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General Surgical Operations is a highly-praised and comprehensive textbook of operative surgery. It is a practical manual aimed at the surgeon who is about to carry out an operation, rather than just a description of the principles suitable for an examiner.

Kirk’s General Surgical Operations continues to be aimed at a broad readership: the candidate preparing for the Intercollegiate FRCS in General Surgery or international equivalents; the trained surgeon faced, through necessity, with undertaking an infrequently performed procedure; and the many surgeons working in hospitals throughout the world without access to specialist services. It remains above all a practical text which will guide the surgeon in training, or one unfamiliar with a procedure, on how to perform it, but more importantly on how to manage the uncertainties which so often arise

This is a ‘What to do’ book. Using it the reader can aspire to gain diagnostic, decision making and operative surgical competence with confidence.

  • The book is written in a clear and direct style and providing explicit instructions using descriptive headings for easy reference.
  • The contents covers standard routine operations in full; non-routine and rarely performed operations are included only where appropriate and in lesser detail
  • The text includes advice on topics such as patient selection; preparation and access to the site of operation; how to accomplish the procedure; closing and aftercare
  • Difficulties are highlighted and advice given on how to respond to unexpected findings
  • Each procedure is fully described thus avoiding repetitions and cutting cross-references to a minimum
  • Regular summaries of key points in the decision making process are included.
  • This Sixth Edition is now known as Kirk’s General Surgical Operations in recognition of its distinguished founding editor, Professor RM Kirk, who is now Editor Emeritus on the textbook.
  • The new editorial team for the Sixth Edition comprises a colorectal surgeon, a vascular surgeon and an orthopaedic surgeon
  • The contents have been restructured and radically revised into 42 chapters, the majority of which have been completely rewritten.
  • Laparoscopic techniques have been incorporated into all relevant chapters.
  • All the illustrations have been redrawn to improve their clarity.



Publié par
Date de parution 23 avril 2013
Nombre de lectures 2
EAN13 9780702051234
Langue English
Poids de l'ouvrage 4 Mo

Informations légales : prix de location à la page 0,8978€. Cette information est donnée uniquement à titre indicatif conformément à la législation en vigueur.


Kirk’s General Surgical Operations
Sixth Edition

Richard Novell, MChir FRCS
Consultant Colorectal Surgeon, The Royal Free London NHS Foundation Trust
Honorary Senior Lecturer, University College London, London, UK

Daryll M. Baker, BSc PhD BM Bch FRCS FRCS
Consultant General and Vascular Surgeon, The Royal Free London NHS Foundation Trust, London, UK

Nicholas Goddard, MBBS FRCS
Consultant Orthopaedic Surgeon, The Royal Free London NHS Foundation Trust, London, UK
Table of Contents
Cover image
Title page
Chapter 1: Choose well, cut well, get well
Chapter 2: Anaesthesia-related techniques
Chapter 3: The severely injured patient
Chapter 4: Laparotomy: elective and emergency
Chapter 5: Principles of minimal access surgery
Chapter 6: Abdominal wall and hernias
Chapter 7: Appendix and abdominal abscess
Chapter 8: Oesophagus
Chapter 9: Oesophageal cancer
Chapter 10: Stomach and duodenum
Chapter 11: Small bowel and operations for obesity
Chapter 12: Colonoscopy
Chapter 13: Colon
Chapter 14: Anorectum
Chapter 15: Biliary tract
Chapter 16: Pancreas
Chapter 17: Liver and portal venous system
Chapter 18: Spleen
Chapter 19: Breast
Chapter 20: Thyroid
Chapter 21: Parathyroid
Chapter 22: Adrenalectomy
Chapter 23: Arteries
Chapter 24: Veins and lymphatics
Chapter 25: Sympathectomy and the management of hyperhidrosis
Chapter 26: Transplantation
Chapter 27: Thorax
Chapter 28: Head and neck
Chapter 29: Orthopaedics and trauma: amputations
Chapter 30: Orthopaedics and trauma: general principles
Chapter 31: Orthopaedics and trauma: upper limb
Chapter 32: Orthopaedics and trauma: lower limb
Chapter 33: Plastic surgery
Chapter 34: Paediatric surgery
Chapter 35: Neurosurgery
Chapter 36: Upper urinary tract
Chapter 37: Lower urinary tract
Chapter 38: Male genitalia
Chapter 39: Gynaecological surgery
Chapter 40: Ear, nose and throat
Chapter 41: Oral and maxillofacial surgery
Chapter 42: Ophthalmology

