Essentials of Endodontic Microsurgery

摘要

In his book Working in a Small Place Mark Shelton chronicles the efforts of a young neurosurgeon, Dr Peter Jannetta, to introduce a radically new microsurgical technique for cranial nerve decompression. Pivotal to the technique was the use of the surgical operating microscope (SOM) for precise visualization and manipulation of the delicate structures. What Dr Jannetta discovered was that not only was the use of the SOM in neurosurgery a rare event but also this particular piece of armamentarium was regarded with disdain by the 'Grand Old Men' of the profession. Programs were hesitant to implement this technology, and their residents were discouraged in its use because the senior staff members either felt estranged by the unfamiliarity with the SOM, or threatened by its presence. What Dr Jannetta realized was that, rather than trying to convince the grand old men of the merits of the SOM, he would work from within the system, slowly teaching his residents and wait for a new generation, his generation, to assume the role of senior staff members. He is quoted in the book as saying 'It takes twenty years for anything new to really catch on, not because it takes that long to convince the establishment, but because it takes that long for there to be a changeover to people who have grown up with the new idea as being accepted. Today, all residency programs in neurosurgery require proficiency with the SOM and microsurgery.