Rob Smith's Operative Surgery
Transcript of Rob Smith's Operative Surgery
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Rob & Smith's
Operative Surgery
Surgery of the Upper Gastrointestinal Tract
Fifth edition
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Rob & Smith's
Operative Surgery
General Editors
David C. Carter MD, FRCS(Ed), FRCS(Gias) Regius Professor of Clinical Surgery, Royal Infirmary, Edinburgh, UK
R. C. G. Russell MS, FRCS Consultant Surgeon, Middlesex Hospital and Royal National Throat, Nose and Ear Hospital, London, UK
Other volumes available in the series
Cardiac Surgery 4th Edition Stuart W. Jamieson and Norman E. Shumway
The Ear 4th Edition John C. Ballantyne and Andrew Morrison
General Principles, Breast and Extracranial Endocrines 4th Edition Hugh Dudley and Walter J. Pories
Genitourinary Surgery 5th Edition Hugh N. Whitfield
Gynaecology and Obstetrics 4th Edition J. M. Monaghan
The Hand 4th Edition Rolfe Birch and Donal Brooks
Head and Neck 4th Edition lanA. McGregor and David J. Howard
Neurosurgery 4th Edition Lindsay Symon, David G. T. Thomas and Kemp Clark
Nose and Throat 4th Edition John C. Ballantyne and D. F. N. Harrison
Consulting Editor
Hugh Dudley CBE, ChM, FRCS(Ed), FRACS, FRCS Emeritus Professor, StMary's Hospital, London, UK
Art Editor
Gillian lee FMAA, HonFIMI, AMI, RMIP 15 Little Plucketts Way, Buckhurst Hill, Essex, UK
Ophthalmic Surgery 4th Edition Thomas A. Rice, Ronald G. Michels and Walter W. J. Stark
Orthopaedics 4th Edition George Bentley and Robert B. Greer Ill
Paediatric Surgery 4th Edition L. Spitz and H. Homewood Nixon
Plastic Surgery 4th Edition T. L. Barclay and Desmond A. Kernahan
Surgery of the Colon, Rectum and Anus 5th Edition L. P. Fielding and S.M. Goldberg
Thoracic Surgery 4th Edition The late J. W. Jackson and D. K. C. Cooper
Trauma Surgery 4th Edition Howard R. Champion, John V. Robbs and Donald D. Trunkey
Vascular Surgery 5th Edition C. W. Jamieson and J. S. T. Yao
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Rob & Smith's
Operative Surgery
Surgery of the Upper Gastrointestinal Tract Fifth edition
Edited by
Glyn G. Jamieson FRACS, FACS Dorothy Mortlock Professor of Surgery, University of Adelaide, Department of Surgery, Royal Adelaide Hospital, Adelaide, Australia
Haile T. Debas MD M. Galante Distinguished Professor of Surgery and Dean of the School of Medicine, University of California, San Francisco, California, USA
~~I'll SPRINGER-SCIENCE+BUSINESS MEDIA, B.V.
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© 1994 Springer Science+ Business Media Dordrecht
Originally published by Chapman & Hall in 1994 Softcover reprint of the hardcover 5th edition 1994
Typeset in 10/11 Garamond lTC by Genesis Typesetting, Laser Quay, Rochester, Kent
ISBN 978-0-412-53550-5 ISBN 978-1-4899-6621-6 (eBook) DOI 10.1007/978-1-4899-6621-6
Apart from any fair dealing for the purposes of research or private study, or criticism or review, as permitted under the UK Copyright Designs and Patents Act, 1988, this publication may not be reproduced, stored, or transmitted, in any form or by any means, without the prior permission in writing of the publishers, or in the case of reprographic reproduction only in accordance with the terms of the licences issued by the Copyright Licensing Agency in the UK, or in accordance with the terms of licences issued by the appropriate Reproduction Rights Organization outside the UK. Enquiries concerning reproduction outside the terms stated here should be sent to the publishers at the London address printed on this page.
The publisher makes no representation, express or implied, with regard to the accuracy of the information contained in this book and cannot accept any legal responsibility or liability for any errors or omissions that may be made.
