Book Review

Minimally Invasive Surgery

N Engl J Med 1993; 329:1900-1901December 16, 1993

Article

Minimally Invasive Surgery
Edited by John G. Hunter and Jonathan M. Sackier. 358 pp., illustrated. New York, McGraw-Hill, 1993. $95. ISBN: 0-07-031372-5

As its title implies, Minimally Invasive Surgery is intended to be a panoramic review of “high-tech” surgery. The book is not limited to laparoscopic procedures, although recent developments in laparoscopic surgery are certainly given ample treatment.

The first part of the book is a review of relevant techniques. Although this part is entitled “New Technologies,” the subjects include some traditional ones, such as fiberoptic imaging and electrosurgery. The chapter on electrosurgery does a particularly good job of explaining an established procedure whose fine points continue to escape many surgeons. As pointed out in this chapter, there are subtle hazards, such as capacitive coupling, that assume greater importance in laparoscopy than in open surgery.

The second part of the book reviews “Old Diseases.” This part is organized along anatomical lines, starting with operations on the esophagus and proceeding through laparoscopic colon and rectal surgery. Also covered are minimally invasive approaches to biliary-tract surgery, hernia repair, lymphadenectomy, splenectomy, endovascular surgery, and thoracoscopic surgery. A worthwhile feature is the interleaving of methods of endoluminal endoscopy, radiologic techniques, and laparoscopic approaches. The section on the biliary tract, consisting of four chapters, is a particularly good example of the multitechnical approach that is now possible for managing both benign and malignant biliary disorders.

The second part also contains a chapter on emergency laparoscopy, by Berci, a visionary in the application of laparoscopic techniques to general surgery. Also included are two chapters on laparoscopic knot tying, suturing, and anastomosis. The first of these, by Szabo, contains many excellent illustrations of the basic techniques; the second chapter, by Nathanson, goes into some of the clinical issues in applying these techniques. The second part is capped by a look by Satava into the future of high-technology surgery. Robotics and “telepresence” surgery are among the ideas presented.

This book is a broad-spectrum compendium of the emerging techniques that are truly reshaping the way in which we perform surgery. It serves the reader well by filling a gap left by the current major surgical textbooks, which mention these new methods only briefly. Both surgeons and nonsurgeons can profit from reading this book.

Michael R. Treat, M.D.
Columbia University College of Physicians and Surgeons, New York, NY 10032