CODE 67505 ACADEMIC YEAR 2024/2025 CREDITS 8 cfu anno 5 MEDICINA E CHIRURGIA 8745 (LM-41) - GENOVA LANGUAGE Italian TEACHING LOCATION GENOVA PREREQUISITES Propedeuticità in ingresso Per sostenere l'esame di questo insegnamento è necessario aver sostenuto i seguenti esami: MEDICINE AND SURGERY 8745 (coorte 2020/2021) PHARMACOLOGY II 67398 2020 MEDICAL RADIOLOGY 80810 2020 PATOLOGY 80811 2020 Propedeuticità in uscita Questo insegnamento è propedeutico per gli insegnamenti: MEDICINE AND SURGERY 8745 (coorte 2020/2021) EMERGENCY AND TRAUMATOLOGY 67589 MODULES Questo insegnamento è composto da: GENERAL SURGERY A GENERAL SURGERY B PLASTIC SURGERY UROLOGY TEACHING MATERIALS AULAWEB OVERVIEW Surgery I course is designed to address the main general topics of surgery. It introduces students to minimally invasive techniques (laparoscopic and thoracoscopic surgery) and robotic surgery. The course covers important pathologies related to the upper gastrointestinal tract and chest, as well as relevant plastic surgery and urological surgery. AIMS AND CONTENT LEARNING OUTCOMES At the end of the course the Student will be able to argue about issues of clinical and surgical relevance, will prove competent in configuring a differential diagnostic reasoning based on observation, on the knowledge of epidemiological data, on the use of instrumental investigations related to the syllabus. The student will learn to give correct therapeutic indications , will will master the most common surgical procedures surgical and prognosis timing, considering the general characteristics of the patient. AIMS AND LEARNING OUTCOMES The course initially consolidates traditional knowledge related to the pathophysiology and clinical signs of various pathologies. However, its primary goal is to teach, using evidence-based medicine methodology, diagnostic and treatment options for the most relevant and frequently encountered clinical scenarios in general surgery, plastic and reconstructive surgery, and urology. Specifically, fundamental concepts of surgical reasoning will be conveyed to effectively address differential diagnoses. This involves clinical observation, understanding epidemiological data, rational use of diagnostic tests, and prevention strategies for common pathologies. Additionally, correct therapeutic indications, timing of common surgical procedures, surgical timing, and prognosis will be taught, considering the psychophysical and social characteristics of the patient. The course will also cover preoperative risk assessment (both general and specific) and postoperative rehabilitation protocols, applicable to both major surgery and short-stay surgery. Finally, students will learn critical appraisal of research results and scientific methodology." PREREQUISITES The student in order to face all the contents of the course has to master the anatomy, physiology and radiology of gastrointestinal, urological and respiratory apparatus. TEACHING METHODS Frontal Teaching in the Classroom (unless otherwise indicated by the University). Seminars (discussion of clinical cases). Professional Training (for small groups of students) in Wards, Outpatient Clinics, Operating Rooms, and Radiological and Instrumental Diagnostics. Attendance is mandatory, with hours distributed according to the types of activities and in relation to the credits provided in the 5th Year - 1st Semester, for the General Surgery Discipline (MED/18) - Integrated Course in Surgery I. The detailed schedule of educational activities is provided each academic year in the Student Guide published online. The teaching method used will be frontal lectures with the presentation of clinical cases and their treatment in accordance with the most recent clinical recommendations. During the lesson, it will be possible to fill gaps and review material to assess and potentially reinforce learning. Lastly, students have access to and can use the models at the University’s Advanced Simulation Center. Any Student with documented Specific Learning Disorders (SLD), or with any special needs, shall reach out to the Lecturer(s) and to the dedicated SLD Representative in the Department before class begins, in order to liase and arrange the specific teaching methods and ensure proper achievement of the learning aims and outcomes. SYLLABUS/CONTENT General Surgery Evidence Based Surgery Introduction to video-laparoscopic surgery Bariatric Surgery: Indications, classification, results, and complications of bariatric procedures Breast Surgery: Principles and reconstructive techniques in breast surgery Preoperative Risk Assessment: The frail patient and preoperative risk evaluation: ASA, P-Possum, NSQIP Application of ERAS protocols Nutritional management of the surgical patient Surgery in the elderly patient Pneumothorax, pleural effusion, and thoracic drainage Perioperative thromboembolic disease Introduction to surgical infections Management of the hemorrhagic patient: hemoperitoneum, gastrointestinal bleeding, blood product transfusions Introduction to solid organ transplant surgery Postoperative Complications Treatment of patients with caustic esophagitis. Treatment of patients with esophageal foreign bodies Mediastinal Mass (compression symptoms, diagnostic pathway, surgical treatment) Dysphagia and achalasia: differential diagnosis and treatment Esophageal