In today’s world of e-books and internet access, the need to physically open a book is diminishing. The ubiquitous availability of a haphazard glut of educational material renders its organization and presentation into a useful and useable format of primary importance. It is therefore refreshing to hold in one’s hand a book that is focused on an essential slice of information without attempting to compress the entire subject into the proverbial nutshell. ‘Fundamentals of Operative Surgery’ by Vipul Yagnik is one such book. It covers the field it claims to in a comprehensive yet unburdened manner and it tells its target readers what they need to know.
The book is aimed at the undergraduate medical student in the Indian subcontinent preparing for the MBBS Practical Examination in Surgery. It does not organize text content into system-wise sections as a theoretical textbook would. Instead, it has chapters on Preoperative preparation, Operative procedures, Radiology, Endoscopy, Ward Procedures, Sterilization, Suture materials, (Surgical) Instruments, (Pathology) Specimens and a section on FAQs that simulates the table viva component of the MBBS Surgery examination. This synoptic review of the pragmatic aspects of surgery will help students understand and remember better what they would have gleaned from weightier textbooks and formal lectures.
The book is very readable, focused as it is on presenting information in palatable, easily assimilable bites. The colour photographs of the operative procedures as well as the stepwise descriptions will enhance students’ understanding and retention of what they see in the OR. There is no shortage of study material today and a student’s assimilation thereof is a function of what educationists call “Time on Task”. The main virtue of this book is that it has compiled and organised the information an MBBS student needs to perform well in the practical and viva components of the surgery examinations, and presented it in a friendly format and handy size. This is an inviting book and riffling through the pages makes one want to read further. Once drawn in, the topics are so concisely laid out that before you know it you are already reading. This is why the book will be of value to the resident or practising surgeon as well. It is easy to dismiss this handbook as mere exam-cram material but that would be the reader’s loss.
However, the book suffers from poor editing and proofing. For example, on a randomly opened page, ‘cryptorchidism’, (a contentious term anyway) is spelled in two different ways, both incorrect. Eponyms such as Halsted, Wilms, Spencer Wells, Roeder, Prehn, Hirschsprung, Backhaus, Troisier, Thiersch, Sloan-Kettering, Dietl, Palomo and Charcot, and non-English terms such as Sitz bath are spelled incorrectly. Native anglophones will find the grammar and syntax awkward at places, but this does not detract from readability, comprehensibility and accuracy. The date-stamps superimposed on the photographs are amateurish. The author’s facile use of brand names in lieu of generic terminology especially for suture materials lacks academic rigour. And there are already too many nondescript eponyms in Medicine for the descriptive ‘string sign’ of ileocaecal tuberculosis to erroneously degenerate into, on page 146, the “Sterling sign”.
Interestingly the FAQ includes ‘shared-secret’ questions that are still favoured by Indian surgeons. The question on the “good morning appendix” or “how do you do appendix” is really an OR joke; if you do not know the answer, read the book! You will also learn that the bluish discoloration of the parietal layer of the tunica vaginalis is due to the Raman effect, another patriotic chestnut.
Apart from a perfunctory addendum of laparoscopic methods of appendicectomy and hernia repair, the book steers clear of minimal access surgery which is unusual for a book debuting in 2007. The author in his preface speaks of the diminishing role of open surgery. For his target readership however, a chapter on the basic principles of laparoscopic surgery or at least a section on laparoscopic cholecystectomy would have made the book complete. Even open cholecystectomy is not described whereas right hemicolectomy is. Hopefully the next edition will be expanded to include this. A section on hemorrhoidectomy, anal fissure and fistula surgery, and the basics of thyroid and breast cancer surgery would complete my wish-list.
The author of this exam-oriented book is Assistant Professor of Surgery at a medical college in India and his enthusiasm for the subject as well as for teaching shines through. Nowhere could I find factual errors or discrepancies of importance. The drawbacks I have pointed out earlier in this review are trivial or inconsequential, par for the course. More reputed textbooks have done much worse. I have nitpicked unabashedly so that I can conclude by wholeheartedly and enthusiastically recommending this book.
The information content and approach of this book are admirable, and I suggest that any one, student or surgeon, who reaches out to browse through this book should unhesitatingly take it home to read. At less than 300 Indian Rupees (approx 6 USD) for a book of 200 pages this represents excellent value when one considers its readability and focused content. It is my privilege as a reviewer to retain this copy on my bookshelf. In all honesty, if I came across this book at a bookstore I would unhesitatingly buy myself a copy.
If your interest in surgery has led you to read this far, perhaps you should get a copy too.
Professor Sushil Dawka MS
Department of Surgery
SSR Medical College, Mauritius