edition
Lee J. Skandalakis, MD, FACS Panajiotis N. Skandalakis, MD, MS
Clinical Professor of Surgical Clinical Professor of Surgical
Anatomy and Technique Anatomy and Technique
Emory University School Emory University School
of Medicine of Medicine
Attending Surgeon Atlanta, Georgia
Piedmont Hospital and
Atlanta, Georgia Professor and Chairman
Department of Anatomy
John E. Skandalakis, MD, PhD, FACS University of Athens School
Chris Carlos Distinguished of Medicine
Professor of Surgical Anatomy Athens, Greece
and Technique
Director, Centers for Surgical
Anatomy and Technique
Professor of Surgery
Emory University School
of Medicine
Atlanta, Georgia
Clinical Professor of Surgery
Medical College of Georgia,
Augusta, Georgia, and
Mercer University School
of Medicine
Macon, Georgia
ISBN: 978-0-387-09514-1 e-ISBN: 978-0-387-09515-8
DOI: 10.1007/978-0-387-09515-8
Library of Congress Control Number: 2008938655
© Springer Science+Business Media, LLC 2009
All rights reserved. This work may not be translated or copied in whole or in part without
the written permission of the publisher (Springer Science+Business Media, LLC, 233
Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with
reviews or scholarly analysis. Use in connection with any form of information storage
and retrieval, electronic adaptation, computer software, or by similar or dissimilar meth-
odology now known or hereafter developed is forbidden.
The use in this publication of trade names, trademarks, service marks, and similar terms,
even if they are not identified as such, is not to be taken as an expression of opinion as to
whether or not they are subject to proprietary rights.
Printed on acid-free paper
springer.com
To the medical staff at Piedmont Hospital in Atlanta.
You are truly the sine qua non.
LJS
Preface to the
Third Edition
A good surgeon must have an eagle’s eye,
a lion’s heart and a lady’s hand.
—English saying
In this third edition of Surgical Anatomy and Technique: A Pocket Manual, we
are very pleased to add three new chapters: the vascular system by Drs. Deepak
G. Nair and Robert B. Smith III; the uterus, ovaries, and tubes by Dr. Ramon
A. Suarez; and microsurgical techniques by Drs. John G. Seiler III and Petros
Mirilas.
Drs. Seth D. Force and Daniel L. Miller revised several procedures in the
chapter on the esophagus. In the section on hemorrhoidectomies, Dr. Joseph J.
Nichols, Jr., provided techniques for stapled hemorrhoidectomy and band liga-
tion. Procedures for laparoscopic left colectomy including sigmoid colectomy
and for laparoscopic-assisted right colectomy were added by Dr. Jay Singh in
collaboration with Dr. Lee Skandalakis.
As in preceding editions we continue to present only basic (“nuts and bolts”)
surgical techniques, not advanced procedures such as transplantation and robot-
ics, because we are committed to maintaining this book as a “pocket manual.”
We hope that the several chapters we reorganized are now easier to use. We
want to mention that the sutures specifi ed in the text are those preferred by the
authors, but comparable sutures can be used at the surgeon’s discretion.
My co-authors and I greatly appreciate the support we have received from
Springer and the confi dence Springer has had in Surgical Anatomy and Tech-
nique: A Pocket Manual. The book has been translated into eight languages in
addition to being distributed throughout the world in English. We are grate-
ful, also, to the anatomists, surgeons, and by all means, the students for their
warm acceptance of this book. In my peripatetic life of lecturing I have found
that signing the book for students eager to learn about surgical anatomy is an
vii
viii Preface to the Third Edition
emotional and heart-warming experience—even to “a lion’s heart”—and some-
times even brings tears to my eyes.
As I wrote recently in a letter published in the Bulletin of the American Col-
lege of Surgeons (BACS 2006;91[8]:48):
I believe it’s time the pendulum shifted back to teaching our students the fun-
damentals of gross human anatomy and instilling a solid foundation on which
to build. After all, surgeons can and will make many unnecessary and fatal
accidents if they don’t know surgical anatomy.
The reader will notice that in this edition my son, Lee, has taken the helm as
the senior author, since I am now passing through the springtime of my senility.
I am proud and grateful that he is continuing this work.
JES
Acknowledgments
From the initial publication of this book in 1995 through the present edition, we
have benefi ted from the support and expertise of several of Springer’s medical
editors. The fi rst edition came to fruition thanks to Esther Gumpert’s enthusias-
tic assistance; the second edition was bolstered by the professionalism of Beth
Campbell; and the current edition is the product of Paula Callaghan’s skilled
guidance. We would like, also, to express our gratitude to the members of the
production department at Springer for their dedicated assistance in the publish-
ing process. For readying the manuscripts for publication, we are indebted to
our authors’ editors at Emory University School of Medicine, Phyllis Bazinet
and Carol Froman; and to Cynthia Painter, Dr. John E. Skandalakis’ secre-
tary. We thank Mark Barbaree, Edie Lacy, Sharon Scott, and Beth Simmons,
librarians at Piedmont Hospital, Atlanta, for their research assistance. Special
thanks, also, to Brook Fehrenbach Wainwright, Robert Wainwright, Jr., and
Eric Grafman for their outstanding illustrations. In addition, the excellent pho-
tographic and artistic talents of the late Tom Fletcher have contributed greatly
to the usefulness of this book. We acknowledge and appreciate Dr. Adel Bagh’s
medical expertise and advice on our coverage of the colon and perianal area.
ix
Contents
Preface to the Third Edition .............................................................. vii
Acknowledgments ............................................................................. ix
1 Skin, Scalp, and Nail ......................................................................... 1
2 Neck .................................................................................................. 17
3 Breast ................................................................................................ 93
4 Abdominal Wall and Hernias ............................................................ 113
5 Diaphragm ......................................................................................... 213
6 Esophagus ......................................................................................... 245
7 Stomach ............................................................................................. 285
8 Duodenum ......................................................................................... 333
9 Pancreas ............................................................................................ 347
10 Small Intestine .................................................................................. 389
11 Appendix ........................................................................................... 403
12 Colon and Anorectum ....................................................................... 415
13 Liver .................................................................................................. 497
14 Extrahepatic Biliary Tract ................................................................. 533
15 Spleen ................................................................................................ 573
16 Adrenal Glands ................................................................................. 603
xi
xii Contents
17 Vascular System ................................................................................ 631
18 Uterus, Tubes, and Ovaries ............................................................... 653
19 Carpal Tunnel .................................................................................... 665
20 Microsurgical Procedures ................................................................. 677
Index ......................................................................................................... 685