This text is designed to present a comprehensive, up to date and safe approach to managing emergency general surgery patients with a minimally invasive approach. This book bridges the gap between the minimally invasive surgery (MIS) expert who may not routinely be involved in the care of the acute care surgery patient and the ACS expert surgeon who may not have a routine MIS elective practice. The first section reviews the physiology of the acute care surgery patient and the physiologic impact of MIS techniques including pnemoperitoneum in critically ill patients. This review is crucial to assure that the surgeon has a clear understanding of when a MIS approach is safe and when it can be potentially dangerous to the patient. The illustrations are presented in an atlas-style format to describe the surgical procedures. The authors of the various sections are minimally invasive and acute care surgeons from prominent academic centers. The format represents a narrative review with appropriate illustrations and links to online videos.

This book provides a concise summation of current operative decision making and techniques for situations faced by the on-call general surgeon. This manual covers pertinent topics such as minimally invasive surgery in the trauma setting, surgical emergencies in the bariatric patient, and treatment of emergencies in pregnancy, cirrhotics, and anti-coagulated patients. The experts at SAGES pooled their knowledge and created this manual to describe the most up-to-date treatment options for the emergent surgical patient. The SAGES Manual of Acute Care Surgery aligns with the new SAGES UNIVERSITY MASTERS Program and supplements the Master’s Program Acute Care Pathway. Its goal is to help educate surgeons to bring the optimum care to the patients that they are called to see in their emergency rooms, and to help surgeons progress from the competent to the proficient and finally to the mastery level.

This book offers an overview of acute care surgery around the world, focusing on the four main branches of this novel subdiscipline: trauma, general emergencies, critical care, and rescue surgery. The book’s primary goal is to provide a general view of acute care surgery, while addressing the most important issues in depth. The content is divided into three parts, the first of which is dedicated to the general organization of trauma centers, including the composition of modern trauma teams. Protocols of activation and action for the trauma team, as well as damage control procedures both in the emergency room and in the surgical theatre, are described. The book also addresses the development of a trauma registry, together with the quality assessment process that can be applied. In turn, the second part describes the principal protocols for making diagnoses, with special attention to circumstances such as unstable hemodynamics, neurological deterioration, normal vital signs, and penetrating injuries. The book subsequently deals with the most important aspects of trauma to the abdomen, chest, and pelvis, with notes on both surgical and intensive care issues. Practical descriptions of how to treat principal injuries to various organs are also provided. Finally, the third part of the book is dedicated to the most frequent general surgical emergencies and rescue surgical approaches, and includes information on diagnostic support with point of care ultrasound and endoscopic advanced techniques. Presenting cutting-edge strategies, this book will be of interest to professionals involved in surgical and intensive care for emergency conditions, such as colonic perforations, obstructions, acute pancreatitis, biliary tree stones, and caustic injuries.

Although most clinicians are aware of the problem of antimicrobial resistance, most also underestimate its significance in their own hospital. The incorrect and inappropriate use of antibiotics and other antimicrobials, as well as poor prevention and poor control of infections, are contributing to the development of such resistance. Appropriate use of antibiotics and compliance with infection prevention and control measures should be integral aspects of good clinical practice and standards of care. However, these activities are often inadequate among clinicians, and there is a considerable gap between the best evidence and actual clinical practice. In hospitals, cultural determinants influence clinical practice, and improving behaviour in terms of infection prevention and antibiotics-prescribing practice remains a challenge. Despite evidence supporting the effectiveness of best practices, many clinicians fail to implement them, and evidence-based processes and practices that are known to optimize both the prevention and the treatment of infections tend to be underused. Addressing precisely this problem, this volume offers an essential toolkit for all surgeons and intensivists interested in improving their clinical practices.

Unique book provides comprehensive discussion of MIS versus traditional techniques in modern Acute Care Surgery The combination of a surgeon shortage and poor access to emergency surgical care led to establishment of the Acute Care Surgery paradigm and subspecialty in 2003. Concurrently, minimally invasive approaches revolutionized surgical practice in the 21st century. In the U.S., acute care surgeons stand at the front line of patient care for emergency general surgery, trauma, and surgical critical care, and thus are positioned to positively impact healthcare delivery and costs. Surgical Decision Making in Acute Care Surgery by renowned surgeons Kimberly Davis and Raul Coimbra is the first text that comprehensively discusses when to use minimally invasive techniques and advanced technology versus traditional open procedures in acute traumatic and non-traumatic surgical emergencies. The text begins with three opening chapters covering the background of the Acute Care Surgery subspecialty, anatomic and physiological considerations, and the impact of acute surgical illness on pre- and post-operative critical care decisions. Subsequent chapters outline surgical approaches for commonly encountered acute conditions. Trauma chapters cover interventions for cervical, blunt and penetrating abdominal, and thoracic injuries. Emergency general surgery topics run the gamut from appendicitis to emergency management of paraesophageal hernias and esophageal perforations. An impressive group of senior surgeons and younger rising stars in American surgery share their expertise throughout the book. Key Highlights Disease-specific chapters include epidemiology, pathogenesis, diagnostic tools, treatment strategies, surgical techniques, cost analyses, complications, and national guidelines where available Subchapters feature expert commentary on preceding chapters, including clinical pearls and controversies (e.g. operative vs. nonoperative management) In-depth discussion of surgical decision making encompasses the type of surgical approach, as well as indications and contraindications for MIS The roles of MIS procedures such as laparoscopy, thoracoscopy, radiology-based percutaneous techniques, as well as endovascular surgery are examined The quintessential resource on contemporary Acute Care Surgery practice, this is a must-read for residents, junior faculty, and practicing surgeons in this discipline.

This book provides up-to-date evidence on laparoscopic emergency surgery and supplies concrete advice on when and how to approach patients laparoscopically in an emergency setting. All the diseases elegible for emergency laparoscopy are addressed, and for each disease recommendations, levels of evidence, and technical key points are discussed and analyzed. Diagnostic flow charts are included for cases in which laparoscopy turns out to be the final diagnostic step and the first therapeutic one. Furthermore, problematic and positive aspects of the laparoscopic approach from the anesthesiologic point of view are fully explored. Finally, a useful overview of current practice in hospitals across the world is provided, highlighting the varying applications in relation to different medical “cultures”, skills, resources, and healthcare systems.

The minimally invasive approach in emergency and general trauma surgery is a key aspect of both scenarios. This book, the first comprehensive manual in the field, takes a global view of the subject and deals with it in depth, ranging from the historical perspective to the pathophysiological and therapeutic aspects in the various body compartments. Thanks to its user-friendly approach, this book will be a useful tool in the daily clinical practice of surgeons, doctors, anesthetists and nurses; thanks to its up-to-date review of the literature, it will remain relevant for several years. Finally, the participation of world opinion leaders in the field guarantees the comprehensive and scientific soundness of the work.