BOOK REVIEWS
Mayo Clinic Gastrointestinal Surgery
Kelly KA, Sarr MG, Hinder RA, eds. Philadelphia, Pa:
W.B. Saunders; 2003, 734 pp, $195.00.
The editors have done a commendable job in assembling to-
gether the gastrointestinal (GI) surgical experiences of the
Mayo Clinic surgeons in this comprehensive textbook. They
have spared no efforts to make the text simple, and yet infor-
mative. This book focuses on the applied clinical aspects of GI
surgery with relatively little emphasis on etiology and patho-
physiology in order to give it a practical outlook. The 73 con-
tributing authors are all from the Mayo Clinic. A great attempt
has been made to demonstrate the tradition and style of the
Mayo Clinic. Throughout the book there is a powerful depic-
tion of the sense of pride of the authors in being “Mayo Sur-
geons.⬙ This is well reflected in the first chapter, which is an
exhaustive account of the culture, vision, traditions, and beliefs
in cooperative individualism, research, fearless recognition, and
acceptance of talents of subordinates.
The book is focused, in the sense that it has a selected array of
topics. Most chapters are designed in the format of historical
perspectives, brief anatomy, and clinical features with emphasis
on management strategies. Vivid descriptions are backed up
with clear reasoning, which makes the textbook a reader’s de-
light and a good choice for students and residents. This also
makes it easier to muster information without the need to mem-
orize facts. Moreover, their institutional outcomes are ade-
quately backed up with research, thereby giving an unbiased
opinion on the current and the conventional standards of care.
At times when there are no clear-cut standards, the authors
present the reader with a clear idea of Mayo Clinic preferences
and practice. Some of the operative sections are very detailed
and yet simple, with clear diagrams and excellent practical
hints. In most chapters, tables are appropriately included to
summarize the topic without any ambiguity.
The reader has to exercise caution in reaching conclusions
with the information provided as the views of the authors may
be personal and reflect a single institutional bias. The text does
not elaborate on the current recommendations in controversial
situations, but it does definitely engage the reader with its sim-
ple and lucid descriptions of the basic principles.
In summary, this book presents a comprehensive approach
toward common gastrointestinal surgical problems and their
management, including the latest minimal access techniques.
As with most books, it is not a substitute for any of the standard
textbooks, but it is an invaluable supplement for all general
surgeons whether in training or in practice.
KOTA VENKATESH, MD
Department of Surgery
St. Luke’s Hospital
Bethlehem, Pennsylvania
doi:10.1016/j.cursur.2004.08.005
CURRENT SURGERY • © 2005 by the Association of Program Directors in Surgery
Published by Elsevier Inc.
Physiologic Basis of Surgery. 3rd ed.
O’Leary JP, Capote LR, eds. Philadelphia, Pa: Lippincott
Williams and Wilkins; 2002, 784 pp, $129.00.
It is probably inappropriate for the author and the editor of a
textbook to review the book for a publication such as Current
Surgery. That having been said, I have undertaken this task with
enthusiasm. If the reader takes into consideration the parochial
position of the editor in his critical review, then the inherent
conflict of interest can be expunged.
The Physiologic Basis of Surgery is now in its third edition. In
actual fact, each chapter was written by a different team of individ-
uals who were given maximal freedom in summarizing the salient
features of basic science they applied to the individual topics. The
editors went over the contributions for consistency of style, punc-
tuation, spelling, length, and, in rare circumstances, applied our
talents for clarification and sequencing. We also were responsible
for identifying chapters that needed to be revised, and if necessary,
new topics were added. There has been a planned migration of
authors so that a fresh view could be given to the text as it matured
through its various printings.
The third edition of The Physiologic Basis of Surgery is built on the
foundation provided by the first 2 editions. In the early 1990s, it
was determined that a formalized curriculum needed to be devel-
oped for not only surgical training, but also for the basic science
aspect of surgery. The idea emerged as the brain child of many
leaders of the APDS, but it came to fruition when several of these
individuals accosted me in a deserted foyer of the Georgia Trade
Center during an American College of Surgeons Meeting in At-
lanta. What developed from that first encounter was the identifi-
cation of a highly select cadre of practicing general surgeons (most
of them holding academic positions) who were educators and who
understood the importance of basic science as it is applied to clin-
ical surgery. It was our primary premise then, and it continues now,
that clinical excellence comes only when the student/resident has a
sound basis in the understanding of the basic principles of the
science of surgery. This quest for understanding is a life-long en-
deavor, and its achievement will never be complete. It is not so
much that the basic principles of science change, for that is not the
case, but our understanding of these principles will change with the
continued elucidation of these basic concepts. Take, for example,
something as truly basic as the human genome. These descriptive
studies bring with them a better understanding of multiple phe-
nomena that could only be assessed at a point downstream from
the originating principle.
In more than a decade since the first edition was published,
much of our understanding of surgical basic science topics has
changed. This third edition reflects some of that changing collage.
Five chapters were completely redone in this edition, and a new
chapter on Geriatrics has been added. With an aging population
and the fact that elderly patients require surgery more frequently
than younger patients, comes an increasing pressure to better un-
derstand how elderly patients respond to the stress of an operation.
0149-7944/05/$30.00 31
 With the current edition, there is a CD-ROM, which includes
the textbook and over 1250 questions that were written by the
various authors. These questions can be sorted by organ system,
disease process, or chapter. They can be used for self-study or can
be arranged into a series of examinations with software included
that will allow for grading and archiving of the tests. The software
even allows an institution to produce their own questions and add
them to the corpus. As the question items are reviewed, a succinct
statement will appear adjacent to the various options to validate the
correct answer or to explain why the other potential answers are
incorrect. References back to the text are made available for most
questions, and transport back into the text can occur with a simple
click of the mouse.
The third edition of The Physiologic Basis of Surgery and its
accompanying CD is an attempt to blend together classic read-
ing and learning and a newer electronic format into a compre-
hensive package that will facilitate the student’s learning of this
vital aspect of surgery. The process is a never-ending quest, and
it is the editor’s hope that this contribution will facilitate the
education of surgeons, both young and not so young.
J. PATRICK O’LEARY, MD
Department of Surgery
Louisiana State University
Health Sciences Center
New Orleans, Louisiana
doi:10.1016/j.cursur.2004.07.007
32
Editor’s Comment
It is unusual for a journal to publish a book review by the author
or editor of the text. Dr. O’Leary’s review of the now classic
Physiologic Basis of Science is an honest appraisal. His review also
provides a short history of how the idea for this text developed.
I use this book in our residency program. It is probably the most
commonly used basic science text used by general surgery
residency programs. Almost all the answers to the basic science
questions from the yearly American Board of Surgery In-
training/Surgical Basic Science Examination can be found in
this book. As a general surgery residency director, I strongly
recommend this text for all residents. The chapters are concise,
easy to read, and provide the reader with a thorough under-
standing of the physiology and pathophysiology of various sys-
tems of the body with which surgeons are involved in an almost
daily basis.
JOEL C. ROSENFELD, MD
Department of Surgery
St. Luke’s Hospital
Bethlehem, Pennsylvania
doi:10.1016/j.cursur.2004.07.008
CURRENT SURGERY • Volume 62/Number 1 • January/February 2005