A catalogue record for this book is available from the British Library
Library of Congress Catalog Card Number: 94-070237
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Contributors
I. Braghetto MD Associate Professor, University of Chile, Department of Surgery, University Hospital, Santos Dumont 999, Santiago, Chile
F.). Branicki DM, FRCS, FRACS Department of Surgery, Royal Brisbane Hospital, University of Queensland, Queensland 4072, Australia
R. Britten-Jones Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia 5000, Australia
G. F. Ruess MD, FRCS(Ed) Professor of Surgery, Minimal Invasive Chirurgie, Eberhard-Karls University, Schnarrenberg Clinic, D7400 Tiibingen, Germany
R. Buhl MD Department of Surgery, University of Heidelberg, lm Neuenheimer Feld 110, D-69120 Heidelberg, Germany
R. Bumm MD Senior Resident in Surgery, Department of Surgery, Technical University of Munich, W-8000 Munich 80, Germany
S. H. Carvajal MD Research Fellow, Department of Surgery, University of California, 513 Parnassus Avenue, S-320 San Francisco, California 94143-0104, USA
J. L. Chassin MD Chairman, Department of Surgery, The New York Hospital Medical Center of Queens, 56-45 Main Street, Flushing, New York 11355-5095, USA
W. G. Cheadle MD Assistant Professor of Surgery, Department of Surgery, University of Louisvillle School of Medicine, Louisville, Kentucky 40292, USA
S.C. S. Chung MD, FRCS(Ed), MRCP Reader in Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
A.). Csendes MD, FACS Professor of Surgery, University of Chile, Department of Surgery, University Hospital, Santos Dumont 999, Santiago, Chile
H. T. Debas MD M. Galante Distinguished Professor of Surgery and Dean of the School of Medicine, University of California, 513 Parnassus Avenue, S-320 San Francisco, California 94143-0104, USA
T. R. DeMeester MD Professor and Chairman, Department of Surgery, University of Southern California School of Medicine, Los Angeles, California 90033-4612, USA
C. Deschamps MD Senior Associate Consultant, Section of General Thoracic Surgery, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA
E. Deslandres MD Assistant Professor, Department of Medicine, University of Montreal, Division of Gastroenterology, H6tei-Dieu de Montreal, 3840 RueSt Urban, Montreal, Quebec, Canada H2W 1T8
P. G. Devitt FRACS, FRCS Senior Lecturer, Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia 5000, Australia
C. Doherty MD, FACS Assistant Professor, Department of Surgery, University of Iowa College of Medicine, Iowa City, Iowa 52242, USA
F. Dubois Professor, CMC Pte de Choisy, 6 Place de Port-au-Prince, 75013 Paris, France
A. Duranceau MD Professor of Surgery, Department of Surgery, University of Montreal, Division ofThoracic Surgery, H6tei-Dieu de Montreal, 3840 RueSt Urban, Montreal, Quebec, Canada H2W 1T8
F. H. Ellis )r MD, PhD Clinical Professor of Surgery, Harvard Medical School, and Chief Emeritus, Division of Cardiothoracic Surgery, New England Deaconess Hospital, 110 Francis Street, Boston, Massachusetts 02215, USA
F. Fekete MD Professor of Surgery and Chief, Department of Digestive Surgery, University Paris VII, H6pital Beau jon, 100 Blvd du General Leclerc, Clichy, Paris 92118, France
D. Fromm MD Penharthy Professor and Chairman, Department of Surgery, Wayne State University and Surgeon-in-Chief, Detroit Medical Center, Detroit, Michigan, USA
D. Gavriliu MD Professor at UNEX-AZ SRL, Universitatea Romana de Stiinte si Arte, Bucharest, Romania
J. A. Hagen MD Esophageal Fellow, Department of Surgery, University of Southern California School of Medicine, Los Angeles, California 90033-4612, USA
C. Herfath MD Professor and Head, Department of Surgery, University of Heidelberg, lm Neuenheimer Feld 110, D-69120 Heidelberg, Germany
C. A. Hiebert MD, FACS Chairman Emeritus, Department of Surgery, Maine Medical Center, Portland, Maine, USA
