Unit GENERAL SURGERY 3

GENERAL SURGERY - MOD. 3

Code	GP004570
Location	PERUGIA
CFU	1
Learning activities	Caratterizzante
Area	Clinica generale medica e chirurgica
Academic discipline	MED/18
Type of study-unit	Obbligatorio (Required)

Cognomi A-L

CFU

1

Teacher

Carlo Boselli

Teachers

• Carlo Boselli

Hours

• 12.5 ore - Carlo Boselli

Language of instruction

Italian

Contents

Chirurgia della milza, peritoneo e fegato
Chirurgia della mammella
Chirurgia dell'Ovaio
Mediastino

Reference texts

Sabiston
Trattato di Chirurgia
Edizioni EDRA

Educational objectives

preparazione teorico-pratica dello Studente nelle principali patologie chirurgiche.

Teaching methods

Lezioni frontali

Learning verification modality

Esame orale

Cognomi M-Z

CFU

1

Teacher

Annibale Donini

Teachers

• Luigina Graziosi (Codocenza)

Hours

• 12.5 ore (Codocenza) - Luigina Graziosi

Language of instruction

ITALIAN

Contents

- The Trauma
- Emergency gastroenterological surgery
- Acute abdomen
- Intestinal obstruction: mechanics, characteristics and treatment
- Pathology of the abdominal wall hernias and incisional hernias
- Pathology of the mesentery, peritoneum and retroperitoneum
- Surgical aspects of the major lesions of the small intestine.
- Surgical indications and surgical treatment of diseases of the
Liver
- Gallbladder and biliary tract: clinical features of cholelithiasis
- Surgical indications and surgical treatment of colorectal diseases
- Surgical indications and surgical treatment of diseases
- Surgical indications and surgical treatment of esophageal pathologies
- Surgical indications and surgical treatment of gastric neoplasms

Reference texts

Sabiston-"Textbook of Surgery"- 18th Edizione - Saunders
CHIRURGIA - Dionigi.

Educational objectives

Know the most important surgical nosologies, make a general abjective examination, specifically oriented towards pathologies of surgical interest, to distinguish the sign and the symptoms of the varions discases to understand the degree of severity of the varions pathologies.

Prerequisites

To the able to understand and face the course, the student must have successfully completed the preparatory exam described in the degree program regulation, in fact, the general knowledge of anatomy , physiology, biochemistry, pharmacology, pathological anatomy and radiodiagnostics are an indispensable prerequisite for the student who wants to follow the course successfully

Teaching methods

Lecture and pratical activities.
Meeting.

Other information

Learning verification modality

The exam includes an oral test consisting of a discussion-interview of about 30 minutes long aimed to ascertaining the level of knowledge and the capacity of understanding acquired by the student , judging also the properties of language and exposure

