Netter's Surgical Anatomy and Approaches, 1e

643 Pages·2013·67.17 MB·English

by  Conor P Delaney MD MCh PhD FRSCI

Netter’s
Surgical
Anatomy
and
Approaches
Conor P. Delaney,
MD, MCh,
PhD, FRCSI, FACS, FASCRS
Chief, Division of Colorectal Surgery
Vice-Chair, Department of Surgery
Surgical Director, Digestive Health Institute
University Hospitals Case Medical Center
Jeffrey L. Ponsky MD Professor of Surgical Education
Case Western Reserve University School of Medicine
Cleveland, Ohio
Illustrations by
Frank H. Netter, MD
Contributing Illustrators
Carlos A. G. Machado, MD
Kristen Wienandt Marzejon, MS, MFA
James A. Perkins, MS, MFA
John A. Craig, MD
1600 John F. Kennedy Blvd.
Ste. 1800
Philadelphia, PA 19103-2899
NETTER’S SURGICAL ANATOMY AND APROACHES ISBN: 978-1-4377-0833-2
Copyright © 2014 by Saunders, an imprint of Elsevier Inc.
No part of this publication may be reproduced or transmitted in any form or by any means,
electronic or mechanical, including photocopying, recording, or any information storage and
retrieval system, without permission in writing from the publisher. Details on how to seek
permission, further information about the Publisher’s permissions policies and our arrangements
with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency
can be found at our website: www.elsevier.com/permissions.
This book and the individual contributions contained in it are protected under copyright by the
Publisher (other than as may be noted herein).
Permission for Netter Art figures may be sought directly from Elsevier’s Health Science Licensing
Department in Philadelphia, PA: phone [phone], ext. 3276, or [phone]; or email
[email protected]
Notices
Knowledge and best practice in this field are constantly changing. As new research and
experience broaden our understanding, changes in research methods, professional practices, or
medical treatment may become necessary.
Practitioners and researchers must always rely on their own experience and knowledge in
evaluating and using any information, methods, compounds, or experiments described herein.
In using such information or methods they should be mindful of their own safety and the
safety of others, including parties for whom they have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to check
the most current information provided (i) on procedures featured or (ii) by the manufacturer
of each product to be administered, to verify the recommended dose or formula, the method
and duration of administration, and contraindications. It is the responsibility of practitioners,
relying on their own experience and knowledge of their patients, to make diagnoses, to
determine dosages and the best treatment for each individual patient, and to take all
appropriate safety precautions.
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or
editors, assume any liability for any injury and/or damage to persons or property as a matter of
products liability, negligence or otherwise, or from any use or operation of any methods,
products, instructions, or ideas contained in the material herein.
ISBN: 978-1-4377-0833-2
Senior Content Strategist: Elyse O’Grady
Senior Content Development Manager: Marybeth Thiel
Publishing Services Manager: Patricia Tannian
Senior Project Manager: John Casey
Senior Design Manager: Steven Stave
Printed in China
Last digit is the print number: 9 8 7 6 5 4 3 2 1
In memory of my father,
Peter Vincent Delaney,
whose love of surgery and its ability to help others led me to this field
About the Artists
Frank H. Netter, MD
Frank H. Netter was born in 1906, in New York City. He studied art at the Art Students’ League
and the National Academy of Design before entering medical school at New York University,
where he received his MD degree in 1931. During his student years, Dr. Netter’s notebook
sketches attracted the attention of the medical faculty and other physicians, allowing him to
augment his income by illustrating articles and textbooks. He continued illustrating as a sideline
after establishing a surgical practice in 1933, but he ultimately opted to give up his practice in
favor of a full-time commitment to art. After service in the United States Army during World
War II, Dr. Netter began his long collaboration with the CIBA Pharmaceutical Company (now
Novartis Pharmaceuticals). This 45-year partnership resulted in the production of the extraor-
dinary collection of medical art so familiar to medical professionals worldwide.
In 2005, Elsevier, Inc. purchased the Netter Collection and all publications from Icon Learn-
ing Systems. Over 50 publications featuring the art of Dr. Netter available through Elsevier, Inc.
