The Editors’ Preface to 27th Edition of Short Practice of Surgery

When Hamilton Bailey and McNeil Love published the first edition of their venerated textbook in 1932 the surgical world was a very different place to that of today. There were no antibiotics, no joint replacement, no open heart surgery, no transplantation and many other procedures that we now take for granted had simply not been invented. Medicine as a whole and surgery in particular never stands still. Surgeons continually strive to innovate so that they can tackle conditions and diseases previously thought to be beyond reach. They do this against a background of new discoveries in both the physical and biological sciences. Such breakthroughs make some surgical procedures redundant but others stimulate new approaches. This is seen in all specialties and consequently it is important for textbooks not only to keep pace with new developments but also to ensure that a balanced view is taken of their place in the therapeutic armamentarium. In developing the 27 th edition of this much-loved textbook, we have striven to keep this in the forefront of our minds and those of our contributors. Nevertheless, in addition to considering the place of innovation, it is important not to ‘throw the baby out with the bathwater’. We have therefore ensured that the basic tenets of surgical practice that have stood the test of time remain where appropriate.

Since the last edition great strides have been made in certain areas and we have ensured that these have been embedded in the book. For instance, in colorectal surgery a tipping point has been reached whereby more elective surgery is performed laparoscopically than by open technique. Similarly, in vascular surgery there has been an explosion in the use of interventional radiology to treat conditions that were previously the sole province of the surgeon. Stenting of aortic aneurysms (EVAR), for instance, is rapidly replacing elective open operations and, in many instances, is being used for treating leaking aneurysms, with a concomitant marked reduction in mortality. Damage control surgery is an increasingly important part of trauma management, in both civilian and conflict settings. Such developments also highlight the important role of the multidisciplinary team and the realisation that modern surgical care can no longer be provided in isolation. This concept is reiterated throughout the book and is also why the importance of human factors is emphasised in the chapter on patient safety, which is a relatively new science of how humans behave physically and psychologically in relation to particular environments. There is no more intense environment than an operating theatre, so how a surgical team interacts is crucial to the outcome for a patient undergoing a surgical procedure. This also applies, of course, outside the operating theatre because multidisciplinary working is now paramount to the delivery of safe and effective patient care. There is no doubt that in recent years regulation of medical practice has become tighter. Whereas in certain jurisdictions some may feel that this has become stifling, there is no doubt that regulation is here to stay. Needless to say, we should all be aware of our responsibilities to patients, both morally and ethically, and, although most need no reminding, the law is continually changing as test cases are brought before the courts. Hence, we draw the attention of the reader to the revamped chapter on ethics and the law, the tenets of which we must all abide by.

Throughout the text, we have also endeavoured to point out where we and our authors think the specialty is moving. Exciting developments are on the horizon. For instance, genome sequencing will have a marked effect on how we practise in certain specialties, none more so than oncology. Robotics is likely to improve many more surgical procedures and tissue engineering will become more commonplace. In order to accommodate these advances, it has been necessary to streamline some of the more established chapters, otherwise the book would become unwieldy. As a consequence, we have ensured that the ‘Further reading’ list at the end of each chapter has been brought up to date, allowing readers to delve further if they so wish.

We are very conscious that the book is popular throughout the world and consequently we have ensured that those diseases that are prevalent outside Europe and North America are included. Where relevant we have involved experts who are used to dealing with such maladies. The chapter on tropical infections and infestations is such an example.

We have also endeavoured in this edition to be more consistent in its layout, ensuring that we use a similar format for tables, graphs and diagrams. Nevertheless, we have been sure to keep the biographical details of individual scientists and practitioners, which have been beloved of all readers throughout the generations. Similarly, we have retained the section on surgical instruments. Although some are now very much of historical interest, they are part of our heritage and students and indeed established practitioners will, we hope, find these vignettes fascinating. We have been told that the Summary boxes are very much appreciated by both undergraduate and postgraduate students revising, sometimes in haste, before exams and hence our authors have ensured that these are up to date.

A book as comprehensive as this could never have been completed without the dedication and professionalism of our contributors. They have invariably answered our demands with alacrity and accuracy, appreciating the responsibility that goes with informing the readership of such a respected and established textbook. We are extremely grateful for all their efforts because we are conscious that a textbook such as this can never rest on its laurels. If it is to remain in the higher echelons of surgical tomes it must have the very best contributors and we believe that we have brought together such a cadre in the present edition. This in no way diminishes the contributions of the authors from the previous edition who are no longer involved. They, for a variety of reasons including retirement, have passed on the baton. We are grateful to them for magnanimously stepping down and making way for ‘new blood’ and none more so than our previous co-editor Professor Christopher Bulstrode. Chris helped revamp the 23rd, 24th, 25th and 26th Editions and these would never have been as successful without his dedicated efforts. Chris’s place in the editorial team has been taken by Andrew McCaskie who has streamlined the trauma and orthopaedic sections as well as overseeing other chapters.

Readers of Bailey & Love have always been an integral part of the development of the book over the years and the present editorial group relish your feedback, which we know from experience will be forthcoming. Such input is vital if the book is to continue to reach the very high standards expected from each new edition. This has been a labour of love for all of us involved in this edition and we do hope it fulfils your needs, no matter whether you are an undergraduate student exploring the exciting world of surgical practice for the first time, a postgraduate trainee studying for exams or an established consultant who wishes to refresh his or her memory.

We wish you all well in your careers no matter which specialty you choose to practise in and we very much hope that the 27th and indeed subsequent editions of Bailey & Love accompany you on your travels through this most rewarding of professions.

Norman S. Williams

P. Ronan O’Connell

Andrew W. McCaskie

The Authors’ Preface to Essential Clinical Anatomy

The expansion and integration of disciplines within the medical curriculum has reduced time for anatomy teaching, particularly for human dissection, but has not reduced its vital importance. While surgeons need to know the detailed anatomy in their operating field, knowledge of the anatomy that underlies every clinical examination and every radiological/ medical image is an essential component of everyday clinical practice.

This text provides a comprehensive cover of most normal and abnormal living anatomy, essential for students across the world. It addresses the knowledge and skills laid down by the General Medical Council (GMC) and the American Association of Clinical Anatomists (AACA; ‘A clinical anatomy curriculum for the medical student of the 21st century: gross anatomy’, Clinical Anatomy 1996;9:71–99; see also Smith et al., ‘The Anatomical Society core regional anatomy syllabus for undergraduate medicine’, Journal of Anatomy 2016;228:15–23).

The regional approach followed corresponds to a typical clinical examination. The nervous system is included, rather than being covered in an additional text; also included is embryology in sufficient detail to explain many common congenital abnormalities. Wherever possible, information, such as muscle attachments, is tabulated and clinical information is highlighted.

The extensive number of illustrations include surface anatomy, coloured labelled diagrams, dissections, a wide range of radiological, laparoscopic and endoscopic images, and clinical pictures of common diseases. A comprehensive index facilitates rapid location of the desired passages. Self-assessment material is included at the end of each chapter; these multiple choice questions (MCQs), single best answer (SBA) questions (used in the USA and also now more widely), extended styles of examination around the world. The answers and explanations can be found in the text, but additional material is included where appropriate.

The authors bring a combined experience of over 150 years of anatomy teaching at all levels, and present this large volume of information in a palatable, interesting and understandable form, emphasizing its relevance to disease and clinical practice.

John Lumley

John Craven

Peter Abrahams

Richard Tunstall