Manual of Urologic Surgery

The color photographs and illustrations appearing in select monographs over the past decade represent a significant advance in surgical commu­ nication. Previously, black and white renderings were standard because color printing had not been perfected and its cost was prohibitive. We be­ lieve the gradual change from black and white etchings and reproductions to detailed color illustrations represents a tremendous twentieth century achievement. In our own urologic practices it became evident that the use of black and white sketches for teaching operative urology, while helpful, left too much to the surgeon's imagination. Even the dimension of depth, produced by varying the intensity of shading, often was inadequate in demonstrat­ ing subtle surgical details in a fossa or bed. Since color photography recently has been used to demonstrate oper­ ative techniques, we climbed on the bandwagon and photographed in color many of the major operative procedures. However, the reflection of light caused by normal tissue fluid significantly reduces the clarity of photo­ graphs. Not infrequently, the crucial operative step is obscured by light reflected on a trickle of blood. Even when meticulous care is taken to ir­ rigate and clean the surgical field, the tissue sheen obscures portions of the field. Color paintings by a gifted artist are not only unique, but can be extraordinary; the vividness with which subtleties can thus be portrayed cannot be matched by photography, black and white or color.