Principal Taught Modules (Year One - Orthopaedics and Spinal Surgery)
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 One
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
Year Two - Soft Tissue Surgery
Taught modules
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.