Anesthesia for Minimally Invasive Surgery: Laparoscopy, Thoracoscopy, Hysteroscopy; Volume 18 Number 1 (March 2001) of Anesthesiology Clinics of North America Girish P. Joshi, MB BS, MD, FFARCSI, ed. Philadelphia: WB Saunders. ISSN: 0889-8537. 205 pages, $65.00.
The book gives a comprehensive account of “oscopies,” i.e. using fiberoptic technology through a small opening in the body. The anatomical areas involved are the abdomen, the thoracic cavity, and the uterus.
There are twelve chapters, of which seven relate to laparoscopy, one to hysteroscopy, and four to thoracoscopy. Each chapter is coauthored by different writers. There is much repetition of factual information in the laparoscopic sections such that the initial chapters become redundant. The issues for pediatric patient are concisely presented. The editor contributed to the chapter on the complications of laparoscopy, which is succinct and well written. He gives a system review addressing the causes and their treatment.
The section on hysteroscopy describes the associated problems when a gas or fluid is the distension medium. The different fluid media (glycine, sorbitol, mannitol, dextran, and physiological solution) are comprehensively discussed.
The chapters on thoracoscopy contain informative pearls that are of help to the practicing anesthesiologist. The topics mentioned include physiologic changes, anesthesia for, and complications related to the procedure. There is a section that addresses this procedure in the pediatric population. Because thoracoscopy is minimally invasive, its use continues to increase. The associated cardiopulmonary changes, lung isolation techniques for better surgical visualization, and CO2 immobilization (CO2 insufflated intrapleurally to enhance collapse) are highlights of the subject mentioned. There are some illustrations regarding patient positioning and the thoracoscope insertion site.
Possible improvements would include numerating the subject headings in the content section to enable quick referencing, minimizing repetition of subject matter in the initial chapters on laparoscopy, and the addition of more illustrations or diagrams.
This quick, easy-reading book is recommended for anesthesia personnel who handle these types of procedures. It certainly would be a subspecialty book to add to an anesthesia department library. Factual information is well referenced. Much sound advice is given. The usefulness of this book is that it addresses the major current “-oscopy” procedures in one place. As minimally invasive surgery continues to advance, this field will undoubtedly grow.