- Email: [email protected]
Applied Laparoscopic Anatomy: Abdomen and Pelvis
BOOK REVIEWS
Editorial Comment: Thousands of continent urinary diversions have been created worldwide and long-term studies are necessary to determine the effects of these new forms of diversion. Changes occur in the epithelium of the intestine exposed to urine. Villous atrophy is well recognized and there are significant potential changes in metabolism.' These changes may be important because they may affect absorption and metabolism of drugs absorbed through the intestinal tract and excreted by the kidneys. These authors indicate that the absorption of vitamin B12 was clearly decreased more than 1 year after construction of the continent ileal reservoir. Fray F. Marshall, M.D. 1. Burnett, A. L., Donowitz, M. and Marshall, F. F.: Inhibition of transport processes of intestinal segments following augmentation enterocytoplasty in rate. J. Urol., 156 1872,1996.
Recommended Reading: Zbar, B.:von Hippel-Lindaudisease and sporadic renal cell carcinoma. In: Genetics and Cancer: A Second Look. Cancer Surv., 25: 219-232,1995.
BOOK REVIEWS Applied Laparoscopic Anatomy: Abdomen and Pelvis G. G. WIND,Baltimore: Williams & Wilkins, 376 pages, 1997 The advent of laparoscopy in surgery has changed how surgeons perceive and manipulate human anatomy. This book, written by a general surgeon and anatomist, presents abdominal and pelvic anatomy "from the perspective of the laparoscopic surgeon." After a general introduction to laparoscopic technique the book presents regional anatomy relevant to some of the most commonly performed laparoscopic procedures. Fully two-thirds of the text is devoted to anatomical regions mainly of interest to general surgeons. Topics discussed are the biliary system, inguinal region, stomach, spleen, colon, pelvis and retroperitoneum. Each section begins with a concise summary of regional embryology followed by a more exhaustive overview of surgically relevant anatomy. The sections conclude with a description of the operative technique for 1 or 2 laparoscopic procedures related to the anatomical region. The book is generously illustrated with beautifully rendered black and white line drawings. Chapters of interest to urologists include the anatomy of the inguinal region, pelvis and retroperitoneum. The section on inguinal anatomy focuses almost exclusively on anatomy pertinent to groin hernias, and gives a good overview of traditional and laparoscopic techniques of hernia repair. Pelvic anatomy is presented somewhat cursorily, and covers the bony and muscular framework of the pelvis, and the course of the vessels, lymphatics and nerves within that framework. The chapter discusses mainly female pelvic anatomy with little mention of male pelvic structures. It details the technique of laparoscopically assisted vaginal hysterectomy and complete pelvic lymph node dissection. Missing from this chapter are descriptions of a number of pelvic laparoscopic procedures, such as bladder neck suspension, modified pelvic lymph node dissection, seminal vesicle dissection, ureterolithotomy and laparoscopic bladder procedures. Since the stated focus of the book is to convey the anatomy of the abdomen and pelvis, omission of operative technique for all possible laparoscopic procedures may be justified. However, by omitting these procedures a number of important and often confusing areas of anatomy, such as the paravesical and paraurethral region, are ignored. The final chapter covers the structures of the retroperitoneum and presents the technique of 3 laparoscopic procedures: 1) simple nephrectomy, 2) adrenalectomy and 3) varicocele ligation. Anatomy and vascular anomalies of the retroperitoneal structures are clearly presented and illustrated. For each of the 3 procedures described in the chapter only the transperitoneal approach is presented. The author advocates fulguration of the cremasteric branches of the inferior epigastric artery and vein to decrease recurrence after laparoscopic varicocele ligation. It is unknown whether ablation of these vessels will decrease recurrence and it is possible that this additional devascularization may compromise ultimate fertility. Retroperitoneal lymph node dissection is not presented and, therefore, para-aortic node anatomy, and parasympathetic and sympathetic nervous plexuses are incompletely described. Laparoscopic pyeloplasty and renal hilar anatomy relevant to this procedure are also not discussed. Perhaps the most intriguing aspect of this book arises from speculation about its intended audience. The book successfully details anatomy and technique for the most common and established laparoscopic procedures, spanning general surgery, gynecology and urology. One wonders whether this book signals the development of laparoscopy as an independent surgical subspecialty in which traditional borders between
