Safe surgery is founded upon accurate knowledge of the appropriate anatomy. The purpose of this book is to bring the latter into the operating theatre to describe operations principally in terms of the anatomy concerned. The second edition of this book describes the anatomy of general surgical operations in 44 chapters written by a variety of specialists in their fields, with all the chapters being co-authored by the main author. Although entitled ‘General Surgical Operations’, many of these operations would currently be undertaken in the UK by specialist surgeons, particularly those on the head and neck, neurosurgery and vascular surgery. Indeed, it is difficult to know what the definition of general surgery is at the present time, especially in the UK.
The preface is very short and does not clearly indicate what the author considers to be the appropriate readership for the book. Certainly, many of the chapters are too advanced for those taking the MRCS but are eminently suitable for those taking the intercollegiate speciality FRCS in general surgery and equivalent examinations, in particular the Fellowship of the Royal Australasian College of Surgeons.
The second edition has been totally redesigned with new art work and there is a greater coverage of the anatomical variation that the surgeon will encounter. There is also a greater accent on endoscopic procedures. The book is divided into seven parts – abdominal operations, general surgical operations in the thorax, head and neck surgery, surgical oncological procedures, arterial and venous surgery, general surgical neurological operations and surgery of the skin.
Chapter 9, which describes the various forms of vagotomy, is a little dated but is of historical interest with the authors indicating that this operation is rarely undertaken nowadays. I particularly enjoyed reading chapter 15, which gives an exceptionally clear and practical approach to the anatomy of the anal canal.
There were one or two inaccuracies in the book. For example, Figure 1.4 is not very clear and is poorly labelled (surely the first part of the figure should be labelled ‘rectus sheath – above the costal margin’). Also the third part of the figure should refer to the internal rather than external oblique aponeurosis while the word aponeurosis is also misspelt. In addition, some of the figures are unclear especially Figure 21.3, which is poorly drawn and at one point incorrectly labelled. Figure 23.1 is also unclear and poorly labelled. There is also some lack of consistency; in Chapter 21, Figure 21.4 contains the Latin nomenclature of muscles.
In Chapter 36, the abdominal aorta is described as passing through the aortic hiatus in the diaphragm. Strictly speaking, there is no aortic hiatus in the diaphragm as the aorta passes behind the crura of the diaphragm in an osseoaponeurotic opening between the vertebral column and the diaphragm and, therefore, clearly behind the latter. In Chapter 37, the external iliac artery is described as crossing behind the mid-point of the inguinal ligament rather than the mid-inguinal point.
Apart from these minor criticisms this is an excellent book describing the anatomical basis for general surgical operations. It is clearly written and the majority of the diagrams are excellent. Being written by surgeons it accentuates the important aspects of applied anatomy, giving sound practical advice. The problem is to whom would I recommend this book in the UK? Certainly, I would recommend it to those studying for the intercollegiate speciality examination in general surgery. Many of the chapters are probably too advanced for those studying for the MRCS. More experienced surgeons will also find it useful as a source of reference that clearly demonstrates the practical application of anatomy to the art of surgery.