Of all the developing fields of surgery, few have had the impact of vascular surgery in affecting so large a section of the population by offering the potential relief of disability and the prolongation of life. As would be anticipated, the interest of surgeons in this evolving specialty has largely been focused upon the selection of the most appropriate operations and the development of modifi cations or new procedures that overcome the limitations of previous ones. The literature contains numerous conflicting claims about the relative merits of various procedures, and those aPlJoaching this field for the first time may understandably be confused. Yet, if one were to approach any single vascular surgeon at any given time, he would upon request be given a firm and precise listing of preferred procedures. The procedures described in this two-volume publication are those that we currently favor. Their selection is the result of continuing analyses of our own experience during the past 30 years. All patients have been available for prolonged follow-up evaluation. Late failures often helped us to identify techniques that lessened the durability of an initially satisfactory operation, and they became a stimulus for the development of modifications or trials with alternative operations. Particular attention is directed to the manner in which knowledge of the natural history of disease influences the choice of operations.

Of all the developing fields of surgery, few have had the impact of vascular surgery in affecting so large a segment of the population with its potential for relief of disability or the prolongation of life. As would be anticipated, the interest of surgeons in this evolving specialty has been largely focused upon the selection of the most appropriate operations and the development of modifications or new procedures to overcome the limitations of previous ones. The literature contains numerous conflicting claims on the relative merits of various procedures. Those approaching this field for the first time may understandably be confused. Yet, if one were to approach any single vascular surgeon at any given time, he would, upon request, receive a firm and precise listing of preferred procedures. The procedures described in this two-volume publication are those which we currently favor. Their selection is the result of continuing anal ysis of our own experience of the last 25 years. All patients have been available for prolonged follow-up evaluation. Late failures often identified techniques that lessened the durability of initially satisfactory operations and stimulated the development of modifications or trials with alternate op erations. Particular attention is directed here to the manner in which knowledge of the natural history of disease influences the choice of opera tion.

This book is a compilation of common and uncommon surgical and ancillary techniques that we have found useful in the multiorgan transplantation pro gram at the University of Minnesota. Descriptions of these techniques are not available at a single source elsewhere. Use the book as a teaching aid, a source of workable techniques, and as a reference for individuals with relatively little experience in a particular area of transplantation. Because of the varying levels of expertise of our readers, vascular access is described in exquisite detail, as it is aimed at an audience of individuals who want to learn the fine points about how to prolong the function of shunts. The chapter on organ preservation is aimed at the surgeon or beginning technician who must learn how to do it from scratch--even the catalogue numbers of the necessary equipment are included. In contrast the chapters on heart, liver, and pancreas transplantation, while omitting fine points of suture technique, concentrate on the essential principles and safeguards. Individuals contemplating such transplants are presumably already schooled in the fine points of surgical technique. The chapters on cadaver organ donation are perhaps the most innovative. They represent our attempt to reorganize organ donation in a way that will provide the greatest usefulness of each donor as a source for multiple organs for transplantation. We hope that the book will become available to centers that, while not performing liver, pancreas, or heart transplants, wish to serve as donation centers.

ment of those endocrine diseases encountered by the general surgeon. Opera tions on the pituitary gland are, therefore, specifically excluded. It should be most useful to general surgical residents and practicing surgeons, but we hope it will also prove useful to the wide range of physicians who deal with surgically correctable endocrine disorders. The book has four sections - Surgery of the Parathyroids, Thyroid, Pan creas, and Adrenals. Each section deals in a systematic manner with practical aspects of surgical anatomy, physiology, pathology, diagnosis, and treatment. Specific attention has been given to a detailed description of operative strategy, operative technique, and postoperative management. Individual operative steps are illustrated in full color, with specific figure legends on facing pages. The artwork represents the distillation of twelve months intensive collabora tion between the authors and a staff of medical illustrators to 'ensure anatomic fidelity and clarity. We believe that the use of full color has opened up a new dimension in surgical illustration by providing greater realism and allowing accent of important features. The techniques described herein represent personal preferences. The authors recognize that there may be several satisfactory alternate approaches in every case. Where there is controversy, we have outlined our approach to the problem somewhat dogmatically in the belief that in certain circumstances a single point of view is better than several without selection.

The first hospital-affiliated surgical unit designed specifically for ambulatory surgery in the state of California began functioning as part of Santa Barbara Cottage Hospital in 1973. As this text is readied for publication, the unit is in its tenth year of operation. More than 20,000 patients have undergone surgery there. The enthusiasm generated by ~\ir experience in Santa Barbara, along with the widespread, growing interest in ambulatory surgery, prompted us to undertake this volume. The first three chapters cover principles and administrative aspects, an esthesiology, and nursing in the ambulatory surgical center. Subsequent chap ters, the major portion of the text, provide detailed, meticulously illustrated descriptions of surgical procedures as they are done in the Santa Barbara Cottage Hospital Outpatient Surgical Center by the surgeons who work there. They reflect current practice and emphasize the techniques found most reliable by the surgeons who use them in the outpatient setting. This manual includes many of the operations most commonly performed in our facility and emphasizes the unique aspects of surgery and patient care in outpatient practice. The text is concise, practical, and based on our collective experience. The illustrations are, for the most part, drawn from the surgeon's perspective and faithfully render the actual appearance of the operative field during surgery. Supplementary cross-sectional and conceptual drawings are included to orient the reader.