© 2013 Richard Novell, Daryll Baker, Nicholas Goddard. Published by Elsevier. All rights reserved.
No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the publisher's permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: .
This book and the individual contributions contained in it are protected under copyright by the publisher (other than as may be noted herein).
First edition 1978      Fourth edition 2000
Second edition 1987    Fifth edition 2006
Third edition 1994     Sixth edition 2013
ISBN 978-0-7020-4481-6
International ISBN 978-0-7020-4482-3
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging in Publication Data
A catalog record for this book is available from the Library of Congress

Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary.
Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions.
To the fullest extent of the law, neither the publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein.

Printed in China
Many of the operations I performed alone as a trainee surgeon were new to me. It was then customary practice. I relied on operative textbooks, frequently dashing to the library between operations. In the books were listed the sequential steps for each procedure. They did not provide advice on likely difficulties and hazards - how to anticipate, avoid, identify or respond to them. This book was a response to them. Experts who write textbooks have, over years, often armed themselves, almost unconsciously, with the required precautions. They are then no longer aware of their intuitively acquired knowledge. I believe it is the duty of experienced surgeons to identify and articulate their hard-won skills.
If you have difficulty with a manoeuvre, watch and question an expert whenever possible. In the absence of advice and guidance, you may nevertheless succeed with a struggle. Recall your actions and carefully record the circumstances and the steps. If your method proves effective, let others know. Similarly, if you face a decision that does not meet the guidelines and so demands an unorthodox solution, carefully record it. Question it as though you will need to justify it. In doing so, you may uncover a worthwhile modification to the guidelines. Although objective, evidence-based knowledge is rightly pre-eminent, all human activities are partly governed by intuition. It is in this area that you may identify a possible advance. Rational, objective thought does not provide all the answers.
The intuitive mind is a sacred gift and the rational mind is a faithful servant. We have created a society that honours the servant and has forgotten the gift. Attributed to Albert Einstein.
What is the relevance of a textbook covering most of the generality of surgery? It is valuable for intending surgeons to rotate, see and understand a variety of possible attractive careers. Too narrow concentration of interests blunts the appreciation of translating techniques across specialities. Even in highly organized countries, emergencies in the form of natural and deliberate disasters may create emergencies in which a soundly trained surgeon may act as a substitute for an unavailable colleague. Finally, there are still some surgeons working from choice or necessity in constrained circumstances. They may offer the only hope for saving life, limb or a special sense.

R.M. Kirk, London, 2013
A good surgeon knows how to operate
A better surgeon knows when to operate
The best surgeon knows when not to operate
Welcome to the Sixth Edition of this much-loved textbook which has guided most of us through the uncharted waters of surgical training for the past 35 years. Much has changed since the last edition, a mere seven years ago, and in an era which is increasingly defined by instantaneous access to information via the world-wide web the question must be asked: is there still a need for a comprehensive overview of operative general surgery, a specialty whose very existence is threatened by relentless subspecialisation? The answer is, we believe, emphatically ‘Yes’. As Jerry Kirk argued in his preface to the previous edition, the new generation of surgeons are trained within a narrower field, but in many countries limited manpower has resulted in only a partial implementation of specialization: surgeons dealing with emergency admissions are frequently required to provide urgent care for conditions outside their sphere of expertise. Indeed, we in the UK are seeing the emergence of a new breed of general surgeon specialising in emergency surgery, with a practice characterized by breadth rather than depth of knowledge. Natural disasters, terrorist bombs and civil war have no respect for specialties and it is more vital than ever that those surgeons managing such patients are familiar with the broad spectrum of conditions and surgical techniques contained herein.
When we were asked to take over the editorship of General Surgical Operations , we were faced with a dilemma: how to make it relevant to a new readership, many of whom are familiar with the latest high-tech, minimally invasive techniques, whilst still retaining the practical, ‘cottage industry’ approach of which Jerry is rightly proud. The results, we hope, speak for themselves. The involvement of no less than 42 new contributors has meant that 33 chapters from the previous edition have been completely rewritten. Laparoscopic surgery is gaining in popularity and is now often the gold standard in management: the six chapters dealing wit

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