Principal Taught Modules (Year One - Soft Tissue Surgery)

01 Surgical asepsis and basic operative techniques

Wounds and wound healing. Instrumentation and instrument handling Antiseptics, sterilisation techniques and use of antibiotics Gloving and gowning Principles of wound healing - primary and delayed closure, secondary healing Principles of reconstructive surgery - skin flaps and grafts Principles and uses of surgical drains

02 Gastrointestinal surgery I

Salivary gland diseases - mucocoeles, trauma, hypersialism, neoplasia Oesophageal foreign bodies, trauma, strictures, diverticulum, neoplasia The stomach - hiatal hernias, gastric foreign bodies, dilatation/volvulus, gastric outflow disease, gastric neoplasia

03 Gastrointestinal surgery II

Liver, spleen and pancreas surgery Intestinal surgery - serosal and omental patching, obstructions and foreign bodies, neoplasia Megacolon, rectal prolapse and stricture The anus and perianal area - atresia ani, anal sac disease, anal furunculosis Liver, spleen and pancreas surgery

04 Urinary and reproductive tract surgery

Obstructive diseases of the urinary tract - ureters, bladder and urethra Urinary tract trauma - kidneys, ureters, bladder and urethra Urinary incontinence Urinary tract neoplasia Disorders and surgery of the female and male reproductive tracts

Two-day soft-tissue practical

Two days spent putting what you have learnt so far into practice! Short review lectures will be followed by hands-on practical sessions with at least 60% of the time being spent on practicals.

Day One

Reconstructive surgery

Wound closure – tension relief, prevention of ‘dog ears’, relaxing incisions Pedicle flaps – advancement flaps, rotational flaps, transposition flaps Muscle and omental flaps – external abdominal oblique muscle flap, omental transposition Skin grafts – full thickness skin grafts and stamp grafts

Day Two

Gastrointestinal and urinary tract surgery

Oesophageal foreign bodies – pre-op management, anaesthesia, surgical anatomy, surgical technique, post-op care and assessment Gastric dilatation volvulus – temporary and permanent gastropexy Nephrectomy and nephrotomy – partial nephrectomy, ureteronephrectomy, indications for nephrotomy Urethrostomy – prescrotal, scrotal, perineal, prepubic 

05 Oral and pharyngeal surgery.

The ear, 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

06 Surgery of the upper airways. Laryngeal and tracheal surgery

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

07 Thoracic surgery

Instrumentation, thoracotomy procedures, thoracic drainage Lung lobectomy, thoracic trauma Diaphragmatic ruptures Chylothorax Patent ductus arteriosus

08 Surgical oncology

Principles of oncologic surgery Surgery for skin tumours, oral tumours, gastrointestinal tumours, urogenital tumours and chest wall tumours Feline specific tumours

Two-day soft tissue practical

Two-day practical session (Second session)

Day One

Head and neck surgery

Total ear canal ablation (TECA) – 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

Day Four

Thoracic surgery

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

The venue for all practical sessions will be the fully-equipped Practical Training Facility at Improve headquarters near Swindon, Wiltshire. We aim to keep your established study groups together so are offering the dates in the table for each venue group. Numbers are kept low for the practical sessions to maximise the delegate/tutor contact time so these dates are offered on a first-come first-served basis. When maximum numbers are reached on these dates you will be informed of alternative dates on which you can attend.

Year Two - Orthopaedics and Spinal Surgery

Principal Taught Modules

01  Orthopaedics I - The forelimb

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

02  Orthopaedics II -The hindlimb

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

03  Orthopaedics III - Decision making in fracture repair

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

04  Orthopaedics IV - Complications of fracture repair

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

Osteomyelitis

Two-day practical course – Spinal/Orthopaedics

Day One

Joint and fracture surgery in the forelimb

Delegates will practice the following surgical procedures under supervision by the course tutor:

Osteochondrosis dissecans – surgical approaches to the proximal and distal humerus for the treatment of shoulder and elbow osteochondrosis dissecans (OD)

Shoulder joint – approach to the biceps tendon for bicipital tenotomy

Fracture repair – surgical repair of a fractured humerus using a bone plate and screws

Carpus – carpal arthrodesis technique

Day Two

Joint and fracture surgery in the hindlimb

Delegates will practice the following surgical procedures under supervision by the course tutor:

Hip joint – surgical approach to the hip for the treatment of luxation

Fracture repair -  surgical repair of a fractured femur using an intramedullary pin and cerclage wires

Stifle joint I – Cranial cruciate ligament repair using the De Angelis suture method

Stifle joint II – Surgical correction of a medially luxating patella by tibial tuberosity transposition

05  Spinal Surgery I

Lesion localisation - the neurological examination and it's interpretation

The application of neurodiagnostics

The approach to and management of paraplegia and tetraplegia

Neurological emergencies, including cranial trauma and status epilepticus

06  Spinal Surgery II

Cervical disc surgery

Thoracolumbar disc surgery

Lumbosacral disc surgery

The final practical session for Year Two

Day One

Bone grafting and external skeletal fixation

Delegates will practice the following surgical procedures under supervision by the course tutor:

Cancellous bone grafting – harvesting cancellous bone from the proximal humerus

Review of external fixation equipment – pins, bars and clamps

Fracture repair I – surgical repair of a fractured tibia using half pins

Fracture repair II – surgical repair of a comminuted radial fracture using full pins

Day Two

Spinal surgery

Delegates will practice the following surgical procedures under supervision by the course tutor:

Localising the lesion - how to perform a neurological examination

Myelography – how to perform a myelogram using cisternal puncture

Cervical disc surgery – fenestration and ventral slot procedure to treat cervical disc disease

Thoracolumbar disc surgery – hemilaminectomy procedure to treat thoracolumbar disc disease

Learning Objectives for the four practical sessions:

At the end of the practical sessions, delegates should be able to:

•   Outline the pre-operative, intra-operative and post-operative care of the patient

•   Understand the principles of surgical planning

•   Apply principles of surgical planning to selected cases

•   Understand the possible surgical complications that may arise following each of the above procedures

•   Perform the above procedures in a wet-lab environment

•   Demonstrate the above procedures to a colleague or the course tutor

•   Evaluate their own surgical skills and recognise their limitations with respect to some of the above procedures

•   Recognise when to seek assistance from a colleague or referral institution