Clinical Surgery: A Text and Atlas Sunil Chumber
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1CLINICAL SURGERY: A Text and Atlas2
Only he who has observed the internal mechanism of the human body, and is well read in the works bearing on the subject, is qualified to practice the art of healing.
—Sushruta
3
CLINICAL SURGERY: A Text and Atlas
Sunil Chumber MBBS MS (AIIMS) Professor Department of Surgical Disciplines All India Institute of Medical Sciences New Delhi, India ForewordRani Kumar
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Clinical Surgery: A Text and Atlas
First Edition: 2016
9789351526797
Printed at
5Dedicated to
Shishir,
My parents,
My teachers—LK Sharma, MM Kapoor,
IK Dhawan, BML Kapur, NK Shukla, AK Dasgupta,
Tara Didi, Indu Pillay, Ramesh Bijlani, RC Shekhar,
Sri Prakash Kandpal of Lansdowne,
Junior and Senior Residents of Surgery Units I and II,
curious students of AIIMS,
and above all
grateful patients at AIIMS and
beautiful inmates of the Sri Aurobindo Ashram.
All India Institute of Medical Sciences New Delhi, India
Samadhi of Sri Aurobindo, Sri Aurobindo Ashram New Delhi, India
7Contributors 11Foreword
It gives me great pleasure to write the foreword of Clinical Surgery: A Text and Atlas. It aims to initiate the students into surgical clinical practice and these skills can be achieved by a skilled teacher in the outpatients, wards and operation theaters. The book is a hard-work of eight years, of a team of surgeons who have joined together to present the students with the new text for inducting them into surgical clinical practice. The same group of experienced and dedicated faculty members and resident doctors have contributed immensely and published a textbook of surgery which acts as a baseline and companion for the current book. The fundamental knowledge of surgical skills is rejuvenated and the Essentials of Surgery as well as clinical practice of surgery will serve as complementary to each other. Chapters are focussed on clinical skills which makes it an everyday reference resource for those who wish to take surgery as the career. The simple and up-to-date information on clinical surgical skill makes the book surgeon-friendly, highly useful and most accessible for everyday surgery for the beginners as well as mid-career level surgeons. It is likely to prove a boon especially for students.
I wish the students all the best in learning surgical skills and in their future careers.
Rani Kumar
13Preface
Students in the All India Institute of Medical Sciences (AIIMS) as well as in other colleges have been using textbooks for clinical surgery for over last 50 years, many of which have not changed in content since the time of writing. Since then, major changes have taken place in the practice of surgery—the most important being creation of several new specialtie and superspecialities and the predominance of digital teaching through the Internet and a vast repository of knowledg being available at the click of a button.
To make available to the students the changes in the current practice of surgery, a special task was taken up by the authors and contributors to revise and rewrite the text of clinical surgery for students with special emphasis according to current needs and de-emphasis on certain areas, mainly due to evolution of newer specialties. This task is a continuu of our earlier undertaking entitled Essentials of Surgery, also for students. It was entirely due to the efforts of the advisors and contributors that a newer and revised textbook of clinical surgery could be generated.
I will take this opportunity to thank all the advisors and contributors for compiling the text. I must thank Faculty from the Department of Surgery—Drs Rakesh Kumar, Rajni Kant, Anand Kumar; Faculty members in the Department of Surgical Disciplines—Mahesh Chander Misra, Anurag Srivastava, Rajinder Prashad, V Seenu, Sandeep Agarwala, Varinder Bansal and Anita Dhar; and others include—S Rajeshwari and RK Batra. I must mention that more than partediting of texts has been done by Drs Sudipto Saha, Lalit Aggarwal, Nitin Agarwal, Amit Gupta, Hira Lal Nag and Ashok Kumar in respective sections. I must thank Drs Anil Kumar and Pratyusha Priyadarshini, who helped with the diagrams and photographs.
My special thanks to Sanjay and Naveen for helping in the typing of the manuscript and other tasks. The book could not have been completed without the encouragement of Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Group President) Mr Tarun Duneja (Director—Publishing), Mr KK Raman (Production Manager), Mr Manoj Pahuja (Graphic Designer), Mrs Yashu Kapoor, Mr Rajesh Kumar (Typesetters) and staff of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India.
This is also the appropriate moment to thank Sandeep Agarwala, Sandeep Aggarwal, Monish Aron, Minu Bajpai, CS Bal, S Bal, Varinder Bansal, Anil K Bhan, Surya Bhan, TK Chattopadhyay, Budhdev Choudhary, SVS Deo, Neeraj Dewenda, PN Dogra, (Late) DN Dwivedi, Apul Goel, Arun Goel, Sandeep Guleria, Amit Gupta, Sanjay Gupta, M Irshad, A Jayaswal, Madhabananda Kar, AK Karak, Lokesh Kashyap, Binod K Khaitan, Rakesh K Khazanchi, AK Kriplani, Arvind Kumar, Sunesh Kumar, Rakesh Lal, Neena Malhotra, SN Mehta, BK Mirdha, MC Mishra, Ravi Mittal, BK Mohanti, LR Murmu, HL Nag, Sujoy Pal, GK Pande, Rajinder Prashad, CS Prabhu, M Ramam, S Rastogi, Vimi Rewari, Ajoy Roychoudhary, Anoop Saraya, Ravi Saxena, V Seenu, Amlesh Seth, Sujoy K Shad, Ajay Sharma, NK Shukla, Anurag Srivastava, Nikhil Tandon, Alok Thakar, Shaji Thomas, Sandeep Vaishya, KK Verma, CS Yadav—all contributors from the earlier textbook that we have produced together, which also acts as a base for the textbook. I must also thank Wikipedia, which has stood by me in all searches, researches, quests and contemplations. I must also acknowledge the two nebulous teachers, Das and Bailey, whose teachings almost all of us have imbibed and who remain a constant part of the surgi-lore. The essence of their teachings is certainly present in here too—passed on through my own teachers!
Lastly, I must say that all the contributors have done a good job and I am now certain that all the errors are only due to me.
Sunil Chumber