A. H. Holscher MD Assistant Professor of Surgery, Department of Surgery, Technical University of Munich, W-8000 Munich 80, Germany
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G. J. Huang MD, FRCS Professor of Thoracic Surgery, Cancer Institute and Hospital, Chinese Academy of Medical Sciences, PO Box 2258, Beijing 100021, People's Republic of China
0. Huber MD Department of Surgery, University of California, San Francisco, California 94143-0788, USA
G. G. Jamieson FRACS, FACS Dorothy Mortlock Professor of Surgery, University of Adelaide, Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia 5000, Australia
S. Johnson MD Esophageal Fellow, Department of Surgery, University of Southern California School of Medicine, Los Angeles, California 90033-4612, USA
G. W. Johnston MCh, FRCS Honorary Professor, Queen's University Belfast, and Consultant Surgeon, Royal Victoria Hospital, Belfast BT12 6BA, UK
J.-P. Kim MD, FACS Professor of Surgery, College of Medicine, Seoul National University Hospital, 28 Yungon-Dong Chongno-Gu, Seoul11 0-744, Korea
0. Korn MD Instructor of Surgery, University of Chile, Department of Surgery, University Hospital, Santos Dumont 999, Santiago, Chile
J. E. J. Krige FRCS, FCS(SA) Associate Professor, Department of Surgery, University of Cape Town, Observatory 7925, South Africa
Z. H. Krukowski PhD, FRCS(Ed) Consultant Surgeon, Aberdeen Royal Infirmary, Foresterhill, Aberdeen, AB9 2ZB, UK
B. launois MD, FACS Professor, Digestive and Transplantation Surgery, Hopital Pontchaillou, Rue Henri Le Guilloux, 3500 Rennes, France
T. lerut MD, PhD, FACS Department of General Thoracic Surgery, Catholic University Leuven, U.Z. Gasthuisberg, 3000 Leuven, Belgium
A. K. C. Li MA, MD, FRCS, FRCS(Ed), FRACS, FACS Professor and Chairman, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
l. Lundell MD, PhD Associate Professor of Surgery, Department of Surgery, Sahlgren's Hospital, University of Gothenburg, S-41345 Gothenburg, Sweden
G. J. Maddern PhD, MS, FRACS Jepson Professor of Surgery, Department of Surgery, University of Adelaide and Queen Elizabeth Hospital, Woodville, South Australia 5011, Australia
J. W. Maher MD Section of Gastrointestinal Surgery, Department of Surgery, University of Iowa Hospitals and Clinics and College of Medicine, Iowa City, Iowa 52242, USA
M.A. Malias MD Resident Surgeon, Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky 40292, USA
A. Mannell FRACS, FRCS, MS Specialist Surgeon, The Rosebank Clinic, and Consultant Surgeon, Baragwanath Hospital, University of the Witwatersrand, johannesburg, South Africa
M. T. Marrinan FRCS(Ed) Fellow in Thoracic Surgery, Mayo Graduate School of Medicine, Rochester, Minnesota, USA
C. J. Martin FRACS Professor of Surgery, University of Sydney and Head of Surgical Division, Nepean Hospital, PO Box 63, Penrith, NSW 2751, Australia
E. E. Mason MD, PhD, FACS Professor Emeritus of Surgery, Department of Surgery, University of Iowa College of Medicine, Iowa City, Iowa 52242, USA
N. A. Matheson ChM, FRCS, FRCS(Ed) Consultant Surgeon, Aberdeen Royal Infirmary, Foresterhill, Aberdeen AB92ZB, UK
H. Matthews FRCS Consultant Thoracic Surgeon, Regional Department of Thoracic Surgery, East Birmingham Hospital, Birmingham and Professor of Surgery, Department of Biological Sciences, University of Warwick, UK
J. E. Meilahn MD Assistant Professor of Surgery, Department of Surgery, Temple University School of Medicine, Philadelphia, Pennsylvania 19140, USA
R. 0. Mitchell MD Resident Surgeon, Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky 40292, USA
M. W. Mulholland MD Associate Professor of Surgery, University of Michigan, 2920 Taubman Health Center, 1500 E, Medical Center Drive, Ann Arbor, Michigan 481 09-0331, USA
S. J. Mulvihill MD Associate Professor of Surgery, Department of Surgery, University of California, 533 Parnassus Avenue, U-122 San Francisco, California 94143-0788, USA
