+91-8383022734, +91-8383013793

HPB & GI Surgery

CUSP Surgeons


Esophageal cancers

Esophagus is long food pipe that brings the food from mouth to our stomach. Any difficulty in swallowing the food must be taken with due seriousness. One should immediately approach the physician if he or she has difficulty in taking the food down in the stomach.

Esophageal cancer is a very aggressive disease with progressive increase in incidence in the Indian population especially smokers. Since smoking is rampant in North India, its incidence has seen a steep rise.

With increase in obesity and sedentary life style, incidence of acid reflux disease is increasing. Patient has the feeling of heartburn. This reflux disease itself is a cause for cancer if present for long duration. So heartburn if present for long time should be adequately investigated.

Risk factors for esophageal cancer

CUSP group has treated hundreds of esophageal cancers till date. With expertise in minimally invasive surgery we are able to avoid any significant incision in chest as well as your abdomen and whole procedure can be performed with pin size incisions. This greatly improves the post operative recovery of the patient and this helps in retaining their higher levels of function and quality of life.

Stomach cancers

Stomach cancer is also known as gastric cancer. It is a common disease in North India and Southern part of India. Stomach is a J shaped organ located between esophagus and small bowel. Its main function is to store the food and aid in food digestion.

Most common symptoms of stomach cancer are vomiting out of undigested food taken about 2 to 4 hours before, vomiting of blood or even difficulty in swallowing with feeling of food being stuck up in lower part of chest.

Risk factors for stomach cancer

Treatment of stomach cancer has undergone significant change over the past few years. With role of surgery being the mainstay of treatment, significant advances are being made in the way surgery is being performed. CUSP group performs extensive surgeries for stomach cancer which is at par with international standards. Laparoscopic gastrectomy with laparoscopic reconstruction is being routinely performed by our group.

Colorectal cancer

Colon and rectum are the distal most part of our GI tract. Colon is the first 6 feet of our large intestine and rectum constitutes the distal six inches of it ending into the anal canal. There has been a steep rise in the incidence of colon cancers in our country especially because of increased awareness about the disease.

Colon cancers present according to the site of involvement. Right sided colon cancers usually present with anemia i.e., weakness, fatigue. Any patient above 40 years of age and having new onset anemia should get himself investigated. Left sided colon cancers usually have alteration of bowel habits i.e., new onset constipation or alternate constipation and diarrhoea.

Rectal cancers also present with alteration in bowel habits. Other symptoms of rectal cancers are sense of incomplete evacuation i.e., patient has the feeling of incomplete evacuation and needs to go to washroom multiple times. Other symptoms are intense urge to pass motion but only able to pass mucus or blood.

These are tell tale signs of underlying cancer and need to be investigated on urgent basis.

Risk factors for colorectal cancer

Screening is a very important tool in detecting these lesions at an early stage. All patients above the age of 50 years should undergo colonoscopy every 5 to 10 years. This helps in early detection of tumors and may even be managed endoscopically.

We as a part of CUSP perform every type of colorectal surgery mini invasively. Use of high resolution display monitors and advanced laparoscopic skills has helped us in performing minimally invasive surgeries in more than 90% cases. Moreover, with the use of high end stapling techniques, need for temporary or permanent stoma have significantly reduced.

Another feather in our cap is the use of Cytoreductive Surgery and HIPEC in the management of peritoneal carcinomatosis from colorectal origin or pseduomyxoma peritonei of appendiceal origin. With introduction of heated chemotherapy inside the abdominal cavity, we are able to negate the systemic side effects of chemotherapy with more effective on peritoneal tumor deposits. We have experience of CRS and HIPEC in more than 100 cases which is one of the largest in this country.

Anal canal cancer

Anal canal is the terminal part of our gastrointestinal tract and allows for the passage of solid waste out of the body. Bleeding during passing motion is one of the most common presenting features of cancer of anal canal. Although most common reason for such bleeding is haemorrhoids, but it should not be taken lightly and thoroughly investigated with proctoscopy or sigmoidoscopy. Sometimes patient may feel some growth or a mass per rectum.

Most common tumors of anal canal are squamous cell carcinoma which can be treated with chemoradiation. Although rarely if the response to chemo radiation is not sufficient, then these tumors need to be tackled with surgery. This can be managed with minimally invasive surgery.

HPB Surgery


It is the largest organ of the body and is considered to be the vital organ without which a person cannot survive. Its main function is to tackle the toxic metabolites in the blood, manufacturing of essential clotting factors and formation of bile which is important for the digestion of food.

Liver cancer usually occurs in the diseased liver be it hepatitis infection or liver damaged by alcohol. In India, Hepatitis B is endemic and its incidence is increasing manifold. With the additive effect of increased alcohol intake in the Indian society, liver cancers are becoming a major cause of worry. Of various types of liver cancers, hepatocellular cancer is the most common type. Management of such cancer is a real tricky situation because one has to deal with two situations simultaneously – cancer itself and underlying diseased liver.

Various treatment options include

CUSP team comprises doctors with the complete armamentarium to deal with these complex tumors. Laparoscopic liver resection significantly decreases the morbidity to the patient as the incision line is very small and hemodynamic disturbances are significantly less. We have extensive experience in laparoscopically removing liver tumors giving maximum benefit with minimal trauma to the patient. We tackle small tumors with state of art radio frequency ablation machine. This being a day care procedure, patient is discharged the same day.

Biliary tract cancers

India is an endemic country for gall bladder cancer especially northern India. Gangetic belt is supposed to be home of GBC. It is a very aggressive disease with poor outcomes if not managed oncologically. Gall stone disease is considered to be the most important cause of GBC although cause and effect relation has not been proved till date.

Various treatment options include

GBC surgery involves complex decision making involving extensive liver resection and adjacent organ resection. Our team has got the experience of dealing with more than 1000 gall bladder cancers. We provide a holisitic approach in the management of GBC. Extended liver resections can now be safely performed laparoscopically.

Pancreatic cancer

Pancreas is that organ of the body which aids in food digestion and maintains the sugar levels in the body. Dealing with pancreatic cancer is really tricky because of its location especially in the head region where bile duct, pancreatic duct and small bowel join. These cancers are aggressive. But if detected early and managed appropriately, they can be curative. Minimally invasive surgery has brought about a major change in the management of these cancers in a big way especially body and tail tumor.

Treatment options include

Laparoscopic Whipple’s pancreaticoduodenectomy is considered to be the summit of minimal access surgery. Our CUSP team has got an experience of more than 25 cases under our belt with stupendous outcomes. Distal pancreatectomies are routinely performed by minimal invasive techniques which gives superior surgical clearance and earlier recovery.

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