Radiofrequency (SECCA Procedure)

Many resource materials exist for the physician or surgeon evaluating and managing the patient with fecal incontinence. Much of the available information is embedded in the context of an overall textbook or compendium of colorectal surgery. There are a relatively limited amount of focused data for the practitioner who wishes to become familiar or updated with the latest relevant diagnostic and therapeutic information. Professor Mongardini is to be commended for having assembled in a cogent, succinct, and imminently readable textbook all of the abovementioned required details. He has selected 14 chapters each of which was authored by between one and fi ve experts. This book commences with a very surgeon-specifi c view of pelvic fl oor anatomy which I found readily comprehensible and clinically relevant. The second chapter which I also very much enjoyed reading is a description of physiology and physiopathology again written from the perspective of the practicing surgeon. Studying this chapter is an excellent prerequisite to digesting the subsequent four chapters each of which delves into a different but important facet of evaluation. Specifi cally, the chapters on endoanal ultrasound, magnetic resonance, anorectal manometry, and electromyography are all very up to date, highly descriptive, and again immediately useful in daily patient management. Reading these four chapters allows one a comprehensive overview of the optimal available current diagnostic tools. The remaining eight chapters describe virtually every currently available therapeutic modality by which the practitioner can try to assist the patient with fecal incontinence. The chapters include the gamut from pelvic fl oor rehabilitation and radiofrequency tissue remodeling to stomas and stem cells. In between these extremes are reviews of injectable and implantable agents, sacral neuromodulation, the artifi cial bowel sphincter and the more “standard” surgical therapies of sphincter repair, post anal repair, and muscle transposition. The easy readability of the material in the textbook is further complimented by the high-quality illustrations and photographs. It is clear that each of the authors commands expertise in his or her respective chapter. It is also quite apparent that Professor Mongardini edited the material to allow for an easy narrative fl ow between chapters with minimal subject overlap but excellent subject juxtaposition and interplay. I am very grateful to Professor Mongardini for having invited me to author this Foreword. I highly commend this textbook to all physicians and surgeons who evaluate and/or manage patients with fecal incontinence. This book shall certainly occupy a prominent place in my personal library and will be enjoyed by all of my residents and fellows. Steven D. Wexner, MD, PhD (Hon), FACS, FRCS, FRCS (Ed) Chairman, Department of Colorectal Disease Director, Digestive Disease Center Cleveland Clinic Florida, USA