Joseph Esmaili arrives at the Supreme Court in Melbourne on Monday. Credit:AAP

A man accused of fatally punching a Melbourne surgeon felt pressured by a dispute over a smoking ban and that the doctor was "up for" a confrontation, a defence lawyer has told the Supreme Court.

Jurors were on Monday shown CCTV footage of the attack at Box Hill hospital as part of the trial for Joseph Esmaili, 24, who is charged with one count of manslaughter over the incident in May last year.

Dr Patrick Pritzwald-Stegmann, 41, died in June 2017 when his life support was turned off four weeks after the alleged assault.

Mr Esmaili, then 22, was turned in to police by his own father, who saw him in footage on the news. He was interviewed by police the next day.