l. K. Nathanson FRACS Senior Lecturer, Department of Surgery, Clinical Sciences Building, University of Queensland, Royal Brisbane Hospital, Herston 4029, Queensland, Australia
P. E. O'Brien MD, FRACS Professor of Surgery, Monash University, Alfred Hospital, Prahtan, Melbourne, Victoria 3181, Australia
l. C. Olbe MD, PhD Associate Professor of Surgery, Department of Surgery, University of Gothenburg, Sahlgren's Hospital, 41345 Gothenburg, Swwden
M. J. Orloff MD Professor of Surgery, School of Medicine, University of California, San Diego, California 921 03, USA
M. S. Orloff MD Assistant Professor of Surgery, University of Rochester School of Medicine and Dentistry, Strong Memorial Hospital, 601 Elmwood Avenue, Rochester, New York 14642, USA
M. Orringer MD Professor and Head, Section of Thoracic Surgery, University of Michigan, 2120 Taubman Health Center, Ann Arbor, Michigan, 48109-0010, USA
Y. Panis MD Department of Digestive Surgery, University Paris VII, Hopital Beau jon, 100 Blvd du General Leclerc, Clichy, Paris 92118, France
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W. S. Payne MD Emeritus Consultant, Section of General Thoracic Surgery, Mayo Clinic, Rochester, Minnesota S5905, USA
C. A. Pellegrini MD, FACS Ben A. Reid Sr Professor and Chairman, Department of Surgery, University of Washington, Seattle, Washington 98195, USA
H. C. Polk MD Senior Professor and Chairman, Department of Surgery, University of louisville School of Medicine, louisville, Kentucky 40292, USA
S. C. Rakic MD, PhD, FACS Department of Surgery, leyenburg Hospital, Postbus 40551, The Hague 2504 lN, The Netherlands
W. P. Ritchie Jr MD, PhD Professor and Chairman, Department of Surgery, Temple University School of Medicine, Philadelphia, Pennsylvania 19140, USA
A. Sali PhD, FRACS, FACS Clinical Associate Professor of Surgery, University of Melbourne, Parkville, Victoria, Australia 3081
J. R. Siewert MD, FACS Professor of Surgery, Chairman of the Department of Surgery, Technical University of Munich, W-8000 Munich 80, Germany
A. E. Siperstein MD Department of Surgery, Mount Zion Medical Center of UCSF, San Francisco, California 94143-1610, USA
J. Terblanche ChM, FRCS, FCS(SA) Professor and Head, Department of Surgery, and Co-Director, MRC liver Research Centre, University of Cape Town, Observatory 7925, South Africa
V. F. Trastek MD, FACS Consultant, Section of General Thoracic Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA
A. Watson MD, FRCS, FRCS(Ed), FRACS Consultant Surgeon, The Wellington Hospital, London NW8 9LE, UK
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Contributing Medical Artists
Antoine Barnaud 11 Rue jacques Dulud, 92200 Neuilly sur Seine, France
Andrew Bezear 6 Queen Street, Godalming, Surrey GU7 1 BD, UK
Diane Bruyninckx MMAA, AIMI 20 Van Halmaelelei, B-2930 Brasschaat, Belgium
Angela Christie MMAA 14 West End Avenue, Pinner, Middlesex HAS 1 BJ, UK
Peter Cox RDD, MMAA, AIMI Canon Frome Court, Canon Frome, Ledbury, Herefordshire HR8 2TD, UK
Susan Darrington P.O. Box 581, Subiaco, Western Australia 6008
Raymond Evans BA(Hons), MMAA Unit of Art in Medicine, Department of Cell and Structural Biology, University of Manchester, Manchester M13 9PT, UK
Diane Kinton BA(Hons) Gillian Lee Illustrations, 15 Little Plucketts Way, Buckhurst Hill, Essex IG9 SQU, UK
Gillian lee FMAA, HonFIMI, AMI, RMIP Gillian Lee Illustrations, 15 Little Plucketts Way, Buckhurst Hill, Essex IG9 SQU, UK
Marks Creative Consultants 31 Waddon Road, Croydon, Surrey CRO 4LH, UK
Gillian Oliver MMAA, AIMI 15 Bramble Road, Hatfield, Hertfordshire AL 10 9RZ, UK
Paul Richardson BA(Hons) 54 Wellington Road, Orpington, Kent BRS 4AQ, UK
Denise Smith BA(Hons), MMAA Unit of Art in Medicine, Department of Cell and Structural Biology, University of Manchester, Manchester M13 9PT, UK