diverticula. Boerhaave’s syndrome and esophageal perforations Pleural Mesothelioma: pathogenesis, differential diagnosis, treatment, and prognosis Lung Tumors: pulmonary nodule, NSLCC treatment, SLCC) Benign breast diseases Breast Cancer: diagnostic pathway and therapeutic strategies Hernias and abdominal wall defects: diagnosis, complications and treatment Acute peritonitic abdomen: presentation, differential diagnosis and treatment Surgical treatment of peptic ulcer complications Duodenal Tumors: diagnosis and treatment Emerging Technologies (robotic surgery) Hiatal Hernias: diagnosis and treatment Gastroesophageal reflux disease (GERD): diagnosis and treatment Esophageal Cancer: diagnosis and treatment Leiomyoma and GIST of the stomach: diagnosis and treatment Early gastric cancer and advanced gastric cancer: diagnosis, staging, prognosis, and surgical treatment Urologic Surgery Introductory Lesson (review of male genital and urinary tract anatomy, symptoms and signs of urological diseases, laboratory and instrumental semeiotics) Anuria and Urinary Retention Benign Prostatic Hyperplasia Hematuria and Urinary Lithiasis Laparoscopic and Robotic Use in Urology Hydrocele, varicocele, cryptorchidism, testicular torsion Upper Urinary Tract Tumors Congenital malformations of the urinary tract, hydronephrosis Bladder Carcinoma Renal Parenchyma Tumors Prostate Carcinoma Testicular and Penile Tumors Erectile Dysfunction Urinary Incontinence Plastic Surgery Basic Techniques in plastic surgery: a) sutures b) grafts c) flaps Prognosis and treatment principles of the burn patient Principles and reconstructive techniques in breast surgery Surgical therapy for migraines and muscle-tension headaches Malformation Syndromes Diagnosis and treatment of median and ulnar nerve compression syndromes. Dupuytren’s disease Body contouring after bariatric surgery Regenerative surgery for the treatment of: a) radiodermatitis - b) difficult wounds - c) scar outcomes The therapy of hyperhidrosis Firearm Injuries: - Injuries from thermal, electrical, baric causes - Violent mechanical asphyxiation - Carbon monoxide poisoning Cosmetic Surgery Contusive Injuries: - Knife injuries RECOMMENDED READING/BIBLIOGRAPHY Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice, CM Townsend; Editore Elsevier - Health Sciences Division; Lingua inglese; ISBN 9780323640626 Schwartz's Principles of Surgery, Eleventh Edition - Charles Brunicardi, F., Mc Graw-Hill; lingua inglese). ISBN 978-1259835353. Chirurgia: Basi teoriche e chirurgia generale-Chirurgia specialistica vol.1-2; Dionigi R. Edizioni EDRA; lingua italiana; ISBN 8821454355 ·Chirurgia Generale; F. Minni; Casa Editrice Ambrosiana. Distribuzione esclusiva Zanichelli Lingua: italiano; ISBN: 9788808320490 TEACHERS AND EXAM BOARD PAOLO TRAVERSO CARLO TERRONE Ricevimento: By mail: carlo.terrone@hsanmartino.it MARCO BORGHESI GUGLIELMO MANTICA CESARE STABILINI FRANCESCO SAVERIO PAPADIA GIOVANNI CAMERINI FEDERICA MARIA MURELLI GREGORIO SANTORI TOMMASO REGESTA FRANCESCO SANTINI PIERO FREGATTI ILARIA BALDELLI Ricevimento: 0105558829 ilaria.baldelli@unige.it EDOARDO RAPOSIO Ricevimento: Students are received by appointment via email "edoardo.raposio@unige.it" FRANCESCO SPAGNOLO Exam Board ANDREA ANTONINI ILARIA BALDELLI MARCO BORGHESI PIERO FREGATTI GUGLIELMO MANTICA FRANCESCO SPAGNOLO CESARE STABILINI PAOLO TRAVERSO GIOVANNI CAMERINI (President and Coordinator of Integrated Course) FEDERICA MARIA MURELLI (President Substitute) FRANCESCO SAVERIO PAPADIA (President Substitute) EDOARDO RAPOSIO (President Substitute) GREGORIO SANTORI (President Substitute) CARLO TERRONE (President Substitute) LESSONS Class schedule The timetable for this course is available here: Portale EasyAcademy EXAMS EXAM DESCRIPTION The final oral examination for this course will involve a board composed by a general surgeon an urologist and a plastic surgeon. ASSESSMENT METHODS The assessment of learning occurs through the final exam, which aims to verify the student’s actual acquisition of the expected learning outcomes. To pass the exam, the student must achieve a grade not lower than 18/30 and demonstrate the following: ·Possession of theoretical knowledge related to the topics covered, with an evaluation of specific knowledge in general surgery, plastic surgery, and urology. ·The ability to critically navigate a diagnostic and therapeutic pathway for pathologies related to general surgery, plastic surgery, and urology, considering the latest guidelines and up-to-date scientific research. ·Effective evaluation of general and specific surgical risk for various surgical procedures, understanding preoperative predictive factors for adverse events and their modifiability. ·Managing the postoperative period for common procedures. ·Proficiency in critically reading scientific articles, understanding their methodology, strength, limitations, and clinical applicability according to evidence-based medicine principles. The final grade, expressed in thirtieths, is influenced by the following factors: ·Ability to comprehensively and critically address the required topics. ·Clarity, correctness, conciseness, and fluency in presentation. ·Mastery of the subject matter. ·Appropriate use of terminology. A grade of 30/30 with honors will be awarded when knowledge and competencies in the subject matter are excellent.
