Niki Springett, University of Helsinki

Sweet Tooth for Surgery? Freshly Picked From the Elsevier Shelf is the 4th Edition of Churchill’s Pocketbook of Surgery by Raftery, Delbridge & Wagstaff. There is a veritable banquet of textbooks out there, so why does this one take the cake? Simply because it is hands-down the easiest way to get yourself noticed in surgery. The operating theatres are infused with generations of knowledge- literally. From the older consultant who still hand-ties vessels, to the rising stars, exhausted residents and the wide-eyed students discreetly googling the branches of the external carotid artery, it is a place where valuable morsels can be gathered and you start to see the pages of your textbooks come to life…or death. Don’t fritter away OT opportunities by walking in unprepared, you may quickly find yourself in a sticky situation or crumbling under the pressure of unanticipated questions. You say you want to be a surgeon- are you going to stand there and say “um, we haven’t been taught that yet..” ? Churchill’s Pocketbook of Surgery is a means of opening up an intelligent dialogue between yourself and the surgeons. It’s short and sweet with easily readable text, giving you a foundation- a surgical scaffold, for common surgical disorders. There are no superfluous wordy accounts here. You have step-by step descriptions of common procedures, the different surgical options for each disorder and brief epidemiology alongside fundamentals like types of sutures and drains. Now what did I mean by ‘opening up a dialogue’? As you’re observing or assisting, you now have a rough idea of what's going on and what you’re looking at. They don’t expect you to be an expert so instead of embracing the stunned mullet routine, your understanding of the operation (in a nutshell) means you can ask questions. Why merely observe when you can be actively taught by seasoned professionals? For Example: Breast reconstruction- “Are you using the pedicled latissimus dorsi flap? Would you mind explaining the common reconstruction options and how the patients are selected? Bladder cancer, cystectomy- “Because you’re doing a cystectomy, am I right in thinking the patient’s staging is at least T2? Could you point out the anatomical landmarks you’re keeping an eye on? Comparing it to Hunt & Marshall’s Clinical Problems in Surgery and Kumar & Clark’s Clinical Medicine, I can happily confirm the information it contains is golden brown and light to the touch: efficient, appropriate and accurate. Peppered throughout this book are very digestible nuggets of definitions and explanations which are often skipped or assumed in other textbooks – What exactly is a burn? (hint- thermal is merely one type) How are burn depths classified? What is the intrathoracic abdomen? What is Goodsall’s rule? (that answer is easy as pie!) Why do colonostomies look different in the RIF vs LIF? And guess what? Those are the types of questions you’re likely to be asked. Furthermore it doesn’t just have the radiological correlations, the diagrams are easily reproducible so you’ll find yourself saying, ‘oh I can just draw you the types of oesophageal stricture from scratch...’ Surgical trainees are often described as stressed. On the flipside, stressed spelled backwards is desserts so perhaps it’s a matter of perspective ☺ Your student years and early PG years are the times when you can have your cake and eat it too; you can indulge in resources, savour the experiences and begin to build your surgical knowledge base. If you love surgery and want a recipe for success or if you’re just trying to survive your surgical placements then do yourself a flavour and pick this book. It’s deliciously easy to read which makes it memorable and applicable. Approach surgery with zest, afterall, apart from if you’re a psych patient, what other occupation lets you walk around in crisp pyjamas with puffy blue clouds on your feet? Niki Springett

Posted 14th Jun 2011

George Collins, University College London

Churchill's Pocketbook of Surgery is a very convenient and useful read, aimed both as a study guide for Medical students and a revision aid for those training for surgical careers. As I read the book I noticed that it is very well thought through, with just enough information to inform and educate the reader without them becoming overwhelmed. Furthermore, I found that included in the book are useful everyday procedural topics that are seldom addressed in other texts of this size with these aims, and therefore it is particularly useful for a Medical student beginning their surgical rotation. Although the structure of the writing and page layout is very didactic and there are few colours or images, the text itself is brilliant and wise and I commend the authors highly on their stringent and rational way of teaching surgery.

Posted 21st Apr 2011

Fions Place, University of Southampton

The first few pages of this book are dedicated to some really useful sections. Firstly common abbreviations are listed, secondly an explanation of surgical terms (e.g. explaining –ectomy, -ostomy, -otomy etc.), important definitions are included and references values for biochemistry and haematology are also there. A page is dedicated to emergencies with the page numbers where these topics are covered being listed. Chapter 1 is an introduction to surgery which includes useful sections such as breaking bad news, history taking, examination of a lump and an ulcer and how to classify disease. There are chapters on surgical techniques and investigative procedures. The other chapters cover shock and trauma, preoperative and postoperative care, infection and surgery, management of malignant disease, head neck and otorhinolaryngology, thorax, breast, endocrine surgery, acute abdomen, alimentary tract, peripheral vascular disease, urology, orthopaedics, neurosurgery, plastic surgery and skin, paediatric surgery, organ and tissue transplantation and gynaecology. This is a very comprehensive list. All chapters are well laid out with a contents list, overview of principles relevant to that specialty, and then various subheadings, tables and summary boxes for each topic. Diagrams and imaging are used well. This book is excellent for quick reference, revision and also to find out about what the different specialties encompass.

