Untitled Page

How to Edit a 19 Pound Surgical Textbook

Tips from Wayne Johnston

The 7th edition of Rutherford's Vascular Surgery arrived in bookstores this spring. Weighing in at 19 pounds, this textbook is the reference standard in the field, comprising 2500 pages in 2 volumes.

Because of the revolution in the practice of vascular surgery over the past decade, much of the material presented by editors Jack Cronenwett and Wayne Johnston is new. Developing the table of contents was the greatest challenge because of the advances that have occurred in intervention, imaging and medical management. Since both editors have served as editors-in-chief of the Journal of Vascular Surgery, they were well-prepared to reorganize the text based on their close knowledge of new developments in the field.

The publisher emphasized that younger readers (e.g. residents) who have grown up in a world of sound bites and tweets do not like long paragraphs. They prefer boxes of key points and summaries to take away to the examination. As a compromise with their more traditional approach, Wayne and Jack used short segmented sections with disciplined and orderly headings and subheadings.

There are abundant illustrations in color. Instead of traditional medical illustrators, the excellent diagrams were prepared through a company that employs freelance artists under contract to the publisher. These artists often derive their illustrations from the abundant supply of Google images on the web. Many of them start out as drawings from the original Gray's anatomy, now out of copyright. Illustrators can then Photoshop these drawings to give them a contemporary and more uniform look. Permission to copy drawings or to adapt them is readily available in the current era. Copyright clearance is obtained by online permission, usually without cost. Illustrators credit the source as "redrawn from..."

The editors were astounded that the distinguished vascular surgeon Robert Rutherford had been able to produce the first six editions of the text book single-handedly over the past 30 years. The advances in imaging, interventional radiology and minimal access techniques required radical

changes to record the revolution that has occurred in the specialty. The editors lowered the average age of the authors by about a generation. In addition, they set strict rules. In order to allow mid-career surgeons to participate as authors, they disqualified themselves on the basis of age from writing any chapter. This eased the task of excluding other senior scholars in the field. A second strict rule was that no author could write more than one chapter. Thus each of the 161 chapters has a different senior author. Authors were provided with templates and examples of outlines. The editors and the eight associate editors gave critical appraisals of the outlines submitted by the authors in order to reduce overlap between chapters and ensure that the topic was completely covered.

Wayne Johnston with textbook
Wayne Johnston

Authors were carefully chosen, emphasizing inclusiveness, openness, activity within the society, and wide geographic distribution. Access to the reviewer and author database of the Journal of Vascular Surgery was very helpful in choosing authors since there were data on their contributions. This gave insight into their expertise and timeliness - indeed, the chapters came in on time. All of the references are online, a significant reduction from earlier editions that devoted up to 15% of the pages to references. Instead with each chapter, there are a small number of selected key references with annotations that explain their significance.

This is one of the few textbooks sponsored by a society. The contract to produce the book was signed by The Society of Vascular Surgery with Elsevier. The society was responsible for choosing the editors. The editors chose the eight associate editors and authors. Purchasers of the book get an activation number which gives them password protected access to the electronic version of the text. They then have access to additional updated references chosen to guide them to advances in the field and 40 vascular videos from the library of the American College of Surgeons.

This textbook brings honor to our Department, and reflects the outstanding scholarship and organizational skills of its editors. See also the article on Wayne Johnston, Surgical Spotlight Summer 2009


Skip Navigation Links