소동물 외과

Key Learning Objectives:

• Salivary gland diseases - mucocoeles, trauma, hypersialism, neoplasia
• Oesophageal disorders and the limitations of oesophageal surgery
• Gastrotomy and gastrectomy: there is more to surgery of the stomach than just GDV
• Small intestinal disease and how your decision-making can reduce complications - serosal and omental patching, obstructions and foreign
• bodies, neoplasia

Key Learning Objectives

• Large intestinal surgery and the differences between cats and dogs - Megacolon, rectal prolapse and stricture
• Surgical approaches to the rectum and anus - atresia ani, anal sac disease, anal furunculosis
• Liver surgery – suture, staples or electrosurgery
• Biliary tract surgery – anatomy and surgical options
• Pancreatic surgery
• Splenectomy – does it need removing and if so, which technique and what are the alternatives to removal?

Key learning objectives:

• Principles of oncology
• Principles of oncologic surgery
• Surgery for skin tumours, mast cell tumour, oral tumours - maxillectomy and mandibulectomy and gastrointestinal tumours
• Feline-specific tumours (+/- injection site sarcoma)
• Principles of reconstructive surgery - skin flaps and grafts
• Principles and uses of surgical drains

Key Learning Objectives:

• Revise asepsis, sterilisation and appropriate antibiosis for surgical cases
• Instrumentation and instrument handling
• Gloving and gowning
• Uses of suture, needles, staples and clips
• Principles of wound healing - primary and delayed closure, secondary healing - and how this applies to clinical cases
• Re-visit the principles of wound management and get up-to-date with what is available now

Key learning objectives:

• The nose – neoplasia, autoimmune disease
• The nasal sinuses
• Brachycephalic airway disease
• Laryngeal diseases – paralysis, collapse, trauma, stenosis, neoplasia
• Tracheal surgery – tracheotomy, tracheostomy, collapse, resection/anastomosis, trauma, foreign bodies, neoplasia

Key learning objectives:

• Surgery of the lips and cheeks, tongue and hard palate
• Maxilla/mandible – maxillectomy and mandibulectomy
• Pharyngeal surgery
• Tonsillar surgery
• The ear – lateral wall resection, vertical canal ablation, total canal ablation/lateral bulla osteotomy, ventral bulla osteotomy, haematomas

Key Learning Objectives:

• Understand the anatomy of the urinary tract
• Discuss the surgical options for obstructive diseases of the urinary tract –ureters, bladder and urethra
• Describe the approach to urinary tract trauma – kidneys, ureters, bladder and urethra
• Discuss treatment options for urinary incontinence, including colposuspension, TVT and urethral occluders
• Describe the surgical approach to neoplasia of the urinary tract
• Surgery of the male reproductive system – from prostatic omentalisation to penile and preputial procedures
• Procedures you can offer for the female reproductive system beyond ovariectomy and ovariohysterectomy

Key learning objectives:

• Review and revise ruptures and hernias
• Hernias – hiatal, perineal, inguinal, umbilical, diaphragmatic, prepubic
• Peritonitis - going into the detail of the pathophysiology, clinical signs, diagnosis and treatment options
• Thoracic surgery:
  • Big dog / little dog: who wins?
  • Thoracostomy for pneumothorax, pyothorax and chylothorax – which tube?
  • Thoracotomy – which side and which rib space?
  • Lung Lobectomy – how many lobes can you take?
  • PDA – is this still a surgical condition?
  • Pericardectomy – how much should you take?
  • PRAA – why does a regurgitating patient need a thoracotomy?
  • Chylothorax – can you find the thoracic duct?
  • Chest wall diseases – how far can you advance the diaphragm?

Key learning objectives:

• Describe the advantages and disadvantages of different monitoring techniques.
• Evaluate and treat fluid and electrolyte imbalances.
• Develop anaesthetic protocols for healthy and high risk patients.
• Understand the techniques used for stabilisation of patients in a critical state including CPR and treatments used in intensive care.

You will practise the following surgical procedures under supervision by the speaker:

Key Learning Objectives:

• Oesophageal foreign bodies
  • Maximise good outcomes for oesophageal foreign bodies by minimising the risks and complications through appropriate knowledge of anatomy, surgical technique and peri-operative care
• Gastric dilation volvulus
  • Investigate which gastropexy you might choose
• Nephrectomy and nephrotomy
  • Perform a ureteronephrectomy for when the whole kidney needs removing
  • Develop your familiarity with partial nephrectomy for saving every precious nephron
  • Investigate possible indications for nephrotomy
• Urethrostomy
  • Practise urethrostomies at a variety of anatomical locations so you can select the right one for your patient

You will practise the following surgical procedures under supervision by the speaker:

Key learning objectives:

• Thoracotomy - Pre-op management, anaesthesia, surgical anatomy, surgical technique, post-op care and assessment
• Lung lobectomy - Partial and complete lobectomy
• Pericardectomy - Subtotal and total
• Patent ductus arteriosus (PDA) - Pre-operative management, anaesthesia, surgical anatomy, surgical technique, post-op care and assessment

