Basic Surgical Skills and Techniques Sudhir Kumar Jain, David L Stoker
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1Basic Surgical Skills and Techniques
2Basic Surgical Skills and Techniques
Editors Sudhir Kumar Jain MS FRCS FACS FICS Associate Professor Department of Surgery Maulana Azad Medical College and Associated Lok Nayak Hospital New Delhi, India David L Stoker MD FRCS FRCSE Consultant Surgeon University College of London Hospitals and North Middlesex University Hospital London, UK
3
Published by
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
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Basic Surgical Skills and Techniques
© 2008, Jaypee Brothers Medical Publishers
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the editors and the publisher.
First Edition: 2008
9788184484083
Typeset at JPBMP typesetting unit
Printed at Ajanta
4Dedicated to
Our wives and children for their support in spite of their neglection by us during the process of this work
Our parents for their blessings
Our teacher for their wisdom
Our students who insipre us daily
our patients, from whom we continue to learn daily
5Contributors 6Preface
Apprentices in surgery need a basic set of practical skills in order to care for their patients well. Although many of these skills are same as those used by their 20th century predecessors, today's trainees need to keep abreast of rapidly changing and advancing technologies that were not available even ten years ago.
At the same time, basic surgical training for medical students and for junior doctors is being compressed into a shorter timeframe, as other medical specialties evolve and need to be taught in growing curricula. There is increasing emphasis on communication skills, and self directed learning in many undergraduate programs, and the student of surgery today has, therefore, to learn more in less available time. He or she will have less “hands on” experience in theater, ward or clinic and inevitably the practical aspects of surgery tend to suffer.
This small book aims to facilitate the more rapid learning required in a modern surgical program, with concise chapters on the main techniques that need to be mastered in the early years of training. It is intended to be read mainly by senior medical students, and housemen or interns, but may also be a useful revision for those about to take their first surgical postgraduate examinations.
It is the book written by working general surgeons to enhance the practical training of their own teams. It is also an international collaboration between London and New Delhi, and will be of use to students studying the art and science of surgery everywhere. It is not an exhaustive reference book, but more of a brief guide, to be used as a learning tool mainly in operating theaters and emergency rooms. It contains simple lists and diagrams with no superfluous text. There are clear explanations which should aid the student from scrubbing up to suturing up.
This book is designed to enhance practical training, and the student is encouraged to spend as much time as possible putting the basic skills described to good use in a clinical environment. Surgery remains largely an apprenticeship specialty, where only lots of practice will make perfect.
Sudhir Kumar Jain
David L Stoker
7Acknowledgements
Our sincere thanks to Shri JP Vij, Chairman and Managing Director of M/s Jaypee Brothers Medical Publishers for his encouragement, support and inspiration. We are grateful to Mr. Tarum Duneja Director (Publishing) for helping us by valuable suggestions during the process of this work.
We express our gratitude to Mr Ravi, Medical Artist, Maulana Azad Medical College, New Delhi for making illustrative and informative diagrams.
We express our special thanks to the whole production team of Jaypee Brothers Medical Publishers for their hard work and professionalism, particularly Mr. Subrato for his help throughout the process of this publication.