Concise Pediatric Surgery Atlas

Abstract

The editors of Rob and Smith Operative Surgery: Pediatric Surgery have taken their highly regarded and definitive atlas and condensed it for “general surgeons and trainees on Pediatric Surgical Rotation.” The Concise Pediatric Surgery Atlas is a selection of operative procedures geared toward the nonspecialist. Using the same format and illustrations from their large atlas, they select and illustrate various procedures the general surgeon may encounter when dealing with pediatric patients. The text is divided into sections dealing with head and neck, thoracic, abdominal, and urologic pediatric surgical procedures. With text and high-quality illustrations, the contributors discuss the principles and justification of the various procedures, the fine points of the techniques, alternative procedures, postoperative care, and the outcome. A short bibliography of key articles is also provided in many chapters. The clarity and thoroughness of this format serves the atlas well and provides the clinician with a good resource for the selected topics. Because the atlas is targeted to a nonspecialist audience, I asked several practicing general surgeons to assist in this review. The comments were generally positive; all considered this a useful addition to a surgical library, reasonably priced considering the high quality of the publication. There was, however, a consensus that several important procedures were not addressed that a general surgeon might encounter in an urgent or emergent situation where the expertise of a pediatric surgeon was not available. For example, while a complete discussion of the multiple scenarios encountered with surgical necrotizing enterocolitis would be beyond the scope of the book, several general surgeons felt that more information about the pediatric surgical principles one must consider when evaluating and operating on these patients was needed. Many of the reviewing surgeons had encountered these patients in an emergent setting and would have liked access to a concise text/atlas that discussed preoperative considerations, surgical options, and the details of stomas in the surgical neonate. Similarly, there was agreement that a chapter on urgent decompressive colostomies, such as for imperforate anus or Hirschsprung’s enterocolitis, would be beneficial, as would a discussion and illustration of the finer points of colostomy formation in pediatric patients, a more thorough discussion of vascular access (including less standard approaches such as the external jugular vein, the saphenofemoral junction, and the brachial cut-down technique), and a section on the evaluation and management of the various umbilical lesions that many general surgeons encounter. With these possible additions, the atlas can certainly be recommended to a very broad section of practicing and training nonspecialist surgeons. In its present form, it still provides a useful resource to this audience. It is particularly recommended for its discussion of alternatives and commonly encountered pitfalls. For the general surgeon who will be practicing a moderate amount of pediatric surgery either out of necessity or interest, however, the full atlas is probably a more valuable purchase.