SURGERY II
Academic year and teacher
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- Versione italiana
- Academic year
- 2019/2020
- Teacher
- GIANCARLO PANSINI
- Credits
- 7
- Didactic period
- Secondo Semestre
Training objectives
- GENERAL SURGERY
Students should be able to diagnose surgical diseases through symptoms, laboratories exams, and instrumental examinations and also to point out the treatment.
The student should learn how to talk to patients, investigate symptoms with a rational approach, and with a careful physical examination (i.e., inspection, palpation, percussion, auscultation).
By visiting the patient, the student should be able to timely and precisely request laboratory exams and, eventually, instrumental examinations in order to achieve an exact diagnosis.
Furthermore, the student should know both the prognosis and surgical treatment as well as the most common surgical operations for each surgical disease.
At the end of the course, the student should know how to examine a patient; take patients’ history and report their case; suture with stitches; remove stitches; draw blood or take a peripheral vein; scrub in the operating room, dress and behave appropriately (put on surgical gown and sterile gloves, wash the hands); evaluate pre-operative laboratory exams; prescribe treatments; know the surgical instrumentation and how they work (e.g., mechanical staplers); place a bladder catheter; place a nasogastric tube.
UROLOGY
Learn the pathophysiology and clinical aspects of major urological diseases
THORACIC SURGERY
Learn the pathophysiology and clinical aspects of major thoracic diseases
VASCULAR SURGERY
Learn the pathophysiology and clinical aspects of major vascular diseases Prerequisites
- GENERAL SURGERY
The student has to know anatomy, physiology, pathology, epidemiology, aetiology, and surgical symptoms of the diseases. Specifically, diseases of the endocrine glands, vascular system, and gastrointestinal and respiratory tracts. Students should have good knowledge about topographic anatomy, surgical and internal medicine semeiotics, and all basic sciences that should simplify clinical learning.
UROLOGY
Anatomy and physiology knowledge of urogenital tract.
THORACIC SURGERY
Knowledge of anatomy, physiology, and pathophysiology of the thoracic and lung diseases.
VASCULAR SURGERY
Knowledge of anatomy, and physiology, and pathophysiology of the vascular diseases. Course programme
- GENERAL SURGERY
Suture and surgical needles. Pre-operative evaluation. Nutritional support in surgical patients. Post-operative complications. Infections. Surgical staplers: use and complications.
Surgical disease of the adrenal glands; multiple endocrine syndromes. Acute abdomen. Gastrointestinal bleeding. Hernias of the abdominal wall, including incisional hernias;
Esophagus: hiatal hernias and diverticula; tumours
Stomach and duodenal diseases: gastric and duodenal ulcers; tumours
Small bowel and appendiceal diseases: acute appendicitis; Meckel diverticulum; Crohns' disease
Colon, rectum, and anus: diverticular disease; colorectal and anal carcinomas; ulcerative colitis; haemorrhoids; intestinal obstruction, volvulus, intussusception; perianal abscess; perianal fistula
Pancreas: acute and chronic pancreatitis; pseudocysts; tumours
Biliary tract: acute and chronic cholecystitis; carcinoma. Jaundice
Breast tumours
Parathyroid glands: tumours, hyperplasia
Thyroid gland: tumours, goiters
Liver: portal hypertension, abscess, tumours, and cysts
Spleen: trauma; hematologic disorders
Infections. Obesity. Intestinal ischemia
UROLOGY
Physiology and pathopysiology of urinary tract obstruction. Physiology of micturition and urinary incontinence.
Urological causes of haematuria. Renal cell carcinoma. Urinary tract urothelial cell tumours. Renal colic and urolithiasis. Management of male LUTS (lower urinary tract symptoms). Urinary tract infections. Benign prostatic obstruction. Prostate cancer. Testicular cancer. Male infertility and varicocele. Testicular torsion.
THORACIC SURGERY
Physiopatology and management of chest injuries.
Diagnosis and staging of lung cancer.
Pulmonary resection: General principles, video-assisted thoracic surgery (VATS). Surgery of the esophagus. Surgery of the diaphragm, mediastinum, and chest wall.
VASCULAR SURGERY
INTRODUCTION AND CIRCULATION PATHOPHYSIOLOGY
Pathophysiology of the arterial system. Acute and chronic arterial diseases.
Pathophysiology of the venous system. Classification of vascular diseases and diseases of the venous system. Semiotics of the arterial system: history & physical examination. Acute ischemia. Chronic peripheral obliterating arteriopathy. Cerebrovascular insufficiency. Aneurysms. Deep vein thrombosis. Pulmonary thromboembolism. Post-thrombotic syndrome .
PATHOLOGY OF THE TSA AND THE WORKING BRAIN
Pathophysiology. Epidemiology of stroke. Pathogenesis of the atherosclerotic plaque. Carotid disease. Instrumental investigations . Treatment.
ABDOMINAL AORTIC ANEURYSMS
Introduction. Anatomy. Etiology. Pathogenesis. Classifications. Morphology. Natural history and clinica course. Diagnostics. Indications for surgical treatment.
THORACIC AORTIC ANEURYSMS
Introduction. Anatomy. Etiology. Pathophysiology. Epidemiology. Diagnosis. Surgical treatment. Endovascular treatment .
PERIPHERAL ARTERIOPATHY
Aorto-iliac, femoro-popliteal, and tibio-fibular failure.
Instrumental diagnostics. Principles of treatment.
DISEASES OF THE VENOUS SYSTEM - Chronic venous insufficiency (CVI): definition
Superficial venous system. Deep venous system. Hemodynamic of the macrocirculation.
Etiopathology and pathophysiology of CVI.
Basics of phlebologic semiotics. Outline of phlebologic instrumental diagnostics.
Classification of CVI: C.E.A.P. Classifiacation. Ablative surgery. Endovascular treatment. Sclerotherapy
Superficial vein thrombosis.
Deep venous thrombosis and venous thromboembolism.
PATHOLOGY OF THE LYMPH SYSTEM: Lymphedema: Definition. Clinical classification. Primary and secondary lymphedema. Clinical History. Physical examination. Complications. Diagnostics. Differential diagnosis. Non-surgical treatments. Interventions of excision. Lympho-venous anastomosis. Didactic methods
- Lectures, rotations on the surgical ward, outpatients office and operating room.
Learning assessment procedures
- Oral examination, about a total of 5 questions regarding general surgery, urology, thoracic surgery, and vascular surgery. The exam lasts for about 20-30 minutes. The clearness and soundness of the contents, the ability to establish connections about the notions acquired, and the appropriateness of communication will be all evaluated.
The final outcome will depend also on the practice sessions. Reference texts
- GENERAL SURGERY
S.Dionigi, Chirurgia, Ed. Masson
S.I. Schwartz, Principi di chirurgia, Ed. UTET
D.C. Sabiston, Trattato di chirurgia, Ed. Piccin
UROLOGY
European association of urology guidelines (free access on the internet)
THORACIC SURGERY
Adult Chest Surgery David Surgarbaker
Surgery of the chest Waldhausen
VASCULAR SURGERY
R. Rutherford, Vascular Surgery, Antonio Delfino Editore