68 1
682
BOOK REVIEWS
established specialties are blurred by the application of new techniques. Urologists must continue as active practitioners and pioneers in laparoscopy to contribute to the development of this exciting field. James D. Brooks, M.D. Department of Urology Johns Hopkins Hospital Baltimore, Maryland
Atlas of Surgical Pathology of the Male Reproductive Tract J. Y. Ro, D. J. GRIGNON, M. B. AMINAND A. AYALA, Philadelphia: W. B. Saunders Co., 243 pages, 1997 This is the seventh in a series of atlases in diagnostic surgical pathology that is familiar to the pathology community but probably not to the urology community. This excellent contribution continues the high standards of previous books in this series. This book is divided into 3 sections discussing the prostate and seminal vesicles, testis, penis and scrotum. There are 18 chapters and the book runs for 243 pages. As an atlas it is obviously heavily illustrated and there are 586 photographs, including 377 in color. The standard of the pictures is exceedingly high. I found less than half a dozen that were perhaps slightly suboptimal and even they are not poor. The majority of the pictures are not only good selections of what they are meant to depict but technically well reproduced. As an atlas the book does not have free-form text but it still contains abundant useful information presented in a reader friendly manner. The cardinal clinical, gross and microscopic features, including differential diagnosis and special procedures that may be required, are clearly listed under individual headings. For those whose subspecialty is not pathology it is easy to get the essential information about the pathology of the numerous lesions reviewed. The book is comprehensive, including many illustrations of common tumors, but it also contains a few illustrations of many esoteric lesions that are infrequently encountered. An additional feature that urologists will probably find of great help is the liberal use of tables throughout the text, contrasting the features of lesions that are in the differential diagnosis of each other. In summary, I find it hard to imagine a presentation of pathological conditions of the male reproductive tract that would be more satisfactory for urologists. The breadth of coverage is obviously of great interest to pathologists but it is also attractive to urologists. Since in my experience urologists have an admirable interest in and knowledge of pathology, I recommend this book to the urological community, practitioners and residents, without reservation. I t is attractively priced and certainly a good value. Robert H. Young, M.D. Department of Pathology Harvard Medical School Boston, Massachusetts
Editorial Comment: Thousands of continent urinary diversions have been created worldwide and long-term studies are necessary to determine the effects of these new forms of diversion. Changes occur in the epithelium of the intestine exposed to urine. Villous atrophy is well recognized and there are significant potential changes in metabolism.' These changes may be important because they may affect absorption and metabolism of drugs absorbed through the intestinal tract and excreted by the kidneys. These authors indicate that the absorption of vitamin B12 was clearly decreased more than 1 year after construction of the continent ileal reservoir. Fray F. Marshall, M.D. 1. Burnett, A. L., Donowitz, M. and Marshall, F. F.: Inhibition of transport processes of intestinal segments following augmentation enterocytoplasty in rate. J. Urol., 156 1872,1996.
Recommended Reading: Zbar, B.:von Hippel-Lindaudisease and sporadic renal cell carcinoma. In: Genetics and Cancer: A Second Look. Cancer Surv., 25: 219-232,1995.
