Recent Advances in

SURGERY—12
 Recent Advances in
SURGERY—12

Edited by
Roshan Lall Gupta MS FRCS (Edin) FRCS (Eng) FACS
Emeritus Professor of Surgery
LLRM Medical College
Meerut (Uttar Pradesh), India
Recipient of the BC Roy National Award
Eminent Teacher in Surgery
Previously
Surgical Editor, Tropical Gastroenterology
Member, Editorial Board
British Journal of Surgery
Examiner
The Royal College of Surgeons of Edinburgh

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Recent Advances in Surgery—12
© 2010, Jaypee Brothers Medical Publishers
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First Edition: 2010

ISBN 978-81-8448-932-3
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 To
Indira, my wife
who continued to inspire me
 Contributors
Pradeep Chowbey

Ananthakrishnan N MS FRCS (Ed and Khanna AK MS MNAMS MBA DSc FACS

Glasgow) FACS FICS FACG FAMS FKS FAIS FUICC FUWAI
Director, Perunthalaivar Professor and Head
Kamaraj Department of General Surgery
Professor of Surgery Institute of Medical Sciences
Mahatma Gandhi Medical College Banaras Hindu University
and Research Institute Varanasi (Uttar Pradesh), India
Puducherry, India
Kim Mammen MS MCh MNAMS
Anubhav Vindal MS DNB MRCS FRCS FACS
Senior Resident Professor and Head
Department of Surgery Department of Urology
Maulana Azad Medical College and Christian Medical College and
Associated Lok Nayak Hospital Hospital
New Delhi, India Ludhiana, Punjab, India
Arvinder S Soin Melroy A D’souza MBBS, MS, MRCS
Liver Transplant and Fellow
Surgical Gastroenterology Department of Surgery
Sir Ganga Ram Hospital Karolinska Institute
New Delhi, India Stockholm, Sweden
Devendra K Gupta MG Bhat MS FRCS (Edin) FRCS (Eng) FICS
Professor and Head DMI RCS (Ed) DMLE (Law)
Department of Pediatric Surgery Consultant
All India Institute of Medical Sciences Gastroenterology and Laparoscopy
New Delhi, India Wockhardt Hospital
Bannerghatta Road
Heman Prasad MBBS Bengaluru, India
Surgical Resident
Department of Urology Narayan Gopeshwar
Christian Medical College and Associate Professor
Hospital Department of Molecular and
Ludhiana, Punjab, India Human Genetics
Banaras Hindu University
Jaya Bhat MD DGO FRCOG (London) Varanasi (Uttar Pradesh), India
Consultant
Gastroenterology and Laparoscopy Parthasarathy G MS
Wockhardt Hospital Resident in Surgical Gastroenterology
Bannerghatta Road, Bengaluru, India SGPGIMS, Lucknow (Uttar Pradesh)
India
Kate V MS FRCS (Glasgow) FACS FICS
FACG PhD Patil Poonam
Professor, Department of Surgery Consultant and Head
Jawaharlal Institute of Postgraduate Medical Oncology, Manipal Hospital
Medical Education and Research Airport Road, Rustom Bagh
Puducherry Bengaluru, India
viii Recent Advances in Surgery—12
Pawanindra Lal MS DNB FRCS (Ed)
FRCS (Glasg)
Professor
Department of Surgery
Maulana Azad Medical College and
Associated Lok Nayak Hospital
New Delhi, India
Pradeep Chowbey MS DSc MNAMS
FIMSA FAIS FICS FACS
Chairman, Minimal Access and
Bariatric Surgery Center
Sir Ganga Ram Hospital
New Delhi, India
Pritee K Pedgaonkar
Vascular and Endovascular Services
Jagjivan Ram Hospital
Mumbai, India
Puneet MS DNB MNAMS
Assistant Professor
Department of General Surgery
Institute of Medical Sciences
Banaras Hindu University
Varanasi (Uttar Pradesh), India
R Sekhar
Vascular and Endovascular Services
Jagjivan Ram Hospital
Mumbai, India
Ram Kasthuri MBBS MRCS FRCR
Consultant Interventional
Radiologist and
Honorary Senior Clinical Lecturer
North Glasgow University Hospitals
Greater Glasgow and Clyde NHS
trust
1053 Great Western Road
Glasgow
G12 0YN.
Ravi Mohanka
Consultant Surgeon
Liver Transplant and
Surgical Gastroenterology
Sir Ganga Ram Hospital
New Delhi, India
Transplant Surgery Fellowship
University of Piltsburg, Member
American Society of Transplant
Surgeons
Roshan Lal Gupta MS FRCS (Edin)
FRCS (Eng) FACS
Emeritus Professor of Surgery
LLRM Medical College
Meerut (Uttar Pradesh), India
Sachin Ingle MBBS MS
Senior Fellow
GI and HPB Surgery
Tata Memorial Hospital
Mumbai, India
Shafiq Ahmed MS
Senior Resident
Department of Urology
Christian Medical College and
Hospital
Ludhiana (Punjab), India
Shailesh V Shrikhande MS
Associate Professor and Consultant
Surgeon, Gastrointestinal and
Hepato-Pancreato-Biliary Surgery
Tata Memorial Hospital
Ernest, Borges Marg
Parel, Mumbai, India
Shilpa Sharma
Assistant Professor of
Pediatric Surgery
Postgraduate Institute of Medical
Sciences and DR RML Hospital
New Delhi, India
Siddharth Rajput
Vascular and Endovascular Services
Jagjivan Ram Hospital
Mumbai, India
Supreeta Arya MBBS MD
Associate Professor and Radiologist
Department of Radiology
Tata Memorial Hospital
Mumbai, India
Umesh Mahantshetty MBBS MD
Consultant Radiation Oncologist
Department of Radiation Oncology
Tata Memorial Hospital
Mumbai, India
 Preface
Pradeep Chowbey