The Manual of Upper Gastrointestinal Surgery was compiled as an aid to surgeons, residents, and students who want to acquire a broader knowl edge of the surgical techniques used in the upper gastrointestinal area. Of necessity, a considerable amount of the work of a general surgeon will be confined to this region. The techniques described herein are those preferred by the authors and most, but not all, of their colleagues at the Mayo Clinic. No attempt has been made to include all of the available possibilities and technical varia tions. Likewise, no attempt has been made to include many of the stapling techniques. Although they are good and quite useful, their inclusion would require a complete and separate volume. The omission of an accepted procedure is not meant as a criticism; our aim was to emphasize only the techniques that are most commonly used in day-to-day practice. Gains in knowledge about the anatomy and physiology of the esopha gus, stomach, and duodenum have been highly instrumental in the devel opment of surgical procedures in these areas, particularly the techniques for benign diseases (for example, ulcer, gastritis, and esophagitis).

This manual presents the operations most often performed by surgeons at the Kerlan-Jobe Orthopaedic Clinic (Inglewood, California, 90301) in treating sports injuries. These operations constitute a complete series of basic surgical procedures for the orthopaedist. In its step-by-step drawings, the manual guides surgeons through the operative techniques of specific procedures. It also pro vides what is equally important for practitioners: the protocols for postopera tive care of patients, including the rehabilitation of those who have-and have not-had to undergo surgery. It must also be said that this manual is not a be-all and end-all of surgical interventions and rehabilitative programs for athletes, amateur or professional, who sustain injuries on the playing field. That elusive goal can only be reached by practitioners who attend strictly to all the diagnostic detail available, who select carefully those patients most likely to benefit from their attention and care, and who share with other practitioners their experience and expertise. As far as diagnosis is concerned, there has been a great improvement in the recent past in both noninvasive and invasive procedures that help to estab lish specific diagnoses and to determine which patients will be served best by a given operation. These new diagnostic tools include the arthrogram in conjunction with the tomogram and the CT scan; the CT scan itself; the arthroscope; and, most recently, the Magnetic Resonance Imaging machine.

Initially we asked Springer-Verlag why they thought the world needed another book about aesthetic surgery. They pointed to the popularity of the Compre hensive Manual of Surgical Specialties Series, suggesting that completeness required our contribution. We recalled the current masters of aesthetic surgery: Rees, Sheen, among others. Each had produced his own monograph-all of them established classics. What could we add? Furthermore none of us was recognized exclusively for aesthetic surgery achievements. Nevertheless, each of us was committed to the challenge of teaching residents aesthetic surgery during their residency, not afterward as was done in the past. Furthermore, Dick Egdahl, Senior Editor and designer of CMSS, made clear to us the specific orientation of the manuals to residents-in-training. as did Springer-Verlag, well known for their commitment He won our support, to high-quality color illustrations. We appreciate being asked by Dr. Egdahl to contribute to CMSS. We were not even offended by his original plan to embrace all of plastic surgery in one volume. He should have known better! The Manual of Reconstructive Surgery will follow this volume in 2 years. Defining its scope remains an unmet challenge. Limiting the scope of Manual of Aesthetic Surgery has been an easier task. It is a sourcebook for beginning residents, not an encyclopedic reference.

for a significant portion of the new information in this book. His ability to select the important developments from the literature of the last five years was essential to the completion of this second edition. Further, Dr. Stone's original research on wounds and sutures is included in this volume. Dr. Felix Rutledge and Dr. Laman Gray, Sr., in addition to all the named authors, made valuable comments. Their years of experience were especially helpful in updating the chapters on ovarian surgery and vaginal hysterectomy. My personal Administrative Assistant, Elizabeth Davies, successfully coor dinated my various clinical schedules, speaking engagements and department obligations, providing me the time necessary for writing this book. The advice and support of Jerry Stone, Senior Medical Editor, Springer Verlag, also were invaluable in the production of this edition. Lastly, one of our team became ill while we were preparing this book and subsequently died of a rare malignancy. Her outstanding work while with us and her continued interest and encouragement, even though quite of us. Mrs. Sue Koenig was a bright, competent ill, was an inspiration to all and effective co-worker whom is missed by all of us in the Department of Obstetrics and Gynecology at the University of Louisville.