(in the US: www.us.elsevierhealth.com/Netter and outside the US: www.elsevierhealth.com)
Dr. Netter’s works are among the finest examples of the use of illustration in the teaching
of medical concepts. The 13-book Netter Collection of Medical Illustrations, which includes the
greater part of the more than 20,000 paintings created by Dr. Netter, became and remains one
of the most famous medical works ever published. The Netter Atlas of Human Anatomy, first
published in 1989, presents the anatomical paintings from the Netter Collection. Now trans-
lated into 16 languages, it is the anatomy atlas of choice among medical and health professions
students the world over.
The Netter illustrations are appreciated not only for their aesthetic qualities, but, more
important, for their intellectual content. As Dr. Netter wrote in 1949, “… clarification of a
subject is the aim and goal of illustration. No matter how beautifully painted, how delicately
and subtly rendered a subject may be, it is of little value as a medical illustration if it does not
serve to make clear some medical point.” Dr. Netter’s planning, conception, point of view, and
approach are what inform his paintings and make them so intellectually valuable.
Frank H. Netter, MD, physician and artist, died in 1991.
Learn more about the physician-artist whose work has inspired the Netter Reference col-
lection: http://www.netterimages.com/artist/netter.htm
Carlos Machado, MD
Carlos Machado was chosen by Novartis to be Dr. Netter’s successor. He continues to be the
main artist contributing to the Netter collection of medical illustrations.
Self-taught in medical illustration, cardiologist Carlos Machado has meticulous updated
some of Dr. Netter’s original plates and has created many original paintings of his own in the
style of Netter as an extension of the Netter collection. Dr. Machado’s photorealistic expertise
and keen insight into the physician-patient relationship informs his vivid and unforgettable
visual style. His dedication to researching each topic and subject he paints places him among
the premier medical illustrators at work today.
Learn more about his background and see more of his art at: http://www.netterimages.com/
artist/machado.htm
vi
Preface
The Atlas of Human Anatomy by Frank H. Netter, MD, has been the pinnacle of demonstrating
the anatomy of the human body for generations of students. To those who would wish to
perform or understand surgical procedures, however, there has been no direct link between
the beautiful images created by Dr. Netter and the surgical procedures being performed. In
Netter’s Surgical Anatomy and Approaches, we try to address a request by many Netter users to tie
these anatomical diagrams to the procedures they perform.
This book presents the curriculum of basic and common general surgical procedures in
chapters that portray the relevant anatomy for each procedure. In his very first edition, Dr.
Netter stated that “anatomy of course does not change, but our understanding of anatomy and
its clinical significance does.” Consequently, in some cases we have been able to pair the
anatomy demonstrated in his illustrations with a modern intraoperative photograph or radio-
graphic image. For some chapters, a new Netter-style illustration has been created to demon-
strate a key anatomical point for an operative procedure or to show a key sur gical perspective
or orientation that is not captured in the original Netter images. The result is a volume that
covers the most important and commonest areas in surgery, addressing common procedures
in the head and neck, endocrine surgery, upper and lower gastrointestinal surgery, hepatobili-
ary surgery, surgery for hernias, vascular surgery, access and emergency procedures, breast and
oncology surgery, and urology and gynecology.
A book like this would not be possible without the help of many people. Being fortunate
to work at institutions such as University Hospitals Case Medical Center and Case Western
Reserve University, I elected to enlist the support of my faculty colleagues in many different
surgical specialties. It is only with the guidance and assistance of the editorial team of Jerry
Goldstone, Jeffrey Hardacre, Julian Kim, Pierre Lavertu, Mark Malangoni, Jeffrey Marks,
Christopher McHenry, Lee Ponsky, Michael Rosen, Christopher Siegel, and Sharon Stein, and
the direction and guidance of the ever-patient Marybeth Thiel at Elsevier that this project has
been completed.
On behalf of my co-editors and I, we hope you enjoy Netter’s Surgical Anatomy and Approaches.