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Contents
Instrumentation techniques
Preoperative and postoperative management
General operative techniques
Preface
Flexible endoscopy of the upper digestive tract A. Duranceau and E. Deslandres
Injection sclerotherapy of oesophageal varices J. E. J. Krige and J. Terblanche
Rigid oesophagoscopy M. T. Marrinan and C. Deschamps
Dilatation of oesophageal strictures A. 5ali
Preoperative and postoperative management of patients undergoing major upper gastrointestinal surgery G. G. Jamieson and H. T. Debas
Technique of cervical approach to the oesophagus T. Lerut
Abdominal-right thoracic approach to oesophagectomy 5. C. 5. Chung and A. K. C. Li
Left posterolateral thoracotomy H. Matthews
Left thoracoabdominal approach for exposure of the oesophagus A. Mannell
Abdominal incisions for approaching the abdominal oesophagus and stomach P. G. Devitt
Sutured oesophageal anastomosis A. Watson
Stapling techniques for anastomoses of the oesophagus G. G. Jamieson
Hand-sewn techniques for gastric anastomoses Z. H. Krukowski and N. A. Matheson
XV
1
10
21
26
39
45
52
56
61
70
79
84
88
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Operations on the cervical oesophagus
Operations on the thoracic oesophagus: malignant conditions
Operations on the thoracic oesophagus: miscellaneous conditions
Stapling techniques for gastric anastomoses 108 j. L. Chassin
Small intestine as a replacement after oesophageal resection 120 P. G. Devitt
Use of colon as an oesophageal replacement 128 j. A. Hagen, S. johnson and T. R. DeMeester
Use of the stomach as an oesophageal substitute 142 A. H. Holscher and j. R. Siewert
Pouches as gastric substitutes 154 C. Herfath and K. Buhl
Extra-anatomical reconstruction of the resected oesophagus 165 A. Duranceau
Surgical anatomy of the cervical oesophagus G. G. jamieson
Cricopharyngeal myotomy and excision of a pharyngooesophageal diverticulum G. G. jamieson and A. Duranceau
Abdominal and right thoracic subtotal oesophagectomy B. Launois and G. j. Maddern
170
173
178
Left thoracic subtotal oesophagectomy 189 H. Matthews
Transhiatal oesophagectomy 196 M. B. Orringer
Eversion extraction oesophagectomy 211 G. G. jamieson
En bloc oesophagectomy for cancer of the distal oesophagus, cardia and proximal stomach 214 j. A. Hagen and T. R. DeMeester
Long oesophageal myotomy and excision of diverticula A. Duranceau
230
Extramucosal enucleation of leiomyoma of the oesophagus 237 G. j. Huang
Perforation of the oesophagus 244 C. A. Pellegrini and 0. Huber
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Operations on the abdominal oesophagus
Operations for uncomplicated gastro-oesophageal reflux
Operations for complicated gastro-oesophageal reflux
Anatomy of the hiatus and abdominal oesophagus H. C. Polk jr, M.A. Malias and G. G. jamieson
256
Myotomy for achalasia: thoracic approach 262 F. H. Ellis jr
Myotomy for achalasia: abdominal approach 267 S.C. Rakfc
Paraoesophageal hiatus hernia 276 P. E. O'Brien
Oesophagogastrectomy for adenocarcinoma of the oesophagus and cardia 280 A. H. Holscher, R. Bumm and j. R. Siewert
Indications and preoperative assessment of patients for antireflux surgery G. G. jamieson
Abdominal fundoplication C. j. Martin
Anti reflux surgery by the thoracic approach C. A. Hiebert
Operations for uncomplicated gastro-oesophageal reflux: miscellaneous procedures P. G. Devitt and G. G. jamieson
Reoperative anti reflux surgery G. G. jamieson
292
294
301
307
316
Intrathoracic fundoplication 320 j. W. Maher
Combined Collis-Nissen operation 327 V. F. Trastek and W. S. Payne
Roux-en-Y diversion and fundoplication for gastro-oesophageal reflux 335 F. Fekete andY. Panis
Resection of oesophageal strictures R. 0. Mitchell, W. G. Cheadle and H. C. Polkjr
Operations for complicated gastro-oesophageal reflux: miscellaneous procedures G. G. jamieson
345
350