Extended program

The Trauma
- Initial evaluation and first surgical treatment of the traumatized person
- Child's trauma, in adults and in pregnancy
- Specific types of trauma:
a) cranial and spinal
b) cervico-thoracic
c) abdominal and perineal
d) retroperitoneal (lumbar and pelvic)
- Non-operative treatment of closed abdominal traumas.
Emergency gastroenterological surgery
- Gastrointestinal haemorrhage:
a) initial treatment
b) clinical evaluation and differential diagnosis
- Indication to the surgical therapy of:
a) bleeding peptic ulcer
b) rupture of esophageal varices
c) hemorrhagic erosive gastritis
d) diverticular hemorrhage
e) angiodysplasia
f) hemorrhage of unknown origin
- Shock classification etiopathogenesis metabolic alterations
and of microcirculation and therapy.
Acute abdomen:
- Abdominal pain: features of onset, localization, frequency and severity.
- Acute abdomen from:
a) acute appendicitis
b) acute disease from Cronh's disease
c) perforated gastric and duodenal ulcer
d) acute cholecystitis
e) acute pancreatitis
f) acute diverticulitis
- Vascular emergencies
- Intestinal obstruction: mechanics, characteristics and treatment:
a) treatment of specific problems of ileal occlusion:
- from post-operative adhesions
- from complications of hernias
- from intussusception
- from early post-operative occlusion
- from peritoneal carcinosis
- biliary ileum
- from Crohn's disease
- from actinic enteritis.
b) treatment of specific problems of colonic occlusion:
- from cancer obstruction
- from volvulus
- from diverticular stenosis
- postoperative paralytic ileus
- from peritonitis
- pseudo colonic occlusion
Pathology of the abdominal wall Hernias and incisional hernias
Pathology of the mesentery, peritoneum and retroperitoneum
- Peritonitis: classification of clinical and instrumental diagnostic etiopathogenesis, therapy
- Peritoneal retro peritoneal neoplasms
Clinical and surgical staging
Concepts of radical and palliative surgery
New technologies in oncological surgery: Locoregional chemotherapy, IORT.
Surgical indications and surgical treatment of:
- Benign esophagus disorders
- Hiatal hernia: clinical features
- Purpose of surgical therapy and types of surgical procedures
- Benign esophageal strictures:
clinics and differential diagnosis
- Esophageal diverticula: by Zencher, by traction, by drive
- Achalasia
- Esophagus neoplasms
- Preoperative evaluation and types of surgical procedures
- Post-operative treatment and results
- Leiomyoma of the esophagus
- Peptic ulcer: clinical features and its complications
- Gastric neoplasms: clinical features with particular regard to the site of the type of metastatic spread. Treatment with curative intent with particular regard to lymphadenectomy.
Surgical aspects of the major lesions of the small intestine.
- Trauma
- Occlusion
- Diverticula
- Crohn's disease
- Neoplasms
Surgical indications and surgical treatment of:
- Liver: surgical anatomy
a) cysts and abscesses
b) benign neoplasms
c) hepatocarcinoma: clinical features
d) surgical therapy: selection of patients, types of surgical procedures, transplantation.
e) Alternative therapies
f) Metastatic liver cancer: purpose of surgical treatment
g) Principles of liver surgery
- Portal hypertension: surgical indications and types of treatment
surgical.
- Gallbladder and biliary tract: clinical features of cholelithiasis
a) clinical syndromes associated with cholelithiasis
b) cholecystectomy: open or laparoscopic
c) concepts of minimally invasive surgery
d) stenosis of the biliary tract: comparative surgical treatment
e) cancer of the gallbladder and biliary tract: clinical features.
Surgical indications and surgical treatment of:
a) exocrine pancreas
b) acute and chronic pancreatitis: surgical treatment vs medical and endoscopic treatment
c) pancreatic and periampullary neoplasia: clinical features
d) surgical treatment: pre-operative preparation and selection of patients, concept of resectability
e) curative treatment, palliative treatment
f) surgical results
g) tumors of the endocrine pancreas: localization problems
h) principles of pancreatic surgery.
Spleen: indications for splenectomy
Surgical indications and surgical treatment of colorectal diseases:
a) chronic inflammatory bowel diseases: clinical features.
b) Polyps and polypose syndromes: surgical options.
c) Malignant neoplasms: clinical features surgical treatment.
1) Benign lesions of the breast
2) Malignant lesions of the breast: clinical features
3) Surgical treatment of neoplasms: extension of surgery, lymphadenectomy, sentinel lymph node
4) Surgical treatment of male breast cancer
5) Breast reconstruction after mastectomy.
Surgical indications and surgical treatment de:
1) Solitary thyroid nodule
2) Multinodular goiter
3) Thyroiditis
4) Hyperthyroidisms
5) Differentiated thyroid carcinoma
6) Medullary carcinoma of the thyroid and multiendocrine syndromes
7) Anaplastic thyroid carcinoma
8) Principles of thyroid surgery and its complications.

GENERAL SURGERY - MOD. 4

Code	GP004571
Location	PERUGIA
CFU	1
Learning activities	Caratterizzante
Area	Clinica generale medica e chirurgica
Academic discipline	MED/18
Type of study-unit	Obbligatorio (Required)

Cognomi A-L

CFU

1

Teacher

Piero Covarelli

Teachers

• Piero Covarelli

Hours

• 12.5 ore - Piero Covarelli

Language of instruction

Italian (english explanation available on demand)

Contents

The basis of the surgical oncology (staging systems, Prognostic assessment and integrated treatments)

More frequent non-oncological surgical pathologies

Reference texts

Sabiston Textbook of Surgery, The Biological Basis of Modern Surgical Practice, 20th Edition

Sabiston Textbook of Surgery, 18 Edizione in lingua italiana, Saunders Company, Philadephia

Educational objectives

To know the most important surgical nosology, to do a general objective examination, specifically oriented to the pathologies of surgical interest, to distinguish the signs and symptoms of the various affections, to understand the degree of severity of the different pathologies.