Conor P. Delaney, MD, MCh, PhD
vii
Video Contents
1. Neck Dissection (Chapter 1)
2. Tracheotomy (Chapter 2)
3. Thyroidectomy and Parathyroidectomy (Chapter 3)
4. Gastric Bypass (Chapter 11)
5. Laparoscopic Cholecystectomy (Chapter 12)
6. Appendectomy (Chapter 19)
7. Right Colectomy (Chapter 21)
8. Left Colectomy (Chapter 22)
9. Low Anterior Resection with Total Mesorectal Excision and Anastomosis (Chapter 24)
10. Carotid Endarterectomy (Chapter 32)
11. Abdominal Aortic Aneurysm (Chapter 33)
12. Oblique Femoral Artery Exposure for EVAR (Chapter 36)
13. Posterior Popliteal Artery Exposure (Chapter 38)
14. Retroperitoneal Sarcoma (Chapter 50)
15. Radical Prostatectomy (Chapter 54)
ix
Contributors
EDITOR Mark A. Malangoni, MD, FACS
Associate Executive Director
Conor P. Delaney, MD, MCh, PhD, FRCSI, FACS,
American Board of Surgery
FASCRS
Adjunct Professor of Surgery
Chief, Division of Colorectal Surgery
University of Pennsylvania
Vice-Chair, Department of Surgery
Philadelphia, Pennsylvania
University Hospitals Case Medical Center
Professor of Surgery
Jeffrey M. Marks, MD, FACS
Case Western Reserve University School of Medicine
Director of Surgical Endoscopy
Cleveland, Ohio
University Hospitals Case Medical Center
Associate Professor, Department of Surgery
SECTION EDITORS Case Western Reserve University School of Medicine
Cleveland, Ohio
Jerry Goldstone, MD, FACS, FRCSEd
Division Chief Emeritus
Division of Vascular Surgery and Endovascular Therapy Christopher R. McHenry, MD
University Hospitals Case Medical Center Vice Chairman, Department of Surgery
Professor of Surgery MetroHealth Medical Center
Case Western Reserve University School of Medicine Cleveland, Ohio
Cleveland, Ohio
Lee E. Ponsky, MD, FACS
Jeffrey M. Hardacre, MD, FACS Leo and Charlotte Goldberg Chair in Advanced Surgical
Section Head, Pancreatic Surgery Therapies
University Hospitals Case Medical Center Director, Urologic Oncology and Minimally Invasive
Associate Professor of Surgery Therapies Center
Case Western Reserve University School of Medicine Urology Institute
Cleveland, Ohio University Hospitals Case Medical Center
Associate Professor, Urology
Case Western Reserve University School of Medicine
Julian A. Kim, MD
Cleveland, Ohio
Chief, Division of Surgical Oncology
University Hospitals Case Medical Center
Program Director, Case Surgery Michael J. Rosen, MD, FACS
Charles Hubay Professor of Surgery Professor of Surgery
Case Western Reserve University School of Medicine Chief, Division of GI and General Surgery
Cleveland, Ohio Director, Case Comprehensive Hernia Center
University Hospitals Case Medical Center
Associate Professor of Surgery
Pierre Lavertu, MD
Case Western Reserve University School of Medicine
Director of Head and Neck Surgery
Cleveland Ohio
Department of Otolaryngology—Head and Neck Surgery
University Hospitals Case Medical Center
Professor
Case Western Reserve University School of Medicine
Cleveland, Ohio
xi
xii Contributors
Christopher T. Siegel, MD, PhD Bradley J. Champagne, MD
Associate Professor of Surgery Associate Professor
Division of Transplant and Hepatobiliary Surgery Case Western Reserve University School of Medicine
University Hospitals Case Medical Center Cleveland, Ohio
Cleveland, Ohio
Edward Cherullo, MD
Sharon L. Stein, MD, FACS Vice Chairman, Clinical Operations
Associate Program Director, General Surgery Program Director, Urology Institute
Surgical Director, Inflammatory Bowel Disease Center, University Hospitals Case Medical Center
Digestive Health Institute Associate Professor of Urology
University Hospitals Case Medical Center Case Western Reserve University School of Medicine
Assistant Professor of Surgery Cleveland, Ohio
Division of Colorectal Surgery
Case Western Reserve University School of Medicine Jeffrey A. Claridge, MD, MS
Cleveland, Ohio Associate Professor of Surgery
Division of Trauma, Critical Care, and Burns
CONTRIBUTORS MetroHealth Medical Center
