Bonney’s Gynaecological Surgery 11th edition
Surgical training in gynaecology has seen dramatic changes in both the UK and the USA over the last 20 years.
When the current editors were in training, there were no restrictions to the number of hours that they could be asked to work. It was common to be resident on call every third night in addition to daytime work, which often resulted in a working week in excess of 110 hours.
In the UK, adoption of the European Union Working Time Directive will mean that trainees will legally be allowed to work only 48 hours per week. In the USA, the working week for residents is limited to 80 hours.
Although the reduction in working hours is important for one ’ s work – life balance, it has inevitably had a major impact on surgical training. The concept of the surgical team or fi rm to which a trainee was attached has all but disappeared. The introduction of shift systems has made it diffi cult, and in some cases impossible, for trainees to attend the surgical and clinical sessions of their team.
At the same time, there has been a marked reduction in the number of hysterectomies performed as a result of more conservative management options for dysfunctional uterine bleeding. In the 9 – year period from 1995 to 2004, there was a 46% reduction in the number of hysterectomy operations performed in NHS hospitals in England (Hospital Episode Statistics). In 2003, at the ‘ Fellows ’ ceremony at the Royal College of Gynaecologists, the then President stated that not every specialist gynaecologist would be expected to be able to perform a hysterectomy.
With the increasing use of laparoscopic surgery in elective gynaecology, including for hysterectomy, the ‘open’ approach to gynaecological surgery, the surgical ‘bread and butter’ for trainees, is also on the decline. Equally, a large number of ectopic pregnancies are now managed conservatively so that trainees are lacking exposure to emergency laparoscopic surgery for tubal pregnancies.
Preface to the eleventh edition
Preface to the ninth edition
Part 1: General
1. Introduction and prologue.
2. Preparation for surgery.
3. Instruments, operative materials and basic surgical techniques.
4. Opening and closing the abdominal cavity.
5. The laparoscopic approach in gynaecology.
6. Postoperative care and complications.
Part 2: Anatomical For the general gynaecologist and gynaecologist in training
7. Operations on the vulva.
8. Operations on the vagina.
9. Operations on the cervix.
10. Operations on the uterine cavity.
11. Operations on the uterus.
12. Uterine fibroids.
13. Operations on the fallopian tubes.
14. Operations on the ovaries.
15. Caesarean section.
Part 3: Condition Recognition of surgical special interest and subspecialties Urinary/pelvic floor
16. Operations for pelvic organ prolapse.
17. Operations for urinary incontinence.
18. Operations for the correction of urinary fistulae.
19. Surgery for carcinoma of the vulva.
20. Vaginal cancer surgery.
21. Cervical cancer.
22. Uterine cancer.
23. Ovarian cancer.
24. Exenterative surgery.
Operations on other organs
25. Vascular surgery: applications in gynaecology and gynaecological oncology.
26. Urinary tract.
27. Operations on the intestinal tract for the gynaecologist.
28. Reconstructive procedures.
Title: Bonney’s Gynaecological Surgery
Edition: 11th edition
Authors: Tito Lopes, Nick M. Spirtos, Raj Naik, John M. Monaghan