Atlas of Pelvic Anatomy and Gynecologic Surgery, 4e

Book Preface

The fourth edition of the Atlas of Pelvic Anatomy and Gynecologic Surgery has maintained and extended the original mind-set of the two authors—“a single picture is worth a thousand words”— which holds true for this book as it similarly did for the antecedent three editions. Busy, practicing gynecologists, residents, fellows, and students do not wish to read laborious, wordy descriptions when photographs and illustrations better display the specific anatomy and the detailed operative techniques. Not only do visual images imprint more rapidly, but additionally, the images are more likely to be retained permanently within the memory centers of the prefrontal and limbic portions of the brain.

Important new chapters, as well as pertinent revisions to existing chapters, have been added to this edition. Chapter 3, titled “Max Brödel’s Pelvic Anatomy,” is unique. Max Brödel, a world- renowned medical artist, drew detailed medical illustrations for Dr. Howard Kelly’s 1898 textbook Operative Gynecology. Howard Kelly was one of the four immortal physicians who comprised the founding staff at Johns Hopkins. The other three physicians were Welch (pathology), Osler (medicine), and Halstead (surgery). Our artist, Joe Chovan, has created full-color reproductions of Brödel’s original black-and-white drawings, showing details of the century-old material that appeared in Kelly’s original two volumes.

Revisions have been made in Chapters 5 and 6, as well as 9, 10, 13, 14, 19, 20, 29, 42, 54, 55, 56, 58, and 60. Drawings that initially appeared as black and white in the first edition have been colorized for the fourth edition. This colorization will be completed to include 100% of all drawings in the next edition. A major revision has been carried out for Chapter 12 (“Abdominal Hysterectomy”). A step-by-step comparison between laparotomy and laparoscopy has been added to show the operative procedure performed.

Within this fourth edition is a novel illustration technique that has been applied to several chapters, including Chapters 32 and 37. An actual photograph was enhanced and added to by our artist using his computer imaging to create a hybrid figure that merged photograph and drawing into a singular, highresolution picture.

Four additional new chapters have been added to this edition: Chapter 57 (“Use of Biologic and Synthetic Mesh to Augment Vaginal Prolapse Repair”) provides greatly detailed illustrations relating to the correct and most appropriate uses of mesh materials for reconstructive pelvic surgery. Chapter 59 (“Avoiding and Managing Synthetic Mesh Complications After Surgeries for Urinary Incontinence and Pelvic Organ Prolapse”) focuses on the most up-to-date information about warnings by the Food and Drug Administration and the current status of commercially available vaginal mesh kits. Numerous illustrations in this chapter show various complications that can occur and the best ways that they can be managed. Chapter 66 (“Atlas of Vulvar Disorders”) depicts a plethora of common and unusual vulvar disease. Numerous photographs have been included to facilitate for the reader the ability to make the most precise diagnosis and to select the most appropriate treatment regimen. Finally, Chapter 120, dedicated to Robotic Surgery, completes the roll of new additions. This latest chapter pictorially describes the techniques of robotics as applied to gynecologic surgery from A to Z. New photographs have been added to the chapter that deals with the treatment of vulvar hypertrophy. These photographs show the step-by-step surgical methodology required to obtain the most satisfactory results. Several chapters within the Laparoscopic Surgery section have undergone significant revisions, including one that depicts the technique of single entry laparoscopic surgery. Chapter 121, which deals with Laparoscopic Complications, has grown with the incorporation of new, unusual photographs and illustrations detailing serious injuries that occur during laparoscopic procedures.

The fourth edition is the most complete volume of the Atlas of Pelvic Anatomy and Gynecologic Surgery ever published. We have created a comprehensive resource comprising a multitude of quality photographs and detailed drawings. More than 100 new illustrations have been added, and nearly 200 existing illustrations have been colorized. The overriding goal for this edition was, most importantly, the preservation of exceptional quality.

Michael Baggish, MD
Mickey Karram, MD