The Wise Scalpel

Surgery remains a challenge for young learners. Perhaps the most difficult of all surgeries are those done on the liver, biliary tree and pancreas. These organs are difficult to expose, difficult to operate and the patients are often difficult to recover. There are significant consequences for any missteps on what is a narrow pathway to a successful outcome. The skills needed to master surgery on these organs are hard to acquire. The volume of information presented to students is enormous and complex to parse. HPB textbooks contain a large amount of information from various authors but are often poorly coordinated. Surgical manuals contain significant anatomic details and descriptions but have difficulty transferring key concepts. Experienced surgeons are often oblivious to their skills and communicate poorly to their students regarding the things they do or understand that make them wise. This book tries to capture this wisdom. The topics in this book are most applicable to hepatobiliary and pancreatic surgeons but really extend to all general surgeons. Anyone who operates in the abdomen must have a basic understanding of these dominant organs; general surgery trainees and staff are an additional focus of this book. The skills needed for a modern surgeon to succeed are much broader than the scalpel tip. Section I, HPB Surgical Craft, imparts important lessons on the laws of human interactions and cognitive aspects of surgery. Sections on the anatomy and operations on the liver, pancreas and bile ducts are presented. The expanded gallbladder section and pancreatitis chapters are of particular importance to general surgery residents. This book has been written in a readable and entertaining style, with many fun historical and contemporary quotes dotted throughout. The Wise Scalpel is an attempt to impart knowledge and understanding to students and practicing surgeons at all levels. The book focuses on tips, traps and underlying truths about the diseases of these organs and their surgical treatment. While this book will not supplant the struggle needed to move from novice to expert surgeon, hopefully it will quicken the process and help avoid some of the dangers and frustrations along the way.