Textbook of Surgery Roshan Lall Gupta
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1Textbook of Surgery
Second Edition
2
Do not fear to repeat what has already been said. Men need most things dinned into their ears many times and from all sides.
Laennec
3Textbook of Surgery
Second Edition
Roshan Lall Gupta MS FRCS (Edin) FRCS (Eng) FACS Emeritus Professor of Surgery University of Meerut Ethicon Visiting Professor of Surgery The Association of Surgeons of India Recipient of the BC Roy National Award—Eminent Teacher in Surgery Editorial Advisor, Indian Journal of Surgery Previously Surgical Editor, Tropical Gastroenterology Member, Editorial Board, British Journal of Surgery Examiner, The Royal College of Surgeons of Edinburgh
4Published by
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
EMCA House, 23/23B Ansari Road, Daryaganj
New Delhi 110 002, India
Phones: 3272143, 3272703, 3282021, 3245672, 3245683 Fax: 011-3276490
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Textbook of Surgery, 2nd Edition
© 2002, Roshan Lall Gupta
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the author and the publisher.
First Edition : 1996
Second Edition : 2002
Publishing Director: RK Yadav
9788171799657
Typeset at JPBMP typesetting unit
Printed at Gopsons Papers Ltd., A-14, Sector 60, Noida
5Preface to the Second Edition
In the age of the internet it is probably useless to ever hope to offer the last word on any subject, let alone surgery, which has changed more rapidly and comprehensively in the last few decades than at any time in its history. This second edition of the Textbook of Surgery updates the first in important ways. It takes note of the key developments and provides a better understanding of the surgical art and practice. It is meant for undergraduates and postgraduates alike, being simply laid out and presented with an awareness of differing levels of knowledge and perception of the surgical trade. I must confess at this point that the book is marginally biased in favour of the undergraduate, offering a potted guide to the essential surgical course work he must learn, if he is to succeed at the final examination and later perhaps progress to postgraduate study.
However, this updated edition also offers a useful introduction to the way surgery is taught and practised at medical schools across the country. As a reality check it should interest all general surgeons, student, apprentice or teacher.
I must thank Mr JP Vij, Chairman and Managing Director, M/s Jaypee Brothers Medical Publishers (P) Ltd., for the unstinting support he gave towards bringing out the new edition.
Roshan Lall Gupta
6
7Preface to the First Edition
If this Textbook of Surgery conforms to the standard in any way, it is in its name and length. In all other respects it has deviated from the beaten track of textbook compilation, particularly in the holistic approach that has sought to be adopted—not unduly fettered by theoretical constructs to the exclusion of practical applicability. Pragmatism has also directed the arrangement of topics, so as to present them in the light of their incidence in the Indian subcontinent.
The Short Textbook that preceded this volume also encapsulated the various subjects comprising the undergraduate course. But that was very differently done. Now there is considerable emphasis on diagrams. There is a compendium at the end of each chapter, listing “further reading” for the intelligent reader. The need for brevity has not come in the way of detailed exposition. The science of surgery is a multidisciplinary art and the process of understanding it can begin only if there is adequate knowledge of its multitudinous concepts. This is what I have tried to do. However, orthopaedics and management of skeletal trauma have not been covered though allied conditions have been included.
Another area which has been severely left alone is the academic controversy and sharp-edged debate that must surely arise in any field where there is scientific inquiry in an attempt to broaden the realm of the possible. Students of surgery, I feel, must first know the certainties of their discipline before they become acquainted with the grey areas.
I would like to thank Mr Paul Atkins of the Department of Surgery, University of Liverpool, for his active association with this book by contributing a chapter each on the thyroid and parathyroid.
In all of this my publisher Mr JP Vij and his editor Mr YN Arjuna have given unstinting support. I must place on record my appreciation.
Roshan Lall Gupta