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Vagotomy operations
Gastric drainage operations
Gastric resections
Operations for bleeding from the stomach and duodenum
Surgical anatomy of the vagus nerves H. T. Debas
354
Total abdominal vagotomy and drainage 360 H. T. Debas
Total (selective) gastric vagotomy 369 H. T. Debas
Proximal gastric vagotomy 373 H. T. Debas
Complications of ulcer surgery: prevention and reoperative management 382 H. T. Debas and 5. Carvajal
Pyloroplasty 5. J. Mulvihill
Gastroenterostomy H. T. Debas
Partial gastrectomy (and antrectomy) with a gastroduodenal anastomosis: Billroth I gastrectomy G. G. Jamieson and H. T. Debas
Partial gastrectomy with gastrojejunal anastomosis including
394
403
414
Roux-en-Y reconstruction 420 M. W. Mulholland
Abdominal total gastrectomy without radical lymph node dissection 436 L. Lundell and L. C. Olbe
Total gastrectomy with lymph node resection 450 J.-P. Kim
High lesser curve gastrectomy with oesophagojejunogastric reconstruction 465 A. Csendes, I. Braghetto and 0. Korn
Miscellaneous gastric resections 472 D. Fromm
Bleeding gastric or duodenal ulcer J. E. Meilahn and W. P. Ritchie Jr
Bleeding oesophageal and gastric varices: shunts M. J. Orloff and M. 5. Orloff
476
493
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Miscellaneous conditions
Laparoscopic surgery
Bleeding oesophageal and gastric varices: stapling procedures 516 G. W. Johnston
Bleeding: three miscellaneous conditions 525 G. G. Jamieson
High gastrostomy with peritoneal cuff D. Gavriliu
Perforated peptic ulcer F.]. Branicki
Surgical management of duodenal diverticula H. T. Debas and S. H. Carvajal
Gastric operations in obesity surgery E. E. Mason and C. Doherty
General techniques in abdominallaparoscopic surgery A. E. Siperstein
527
530
537
548
561
Laparoscopic Nissen fundoplication 571 G. G. jamieson and R. Britten-Jones
Laparoscopic gastroenterostomy 575 L. K. Nathanson
Laparoscopic vagotomies 584 F. Dubois
Achalasia of the oesophagus: management by videoendoscopic ~~ry 5~ C. A. Pellegrini
Endoscopic oesophagectomy 601 G. Buess and G.]. Maddern
List of products 607
Index 609
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Preface
In his preface to the previous edition of this volume, Hugh Dudley commented that 'although gastrointestinal surgery is an old established discipline, it continues to move forward'. Gastrointestinal surgery does indeed continue to move forward, and even the contributors to the last volume (which was published in 1983) would have been surprised at the rapid changes which were about to take place in gastrointestinal surgery. One of the changes, which amounts to a paradigm shift, is thoracoscopic and laparoscopic surgery. Another of the changes which was well established in 1983, but which has gathered momentum in the intervening years, is the separation of general surgery into subspecialties. This edition, for the first time, acknowledges these changes, and this volume is concerned with the upper gastrointestinal tract alone and includes laparoscopic and thoracoscopic techniques.
As with previous editions we have asked experts to describe how they undertake procedures in their field of expertise. The emphasis is always on the practical, with the aim being that a competent surgeon, without great familiarity in an area, in appropriate circumstances would be able to carry out the procedure being described.
Hugh Dudley finished his preface with: 'Here then is how to do it in the gastrointestinal tract by those who know how to do it (with the possible exception, of course, of the editor's own contributions!)' We can think of no better way to finish, but will circumvent Hugh's modesty by paraphrasing his remark to: 'This volume is how to do it in the upper gastrointestinal tract by those who should know how to do it!'
Glyn G. Jamieson Haile T. De bas February 1994