Posted 16th Mar 2011

Elizabeth Carr, The University of St Andrews

(For Churchill's Pocketbook of Surgery 4e) The Churchill's Pocketbooks are similar to the Oxford Handbook series, although the pages are less colourful and the Churchill's pocketbooks are slightly larger (you would have to have quite large pockets for it to fit!). The images are not in full colour, but are shaded in with two-tone red. There are lots of examples of radiological imaging associated with the text. It would have been useful for some photographs of gross pathology etc. to be included, but you can refer to a textbook at a later point. At the front of the book, a list of surgical emergencies is given, which is probably useful in such an instance! On the whole, this book is very easy to read. There are no large chunks of text. All the chapters are divided into clinical problems, which are then subdivided into diseases. For each disease/condition, a range of subtopics are given; a brief description of the condition, symptoms and signs as to how to identify the condition, investigations, management, and complications. Management includes surgical as well as non-surgical treatment options, which is useful to provide a balanced view. The sections are concise, but still quite detailed. The topics covered include surgical techniques, practical procedures, and investigative procedures. It also includes a general introduction to surgery, covering useful topics such as consent, death certification and clinical audit. The remaining chapters are arranged into surgical specialties. An advantage of this book is that it contains a small chapter on gynaecological surgery (which the Oxford Handbook of Surgery does not have). Although this book is designed for students/junior doctors on wards, it is also useful for pre-clinical. For pre-clinical medical students, this is a good book to read if you’re interested in surgery. It’s also useful to read in order to relate the subjects you are covering, such as anatomy and pathology, to the relevant surgical procedures. I find it useful to read over the relevant areas after dissection or anatomy/pathology lectures. Overall, this is a useful and interesting book to have.

Posted 27th Feb 2011

Emma Jackson, University of Manchester

I have found the Churchill’s Pocketbooks very useful as a medical student. Surgery is not exception, although I feel it may be of more use to foundation doctors undertaking their first surgical rotation. The book provides a comprehensive but concise overview of surgical conditions. It’s format is to take the condition describe it, signs and symptoms, investigations and then treatment. If you are looking for in depth descriptions of surgical procedures then this is not included, but realistically at an early stage this is something we don’t need to know, we need to know how to look after sick patients. This book provides information on how to do this. I thought the introductory section was particularly good as it has information on how to gain consent, death certificates and legal issues. It also gives good descriptions on how to take focused histories and examinations relevant to surgical conditions e.g. how to examine a lump or ulcer. There is also a background chapter introducing surgical techniques and procedures. One chapter that I thought was particular good was the organ transplant chapter, which dealt with a lot of complex issues well, giving a very good overview of organ transplant surgery. Some of the weaker points of the book are its formatting. There is a lot of information in the book and I felt at times that I was just staring at a block of text, where it might have been better to format some of the text so it stands out. At the start of the book there is a contents page of surgical emergencies, but when you turn to the relevant page there is no indication that the condition is a surgical emergency. Finally I felt that in comparison to the other chapters the gynaecology chapter seemed to be tacked on at the end as an after thought. To conclude a good book, perhaps a little advanced for medical students at the moment but would be very useful as a foundation doctor.

Posted 17th Feb 2011

Bernard Ho, St George's, University of London

The new 4th edition is out, so the review will be based on the newer edition (http://www.elsevierhealth.co.uk/uk/product.jsp?sid=EHS_UK_BS-BS-4&isbn=9780702039935&lid=EHS_UK_BS-BS-DIS-1&iid=) Simply amazing. I love this book. It's like the Elsevier's equivalent of the Oxford Handbook for General Surgery. The book has very concise text, perfect for looking up concepts or procedures on wards, revising for any exams, or just as a book to bring for PBL. The sections are split into very logical sections. My favorite is the fact that there are sections specifically on preoperative and postoperative care. Not only does the book explain what you do, it also explains quickly WHY you do it. I also like the table of antibiotics used on surgical wards - makes this book very practical on the wards. Not the best book to look for pictures in - as there are only minimal pictures used throughout the book (i guess to keep it condense). I would use this book as a supplementary textbook as a detailed revision guide and as a quick reference book. note: the size isn't exactly 'pocket' size. but it will fit into most bags.

Posted 14th Feb 2011