This book is intended for surgeons and other physicians who use ultrasound to guide their interventions. Although diagnosis may be part of the exam, it is ultrasound that helps to more precisely and effectively deliver a biopsy instrument or therapy that is the focus of this work.
During my practice in academic surgery over the past decade or so, I have often appreciated the learning opportunity afforded by my interactions with physicians in other specialties. I have discovered new “toys” or techniques that I can apply to “my” organs, whether it is a suturing device that I saw my urology colleague using when working together on a joint case, or a particular coding strategy for appropriate reimbursement.
This book spans a number of interventional specialties that use ultrasound, with specific emphasis on image-guided procedures. Following a foundation on the basics of ultrasound physics, imaging techniques, and instrumentation, the subsequent chapters are written by experienced practitioners of ultrasound in their fields, including breast surgery, neck surgery, endoluminal ultrasound, urology, critical care, pain management, and liver and pancreas surgery. Undoubtedly a surgical oncologist would turn his or her eyes to the pancreas and breast chapters first, perhaps, but then may wander to the endoscopic ultrasound chapters if not to expand his or her practice, but at least to understand their patients' workup. Clearly a urologist would not likely endeavor to image the thyroid, yet a perusal of this chapter may present insights into improving technique, offer alternative approaches, or expand descriptions of the genitourinary system.
In particular, the emerging advanced technologies chapter presents much prospect for mining other fields for improvements on your own. Just as radiofrequency ablation for the local treatment of solid tumors was first applied in the liver—and subsequently employed in the kidney, lung, bone, and breast—perhaps ultrasound-assisted drug delivery will also enjoy such a widespread application to the benefit of many.
This book also offers instruction into the banal but necessary realties of medical practice, including credentialing and coding. In these sometimes complicated matters a practitioner in one specialty could very well learn from the experiences of those in other specialties. Indeed even regulatory bodies look to precedents in developing new standards and practices.
The seemingly broad span of specialties in this work is also an attestation to the blurring of the lines of practice in today's medicine, where traditionally “hands-on” specialists such as surgeons now share procedures and surgical treatments with their medical colleagues. Thus the direction in the title to the “interventionalist,” not just the surgeon.