You will practise the following surgical procedures under supervision by the speaker:

Key Learning Objectives:

• Wound closure - Tension relieving techniques, management of ‘dog ears’
• Pedicle Flaps - advancement, rotational and transposition to help close the larger or trickier defects
• Muscle and omental flaps - using muscle in defects by practising the external abdominal oblique muscle flap
• Skin grafts - full thickness and stamp and how to maximise their chances of success

Key learning objectives:

• Total ear canal ablation (TECA) and lateral bulla osteotomy - Suture materials and special instruments, post-op care and assessment, complications
• Ventral bulla osteotomy - Suture materials and special instruments, post-op care and assessment, complications
• Thyroid surgery - Thyroidectomy in the dog, thyroidectomy in the cat demonstration
• Unilateral arytenoid lateralisation - Pre-op management, anaesthesia, surgical anatomy, surgical technique, post-op care and assessment

Key learning objectives:

• The initial assessment of the fracture patient
• Descriptions and applications of fracture classification
• Principles and decision making in fracture repair
• Methods of fracture fixation and implants, including plating and external fixation devices

Key learning objectives:

• The principles of fracture reduction, including both closed and open techniques
• Options for bone grafting including both cancellous and cortical grafts
• Approaches to the following complications: delayed union, non-union, mal-union and osteomyelitis

Key learning objectives:

• Luxation, osteochondrosis, dysplasia, excision arthroplasty and fractures of the shoulder
• Luxations, developmental disease, un-united anconeal process and fractures of the elbow
• Developmental carpal disease, carpal hyperextension and arthrodesis, luxations and fractures of the carpus and foot
• Growth plate disorders

Key learning objectives:

• Conditions of the hip, including dysplasia, luxations, arthroplasty and total hip replacement
• Pelvic fractures
• Femoral fractures
• Conditions of the stifle, including patellar luxation, osteochondrosis, fractures and cruciate rupture
• Conditions of the hock, including osteochondrosis, luxation and fractures

During this practical session you will perform the following procedures:

Key learning objectives:

• Internal Fixation Practical Session:
  • Radial Fracture - Surgical repair using a bone plate and screws
  • Humeral Fracture - Surgical repair using an intramedullary pin and a bone plate and screws
  • Femoral Fracture - Surgical repair using an intramedullary pin and a bone plate and screws

• External Fixation and Bone Grafting Practical Session:
  • Cancellous bone grafting - Harvest cancellous bone from the proximal humerus
  • Review external fixation equipment - Familiarise yourself with the pins, bars and clamps
  • Tibial Fracture - Surgical repair with a type II linear frame
  •  Comminuted Radial Fracture - Surgical repair with a type Ib linear frame

You will practise the following surgical procedures under supervision by the speaker:

Key learning objectives:

• The Forelimb Practical Session
  • Shoulder Joint - Revise the surgical approaches to the joint and perform a bicipital tenotomy
  • Elbow Joint - Elbow dysplasia is a widespread and complex disease – review which surgical approaches to the joint are most appropriate for your individual cases
  • Carpus - Sometimes a salvage procedure is the only option – meticulous technique will enhance your ability to perform carpal arthrodesis

You will practise the following surgical procedures under supervision by the speaker:

Key learning objectives:

• Hip joint
  • Sometimes the best option is to perform a femoral head and neck ostectomy and good technique should allow a quick return to weight bearing
• Stifle joint I
  • Extracapsular repair of cranial cruciate ligament disease can still be a valid treatment provided you prioritise thorough meniscal inspection
• Stifle joint II
  • Surgical correction of a luxating patella by tibial tuberosity transposition will benefit many of your small dog patients
• Tarsus
  • Arthrodesis of the hock can be the only option – choose whether to perform a partial or pantarsal arthrodesis

Key learning objectives:

•  Integrate the principles of lesion localisation to your spinal cases via a systematic neurological examination and its interpretation
• Understand the application of neurodiagnostics
• Appreciate the approach to and management of paraplegia and tetraplegia
• Be familiar with the clinical approach to spinal trauma

Key learning objectives:

• Revise the surgical options for spinal surgery according to site
• Cervical spine
  • Ventral slot procedure
• Thoracolumbar spine
  • Hemilaminectomy
• Lumbosacral spine
  • Dorsal laminectomy
• CSF tap and Myelography
  • Identify the appropriate landmarks for acquiring CSF samples and obtaining diagnostic myelograms

Observe a demonstration of the above procedures performed by the speaker in the wet lab.

You will practise the following surgical procedures under supervision by the speaker.

Key learning objectives:

• Myelography
• Lumbar puncture and puncture of the cisterna magna
• Cervical disc surgery by ventral partial spondylectomy ("ventral slot")
• Thoracolumbar hemilaminectomy;
• Lumbosacral stenosis (DLSS) treated by dorsal laminectomy