Cleveland, Ohio
Mujjahid Abbas, MD
Staff Surgeon
John J. Como, MD, MPH
Louis Stokes Cleveland Veterans Administration Medical
Associate Professor of Surgery
Center
Division of Trauma, Critical Care, and Burns
Cleveland, Ohio
MetroHealth Medical Center
Cleveland, Ohio
Robert Abouassaly, MD, MSc
Assistant Professor
Robert L. DeBernardo, MD
Urology Institute
Assistant Professor
University Hospitals Case Medical Center
Division of Gynecologic Oncology
Cleveland, Ohio
Seidman Cancer Center
Case Western Reserve University School of Medicine
Matthew T. Allemang, MD
Cleveland, Ohio
Department of Surgery
University Hospitals Case Medical Center
Samuel J. DeJoy, DMD, MD
Cleveland, Ohio
Assistant Professor of Anesthesiology
Case Western Reserve University School of Medicine
Henry R. Baele, MD
MetroHealth Medical Center
Assistant Professor of Surgery
Cleveland, Ohio
Department of Surgery, Division of Vascular Surgery
University Hospitals Case Medical Center
Thomas J. Edwards, BSc, MBBS, MSc, FRCS
Cleveland, Ohio
Consultant, Colorectal Surgeon
Taunton Hospitals NHS Trust
Jeffrey A. Blatnik, MD
Somerset, England
General Surgery Resident
Allen Research Scholar
Heidi L. Elliott, MD
University Hospitals Case Medical Center
Department of Surgery
Cleveland, Ohio
University Hospitals Case Medical Center
Cleveland, Ohio
Joshua I. S. Bleier, MD
Assistant Professor of Surgery
Bruce L. Gewertz, MD
Division of Colon and Rectal Surgery
Surgeon-in-Chief, H. & S. Nichols Endowed Chair in
Hospital of the University of Pennsylvania
Surgery
Philadelphia, Pennsylvania
Chairman, Department of Surgery
Vice President for Interventional Services
Walter S. Cha, MD, FACS
Cedars-Sinai Medical Center
Cleveland Clinic General Surgery
Los Angeles, California
Digestive Disease Institute
Cleveland, Ohio
Contributors xiii
Jason F. Hall, MD, MPH Jeremy M. Lipman, MD
Surgeon, Department of Colon and Rectal Surgery Assistant Professor of Surgery
Lahey Clinic Case Western Reserve University School of Medicine
Burlington, Massachusetts; MetroHealth Medical Center
Assistant Professor of Surgery Department of Surgery
Tufts University School of Medicine Cleveland, Ohio
Boston, Massachusetts
Yi-Chun Carol Liu, MD
Michael D. Holzman, MD, MPH Resident Physician
Associate Professor, Department of Surgery Ear, Nose, and Throat Institute
Vanderbilt University Medical Center University Hospitals Case Medical Center
Nashville, Tennessee Cleveland, Ohio
Harry A. Hoyen, MD Mark L. Manwaring, MD
Associate Professor Colorectal Surgery
Department of Orthopaedic Surgery Department of Surgery
Case Western Reserve University East Carolina University
Cleveland, Ohio Greenville, North Carolina
Natalie E. Joseph, MD, FACS Eric L. Marderstein, MD, MPH
Assistant Professor of Surgery Director of Colorectal Surgery Services
Case Western Reserve University School of Medicine Louis Stokes Cleveland VA Medical Center
Division of Surgical Oncology Assistant Professor of Surgery
MetroHealth Medical Center Division of Colorectal Surgery
Cleveland, Ohio University Hospitals Case Medical Center
Cleveland, Ohio
Arielle Kanters, MD
Division of Pediatric Surgery Evan R. McBeath, MD
University Hospitals Case Medical Center Resident Physician
Cleveland, Ohio Ear, Nose, and Throat Institute
University Hospitals Case Medical Center
Vikram S. Kashyap, MD, FACS MetroHealth Medical Center
Chief, Division of Vascular Surgery and Endovascular Louis Stokes Cleveland VA Medical Center
Therapy Cleveland, Ohio
Co-Director, Harrington Heart and Vascular Institute
University Hospitals Case Medical Center Amy McDonald, MD, FACS
Professor of Surgery Assistant Professor of Surgery
Case Western Reserve University School of Medicine Case Western Reserve University School of Medicine
Cleveland, Ohio Director, Trauma Intensive Care Unit
MetroHealth Medical Center
Jonathan E. Kiechle, MD Cleveland, Ohio
Resident Physician