This volume Recent Advances in Surgery 12 continues

providing surgeons access to news and information
about surgical innovation and best practice.
The update on interventional radiology continues
to inform the surgeon that ‘surgical care’ is increasingly
a “team effort” with the radiologist aiding the surgeon
and providing support when surgical excision is no
longer possible.
The chapter on infections causing cancer is in tune
with our changing times as vaccines against the development of
malignancy are increasingly available and in fact are becoming
mandatory in some societies.
End-stage renal disease gives the unaware surgeon a glimpse of this
unfortunate condition, which is becoming more prevalent as societies
everywhere, become more affluent and diabetes and hypertension cause
kidney failure.
I would like to thank the contributors for their knowledge in their
chosen subspecialty and the willingness to share this with their surgical
brethren.
I gratefully acknowledge loyal efficiency of Yohannan John, who
typed manuscripts in Meerut and more latterly, Anne Kendall in
Macclesfield, UK and Naresh Kashyap, who supported faithfully.
As always I am grateful to my publisher, Shri Jitendar P Vij, who
shared his passion for timely, effective, well-written and beautifully
produced books.

Roshan Lall Gupta

JUST IN

Professor Roshan Lall Gupta passed away in the UK. Though he is no more,
we, Jaypee Brothers Medical Publishers, are confident and determined that his
work and vision would live on forever.
 Contents
Pradeep Chowbey

1. Glimpses of Progress in Surgery .......................................................... 1

Roshan Lall Gupta
2. Liver Transplantation ............................................................................ 21
Arvinder S Soin, Ravi Mohanka
3. An Approach to Space Occupying Lesions in the Liver .............. 46
4. Infection as a Cause of Cancer ........................................................... 68
Patil Poonam
5. Borderline Resectable Pancreatic Tumors ........................................ 76
Shailesh V Shrikhande, Sachin Ingle, Melroy A D´Souza,
Umesh Mahantshetty, Supreeta Arya
6. Recent Advances in Surgical Management of End Stage
Renal Disease (ESRD) ........................................................................... 91
Heman Prasad, Shafiq Ahmed, Kim Mammen
7. Fundoplication for GERD—Where Do We Stand Today? ......... 110
Anubhav Vindal, Pawanindra Lal
8. Recent Advances in Interventional Oncology ............................... 127
Ram Kasthuri
9. Acute Pain in a Female Patient......................................................... 141
Jaya Bhat, MG Bhat
10. Current Concepts in the Management of Varicose Veins ......... 154
Pritee K Pedgaonkar, R Sekhar
11. Tissue Engineering in Vascular Constructs ................................... 185
R Sekhar, Siddharth Rajput
12. Epigenetics and Cancer ....................................................................... 204
Puneet, Narayan Gopeshwar, Khanna AK
13. Recent Advances in Obstructive Uropathy .................................... 212
Devendra K Gupta, Shilpa Sharma
14. Laparoscopic Management of Large Hiatus Hernia .................... 231
Pradeep Chowbey
15. Progress in Early Diagnosis of Gastric Carcinoma ...................... 252
Parthasarathy G, Kate V, Ananthakrishnan N
Index ......................................................................................................... 267