Atlas of Procedures in Gynecologic Oncology

This is an excellent book for those interested in a career in gynaecological oncology, and especially for those embarking on higher surgical training in gynaecological oncology. It is divided into chapters that cover most of the basic, and several of the more specialised procedures in gynaecological oncology. Each chapter is illustrated with step-by-step digital images of each stage of the procedure, with a description of the steps and annotations accompanying every image. The images are clear and of good quality, and the comments are useful, highlighting important technical aspects of relevant stages and potential pitfalls.

The book is broadly divided into four sections, open procedures, laparoscopic procedures, vulval/vaginal procedures and related surgical procedures, such as paracentesis and chest drain placement. There is a DVD to accompany the laparoscopic section. The book focuses on the procedures themselves, although there is some discussion at the beginning of each chapter as to the indications for surgery.

Although the images are well labelled and of excellent quality, the direction from which they are taken changes frequently, especially in the radical hysterectomy and pelvic lymph node dissections, so as to get the best view of the operative field. This is at first a little confusing and necessitates checking the orientation of each image from your knowledge of anatomy. It would also make the procedures difficult to follow for those not already knowledgeable of pelvic anatomy and gynaecological procedures. Labelling the edges of the images with left/right/anterior/posterior/medial/lateral or a small diagram indicating the point of view would be helpful to those without an in depth knowledge of the procedures. In the introduction, the book is recommended for medical students up to experienced gynaecological oncology surgeons; however, it is unlikely that the more junior medics will require this detailed level of surgical knowledge and they would find the procedures hard to follow in their current format.

The accompanying DVD includes the four main laparoscopic procedures: staging, radical hysterectomy, pelvic lymph node dissection and second-look procedure with intraperitoneal catheter placement. These procedures are described clearly and demonstrated at an appropriate pace: slow enough to take everything in, but not too slow. They demonstrate the benefits of laparoscopic surgery, in terms of visualisation and magnification, are very instructive and a pleasure to watch. My only complaint is the musical accompaniment, which is unnecessary, vaguely irritating and gives the impression of being stuck in a lift!

It should be noted that the surgery demonstrated is from a radical North American perspective. The limitations of evidence to support the role of radical debulking surgery are not discussed and there is no mention of interval debulking surgery, which is popular in Europe. In addition, the specific risks of the procedures and complications are not addressed. However, in conjunction with a standard gynaecological oncology text book, this atlas is invaluable to those in surgical training.

Overall the book is excellent and I would thoroughly recommend it to anyone seriously interested in gynaecological oncology, be they gynaecological surgeons or oncologists with a special interest in gynaecology.

J. Morrison

Nuffield Department of Obstetrics and Gynaecology, John Radcliffe Hospital, Oxford, UK

Notes

D. Levine, R. Barakat, W. Hoskins (eds). Taylor & Francis, London, 2003, 288 pp, £132.96





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