Operative Manual of Neurosurgery: A Step by Step Pictorial Atlas —A Review

Operative Manual of Neurosurgery: A Step by Step Pictorial Atlas, published by Jaypee Brothers and authored byDr. Balaji Pai and his team comprising Asima Banu and Sandesh Khandelwal, is a two-volume visual delight. This twovolume operative atlas of neurosurgery is the sweet product of Dr. Balaji Pai’s “labor of intense fascination and love for thefine art of neurosurgery.”Dr. Balaji, in his preface, highlights that the focus of this venture is to teach neurosurgery through photographs and illustrations rather than through theory. This step-by-step pictorial operative atlas of neurosurgery hits the mark, and the editorial team can certainly be complimented for a goal well accomplished. The book is virtually an illustrated guided tour through all aspects of neurosurgery starting from basic technique to recent advances in neurosurgery. The book has 2 volumes comprising 21 sections with 155 chapters spread over a total of 1,684 pages, with each chapter authored by subject experts (►Fig. 1). Volume I includes preoperative planning, basic techniques, surgery for trauma and tumors, skull base surgery, and cerebrovascular surgery. Volume II concentrates on neuroendoscopy, orbital surgery, functional neurosurgery, pediatric neurosurgery, craniovertebral junction surgery, and spine surgery including spinal endoscopy and minimally invasive spine surgery. Chapters are organized in a systematic manner, starting with a brief introduction and details about positioning followed by a step-by-step operative documentary supplemented by operative photographs and radiological images. The icing on the cake is the pearls of wisdom provided at the end of each chapter. Singling out chapters for special comment would be invidious. In addition to often-discussed chapters on trauma, tumors, and vascular surgery, there are chapters that deal with newer concepts such as neuroendoscopy and minimally invasive spine surgery, which makes this book a comprehensive, go-to reference atlas for any neurosurgeon in evolution. In addition, for a practicing neurosurgeon, it is an easy ready reckoner, which he/she can brush through and revise just before scrubbing up for any surgery. The production aspect of the atlas is excellent considering the fact that this is a book based exclusively on camera photographs, endoscopic views, and highquality microscopic images. Expecting uniformly highquality images from the over hundred authors who have contributed to this book is difficult. Moreover, photographs obtained through the operation microscope vary considerably in clarity and glare often obscures crucial features. Yet, the illustrations are clear and the quality of the print, text, and images provides a smoothening read to the eyes. The annotations of the images and brief and detailed captions make for an easy reference. The text content in each chapter has been reduced to a minimum, and there is an average of 15 illustrations per chapter. Yes, one concern is the physical bulk of the two volumes, which is a bit tough for the reader to carry around. An alternative would have been to split it into multiple volumes, which again adds bulk to the edition. Inevitably, comparisons will be made, and being an operative atlas, the volumes under review will be compared with others, especially the most popular current online atlas by Aaron Cohen. Dr. Balaji’s book is unique in that the surgical approaches described reflect each author’s technique refined over years of accumulated experience. The technique may differ from a standard textbook description but provides a practical and time-tested approach to the inquisitive learning mind. The editors have deliberately omitted references for the same reason, as the manual is drawn out of each author’s personalized experience polished after years of repeated bruising and failures. This, I believe, is what makes this book an exclusive gem, whichmake it stand out from the innumerable number of operative neurosurgery books available both offline and online.