Urology Institute Husein Moloo, MD, FRCS
University Hospitals Case Medical Center Assistant Professor and Interim Chair
Cleveland, Ohio Division of General Surgery
University of Ottawa
David M. Krpata, MD Interim Chief, Division of General Surgery
Department of Surgery Director, Minimally Invasive Surgery Program
University Hospitals Case Medical Center The Ottawa Hospital
Cleveland, Ohio Ottawa, Ontario, Canada
Matthew J. Kruse, MD Yuri W. Novitsky, MD
Department of Surgery Co-Director, Case Comprehensive Hernia Center
Cedars-Sinai Medical Center Director, Surgical Research
Los Angeles, California Department of Surgery
University Hospitals Case Medical Center
Associate Professor of Surgery
Case Western Reserve University School of Medicine
Cleveland, Ohio
xiv Contributors
Raymond Onders, MD Juan Sanabria, MD, MSc, FRCSC, FACS
Professor of Surgery Director, Pancreas Transplant Program
Director of Minimally Invasive Surgery University Hospitals Case Medical Center
Margaret and Walter Remen Chair of Surgical Assistant Professor of Surgery and Nutrition
Innovation Case Western Reserve University School of Medicine
University Hospitals Case Medical Center Cleveland, Ohio
Cleveland, Ohio
Edmund Q. Sanchez, MD
Melissa S. Phillips, MD Surgical Director, Liver and Pancreas Transplant
Assistant Professor Programs
Department of Surgery Division of Transplant and Hepatobiliary Surgery
University of Tennessee Graduate School of Medicine Department of Surgery
Knoxville, Tennessee University Hospitals Case Medical Center
Cleveland, Ohio
Gilles Pinault, MD, FACS
Department of Vascular Surgery Victor M. Sandoval, MD
Case Western Reserve University School of Medicine Resident Physician
Louis Stokes Cleveland VA Medical Center Department of Surgery
Cleveland, Ohio University Hospitals Case Medical Center
Cleveland, Ohio
Todd Ponsky, MD
Associate Professor of Surgery and Pediatrics James Schulak, MD
Division of Pediatric Surgery Director, Transplant Institute
Akron Children’s Hospital Chief, Division of Transplant and Hepatobiliary Surgery
Akron, Ohio Department of Surgery
University Hospitals Case Medical Center
Benjamin K. Poulose, MD, MPH Cleveland, Ohio
Assistant Professor, Department of Surgery
Vanderbilt University Medical Center Charles E. Smith, MD, FRCPC
Nashville, Tennessee Professor, Case Western Reserve University School of
Medicine
Kimberly Resnick, MD Director, Cardiothoracic and Trauma Anesthesia
Assistant Professor, Division of Gynecologic Oncology MetroHealth Medical Center
Department of Obstetrics and Gynecology Cleveland, Ohio
University Hospitals Case Medical Center
Cleveland, Ohio Christopher J. Smith, MD
Assistant Professor of Surgery
Harry L. Reynolds, Jr., MD, FACS, FASCRS Division of Vascular Surgery
Director, Section of Colon and Rectal Cancer Surgery Case Western Reserve University School of Medicine
Division of Colon and Rectal Surgery MetroHealth Medical Center
University Hospitals Case Medical Center Cleveland, Ohio
Associate Professor of Surgery
Case Western Reserve University School of Medicine Lee L Swanstrom, MD, FACS
Cleveland, Ohio Division Chief, GI and Minimally Invasive Surgery
The Oregon Clinic
Rod Rezaee, MD, FACS Clinical Professor of Surgery
Assistant Professor Oregon Health and Sciences University
Director, Microvascular Head and Neck Reconstructive Portland, Oregon
Surgery
Department of Otolaryngology—Head and Neck Surgery William Tabayoyong, MD, PhD
University Hospitals Case Medical Center Urology Institute
Cleveland, Ohio University Hospitals Case Medical Center
Cleveland, Ohio
Alan A. Saber, MD, MS, FACS, FASMBS
Chief of Minimally Invasive Surgery Anthony Visioni, MD
Medical Director of Bariatric and Metabolic Surgery General Surgery Resident
The Brooklyn Hospital Center University Hospitals Case Medical Center
The Weill Medical College of Cornell University Cleveland, Ohio
The New York Presbyterian Healthcare System
New York, New York