BOOK REVIEWS Applied Laparoscopic Anatomy: Abdomen and Pelvis G. G. WIND,Baltimore: Williams & Wilkins, 376 pages, 1997 The advent of laparoscopy in surgery has changed how surgeons perceive and manipulate human anatomy. This book, written by a general surgeon and anatomist, presents abdominal and pelvic anatomy "from the perspective of the laparoscopic surgeon." After a general introduction to laparoscopic technique the book presents regional anatomy relevant to some of the most commonly performed laparoscopic procedures. Fully two-thirds of the text is devoted to anatomical regions mainly of interest to general surgeons. Topics discussed are the biliary system, inguinal region, stomach, spleen, colon, pelvis and retroperitoneum. Each section begins with a concise summary of regional embryology followed by a more exhaustive overview of surgically relevant anatomy. The sections conclude with a description of the operative technique for 1 or 2 laparoscopic procedures related to the anatomical region. The book is generously illustrated with beautifully rendered black and white line drawings. Chapters of interest to urologists include the anatomy of the inguinal region, pelvis and retroperitoneum. The section on inguinal anatomy focuses almost exclusively on anatomy pertinent to groin hernias, and gives a good overview of traditional and laparoscopic techniques of hernia repair. Pelvic anatomy is presented somewhat cursorily, and covers the bony and muscular framework of the pelvis, and the course of the vessels, lymphatics and nerves within that framework. The chapter discusses mainly female pelvic anatomy with little mention of male pelvic structures. It details the technique of laparoscopically assisted vaginal hysterectomy and complete pelvic lymph node dissection. Missing from this chapter are descriptions of a number of pelvic laparoscopic procedures, such as bladder neck suspension, modified pelvic lymph node dissection, seminal vesicle dissection, ureterolithotomy and laparoscopic bladder procedures. Since the stated focus of the book is to convey the anatomy of the abdomen and pelvis, omission of operative technique for all possible laparoscopic procedures may be justified. However, by omitting these procedures a number of important and often confusing areas of anatomy, such as the paravesical and paraurethral region, are ignored. The final chapter covers the structures of the retroperitoneum and presents the technique of 3 laparoscopic procedures: 1) simple nephrectomy, 2) adrenalectomy and 3) varicocele ligation. Anatomy and vascular anomalies of the retroperitoneal structures are clearly presented and illustrated. For each of the 3 procedures described in the chapter only the transperitoneal approach is presented. The author advocates fulguration of the cremasteric branches of the inferior epigastric artery and vein to decrease recurrence after laparoscopic varicocele ligation. It is unknown whether ablation of these vessels will decrease recurrence and it is possible that this additional devascularization may compromise ultimate fertility. Retroperitoneal lymph node dissection is not presented and, therefore, para-aortic node anatomy, and parasympathetic and sympathetic nervous plexuses are incompletely described. Laparoscopic pyeloplasty and renal hilar anatomy relevant to this procedure are also not discussed. Perhaps the most intriguing aspect of this book arises from speculation about its intended audience. The book successfully details anatomy and technique for the most common and established laparoscopic procedures, spanning general surgery, gynecology and urology. One wonders whether this book signals the development of laparoscopy as an independent surgical subspecialty in which traditional borders between
68 1
682
BOOK REVIEWS
established specialties are blurred by the application of new techniques. Urologists must continue as active practitioners and pioneers in laparoscopy to contribute to the development of this exciting field. James D. Brooks, M.D. Department of Urology Johns Hopkins Hospital Baltimore, Maryland
Atlas of Surgical Pathology of the Male Reproductive Tract J. Y. Ro, D. J. GRIGNON, M. B. AMINAND A. AYALA, Philadelphia: W. B. Saunders Co., 243 pages, 1997 This is the seventh in a series of atlases in diagnostic surgical pathology that is familiar to the pathology community but probably not to the urology community. This excellent contribution continues the high standards of previous books in this series. This book is divided into 3 sections discussing the prostate and seminal vesicles, testis, penis and scrotum. There are 18 chapters and the book runs for 243 pages. As an atlas it is obviously heavily illustrated and there are 586 photographs, including 377 in color. The standard of the pictures is exceedingly high. I found less than half a dozen that were perhaps slightly suboptimal and even they are not poor. The majority of the pictures are not only good selections of what they are meant to depict but technically well reproduced. As an atlas the book does not have free-form text but it still contains abundant useful information presented in a reader friendly manner. The cardinal clinical, gross and microscopic features, including differential diagnosis and special procedures that may be required, are clearly listed under individual headings. For those whose subspecialty is not pathology it is easy to get the essential information about the pathology of the numerous lesions reviewed. The book is comprehensive, including many illustrations of common tumors, but it also contains a few illustrations of many esoteric lesions that are infrequently encountered. An additional feature that urologists will probably find of great help is the liberal use of tables throughout the text, contrasting the features of lesions that are in the differential diagnosis of each other. In summary, I find it hard to imagine a presentation of pathological conditions of the male reproductive tract that would be more satisfactory for urologists. The breadth of coverage is obviously of great interest to pathologists but it is also attractive to urologists. Since in my experience urologists have an admirable interest in and knowledge of pathology, I recommend this book to the urological community, practitioners and residents, without reservation. I t is attractively priced and certainly a good value. Robert H. Young, M.D. Department of Pathology Harvard Medical School Boston, Massachusetts