SGPGI Neurosurgery: The Operative Atlas of Neurosurgery. A Compendium of 120 Neuro-Oncological, Case-Based, Surgical Approaches
Correspondence Address: Source of Support: None, Conflict of Interest: None DOI: 10.4103/0028-3886.314557
Source of Support: None, Conflict of Interest: None
As you have noticed, there is no individual who has been listed as an author or editor. To understand why this is so, we need to go to the Editorial on page xv, where we learn that eleven staff members of the Sanjay Gandhi Postgraduate Institute in Lucknow, headed by Dr. Sanjay Behari, are the editors. Associate editors, assistant editors, and illustrators are also listed here.
The editorial also provides the raison d'être that resulted in the production of the books: “a labour of intense fascination and love for the fine art of neuro-oncological surgery…” and “…to give surgeons… a step-wise approach to… the safe excision of tumors…”
The cost of the book has been kept low. No editor or author has been paid any royalty. The book was put together in 2 months. These facts speak volumes about the dedication of editors and authors.
The size of each chapter has been reduced to a minimum, with a few selected references appended to permit concentration on illustrations and operative photographs demonstrating the approach and steps involved in each operation. In a range from 5 – 71, there is an average of 16 illustrations per chapter in volume 1 and 20 in Volume 2.
One hundred twenty-seven chapters, spread over a total of 1552 pages, comprise the two volumes. The list of contributors, with their addresses listed in the order of their first names, is provided on pages xix-xxviii (Dr. Sivashanmugam Dhandapani is included under 'D'.) The list includes those from all parts of India and from abroad, the latter numbering 17.
In the midst of professors and consultants as authors of chapters, we find a student (from New York), registrars, residents, postdoctoral fellows, and research assistants. I counted 11 residents and 7 post-doctoral fellows as first authors of chapters. At a time when heads of departments and professors are notorious for ensuring that their own names feature as first authors, this is a salutary step. It is of interest that amongst the residents, Ashutosh Kumar is the first author of four chapters. Of the fellows, Priyadarshini Dikshit is the first author of five chapters and Suyash Singh of seven chapters.
Whilst most authors are from neurosurgery departments, there is scattering from pathology, neuropathology, anesthesiology, ophthalmology, ear-nose-throat surgery, and radiology departments. A sole neurologist also features in this list. The index is provided at the end of volume 2 on pages xxix-xlvi.
In each chapter, an Overview introduces the subject. Sub-heads vary from chapter to chapter and include Anatomical principles, Classification of neoplasms, Surgical Steps, Avoidance of complications, Chemotherapy, Radiotherapy, “Tips and pearls” and Suggested readings. I must confess that I have always been wary of 'pearls' being cast before me on account of the Biblical allusion! (In fact, Mathew 7:6 in the King James' version of the Bible cautions against such offerings.)
In addition to chapters on tumors within the skull and orbits, there are those which deal with infratemporal, spinal, glomus, sympathetic chain, and peripheral nerve tumors. Chapters 9.1, 9.2, 9.3 discuss magnetic resonance studies, angiography, and sonography as aids in the treatment of tumors. The assistance granted by neuro-monitoring during surgery is referred to in some chapters, whilst Chapter 9.4 is entirely devoted to it. Chapter 9.5 discusses immunohistochemistry of tumors. The final chapter helps clinicians in the interpretation of blood-gas analysis but is not specific to neurosurgery.
Most chapters are based on micro neurosurgery or endoscopic surgery but those dealing with tumors of the skull, gamma knife surgery and embolization of tumors show naked eye views.
Singling out chapters for special comment would be invidious. I offer some general observations.
Photographs obtained through the operation microscope vary considerably in clarity. Obtaining uniformly sharp, focused views appears to have been beyond the reach of some authors. Glare often obscures crucial features. When the microscope is not angled properly, the site of interest lies in shadows. At times considerable unnecessary surface tissue is included in the image with the result that the area of interest is overshadowed. Blood-stained gauze and wrappings around the scalp and bone flaps and blood on the scalp and cortex and in the wound in the brain mar some illustrations. In quite a few photographs, we must rely more on the eye of faith than our natural visual apparatus. In contrast line drawings, color paintings and histology slides are clean and clear.
Chapter 1.34 on cerebral revascularization to enable total removal of brain tumors is complemented by Chapter 4.3, which discusses vascularized temporoparietal fascial flap insertion to facilitate chemotherapy.
Young neurosurgeons will find considerable information in the four papers on glomus tumors (Chapters 3.3, 5.6, 5.7, 5.8).
There is need for clarification in some chapters. Let me give you one example. Curious about the 'wax pile' method, I studied Chapter 1.10. I encountered this statement: “We propose an even easier method to obtain the exact orientation of the residual tumor…using bone wax.” This led me to believe that this was an original contribution especially since none of the references to this chapter discussed this technique. A search of the literature showed the paper by Tanaka et all (Neuroscience Discovery January 2013) titled “Wax pile method for glioma surgery…” These authors stated that they used this term to describe the placement of siliconc tubes filled with bone wax in the tumor bed. I wish our authors had quoted this paper and clarified the origin of this technique.
Inevitably, comparisons will be made between these volumes and that entitled Practical neurosurgery: analysis of clinical cases, published in 2017. That volume was edited by four neurosurgeons: Dr. Sanjay Behari, Dr. Chandrashekhar Deopujari, Dr. Natarajan Muthukumar and Dr. Vedantam Rajshekhar. (Dr. Natarajan is missing as a contributor in the current two volumes.) The review of this book by Dr. V. G. Ramesh in Neurology India had concluded that reading the chapters was a very pleasant experience.
Being an operative atlas, the volumes under review will also be compared with those by Dr. K. Sugita (single volume) and Dr. M. G. Yasargil (four volumes, with each of volumes 3 and 4 in two parts). These two revered masters of neurosurgery, however, dealt only with microneurosurgery. Their books were also works by single authors. (Dr. Sugita had been helped by Dr. S. Kobayashi.)
The editors have chosen their publisher well. As a result, we have these two volumes that can match any other anywhere.