SRB'S Manual of Surgery, 3/E

1214 Pages·2009·61.177 MB·English

by  Bhat

SRB’s
Manual of Surgery

SRB’s
Manual of Surgery
THIRD EDITION
Sriram Bhat M
MS (General Surgery)
Associate Professor in Surgery
Kasturba Medical College
Mangalore
Karnataka, India
e-mail: [email protected]
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SRB’s Manual of Surgery
© 2009, Sriram Bhat M
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.
This book has been published in good faith that the material provided by author is original. Every effort is made to ensure
accuracy of material, but the publisher, printer and author will not be held responsible for any inadvertent error(s). In case
of any dispute, all legal matters are to be settled under Delhi jurisdiction only.
First Edition: 2004
Second Edition: 2007
Third Edition: 2009
ISBN 978-81-8448-551-6
Typeset at JPBMP typesetting unit
Printed at Replika
God could not be everywhere all the time,
so, He created Mothers
This Book is in the memory of my mother
Late Mrs Devaki Krishna Bhat
who continues to inspire and guide me

Foreword
A true surgeon is never fearless; he fears for his patients, he fears for his shortcomings, his own mistakes,
but never fears for himself or his professional reputation.
—Samule J Mixter
The manual is written for the students in this firing line for their MBBS degree. Common conditions
seen on a day-to-day basis have dealt with a little more detail. The uncommon and rare conditions have
been dealt briefly. The mode of clinical presentation and the physical signs are mentioned vividly so as
to register in the mind of the reader. There is a brief mention of necessary investigations in each of the
surgical conditions. The accepted mode of recent advances in investigation and treatment has been included.
This manual is meant for Final MBBS degree examination and not a consolidated textbook. Certain chapters
are included at the end of the book for the more enthusiastic students and for those interested in participating
in quiz programmes.
The clinical photographs are of very good quality, which are self-explanatory of the conditions. The
clinching physical signs have been highlighted in box forms with different shades of colour. This mode
of presentation emphasises the point to be conveyed to the students which they can recollect when required
either while arriving at a diagnosis in their examination or while in practice after obtaining the degree.
This book gives a good foundation in surgery for those who wish to pursue surgery as a career.
What does the surgeon ought to be?
The conditions necessary for the surgeon are four—first, he should be learned; second, he should be
an expert; third, he must be ingenious; fourth, he should be able to adapt himself.
Foremost, it is required that the surgeon should know not only the principles of surgery, but also those
of medicine in theory and practice; second, he should have seen others operate; third, he should be ingenious,
of good judgement and memory to recognize conditions; and the fourth, he should be adaptable and able
to accommodate himself to circumstances.
Let the surgeon be bold in all sure things, and fearful in dangerous things, let him avoid all faulty
treatments and practices. He ought to be gracious to the sick, considerate to his associates, cautious in
his prognostications. Let him be modest, dignified, gentle, pitiful, merciful; neither covetous nor an extortionist
of money; but rather let his reward be according to his work, to the means of the patient, to the quality
of the issue, and to his own dignity.
—Ars Chirurgica
I thank Sriram Bhat M for giving me this privilege of writing a foreword to his excellent manual.
Dr Prakash Rao MS
Professor in Department of Surgery
Kasturba Medical College, Mangalore

Preface to the Third Edition
It is my pleasure to release the third edition within two years of release of second edition of SRB’s Manual
of Surgery. Earlier editions were well-accepted by undergraduates and postgraduates. I felt to bring out
the third edition in the intention of making it much more illustrative with more diagrams and clinical
and operative photographs. I have extensively done corrections in this edition. I added many new materials,
text details, new additional topics in different chapters. Malignancies are discussed in much more detail
with new staging and present oncological trends. Mistakes are corrected and insufficient topics are upgraded.
I have referred many books, journals and took help of my colleagues in surgery and other departments
like radiodiagnosis and ENT from my college KMC Mangalore. I have retained all chapters with some
rearrangements of few chapters and topics.
I sincerely express my thanks to everybody who have helped me and also to the publishers who are
the backbone of this upgraded edition.
I hope this new book will be well-accepted by the teachers, undergraduates and postgraduates of surgery
department. I sincerely welcome all criticisms.
December 2008 Sriram Bhat M