Prerequisites

To be able to understand the course, the student must have successfully passed the preparatory examinations as described in the course rule book.
The knowledge of general notions of anatomy, pathology and radiology is a prerequisite for the student who wants to follow the course with profit.

Teaching methods

face to face
operating room attendance
Distance online didactic on TEAMS platform

Other information

Site of the course:
Facoltà di Medicina e Chirurgia, Building B, Floor -2, S.Andrea delle Fratte, Perugia

Learning verification modality

The exam provides an oral test that consists of a discussion aimed at assessing the level of knowledge, comprehension and synthesis achieved by the student as well as checking the acquisition of method, language and exposure properties.
The interview takes place in the various thematic areas that characterize teaching with a duration of about 15/30 min, varying in relation to the evolution of the test itself

For information on support services for students with disabilities and / or SLD, visit the page http://www.unipg.it/disabilita-e-dsa

Extended program

Inflammatory Bowel Diseases; clinical features, diagnosis, relationship with colonic cancer and principles of surgical management.
Benign proctology; hemorroids, anal fissures, fistulas, abscesses and rectocele.
Surgical treatment of melanoma and soft tissue neoplasms: Lymphectomies, The Sentinel Node Concept , Isolated Limb Perfusions and Infusions, Electrochemotherapy
Soft tissues sarcomas
GI bleeding, gastric cancer and ulcer
Intestinal ischemia.
Hernias

Cognomi M-Z

CFU

1

Teacher

Annibale Donini

Teachers

• Emanuel Cavazzoni (Codocenza)
• Annibale Donini

Hours

• 7.5 ore (Codocenza) - Emanuel Cavazzoni
• 12.5 ore - Annibale Donini

Language of instruction

Italian

Contents

-Surgical indications and treatment of liver diseases
-Surgical indicatios andtreatment of pancreatic neoplasms

Reference texts

Sabiston-"Textbook of Surgery"- 18th Edizione - Saunders
CHIRURGIA – Dionigi

Educational objectives

Know the most important surgical nosologies, make a general abjective examination, specifically oriented towards pathologies of surgical interest, to distinguish the sign and the symptoms of the varions discases to understand the degree of severity of the varions pathologies.

Prerequisites

To the able to understand and face the course, the student must have successfully completed the preparatory exam described in the degree program regulation, in fact, the general knowledge of anatomy , physiology, biochemistry, pharmacology, pathological anatomy and radiodiagnostics are an indispensable prerequisite for the student who wants to follow the course successfully

Teaching methods

Lecture and pratical activities.
Meeting.

Other information

Learning verification modality

The exam includes an oral exam consisting of a discussion lasting about 30 minutes aimed at ascertainig the levels of knowledge, the ability to understand and synthesis achieved by the student as well as verifyng the acquisition of methodologies of launguage and exposure.

Extended program

Surgical indications and surgical treatment of:
- Liver: surgical anatomy
a) cysts and abscesses
b) benign neoplasms
c) hepatocarcinoma: clinical features
d) surgical therapy: selection of patients, types of surgical procedures, transplantation.
e) Alternative therapies
f) Metastatic liver cancer: purpose of surgical treatment
g) Principles of liver surgery
- Portal hypertension: surgical indications and types of surgical treatment.
- Surgical indications and surgical treatment of the pathologies of:
a) exocrine pancreas
b) acute and chronic pancreatitis: surgical treatment vs medical and endoscopic treatment
c) pancreatic and periampullary neoplasia: clinical features
d) surgical treatment: pre-operative preparation and selection of patients, concept of resectability
e) curative treatment, palliative treatment
f) surgical results
g) tumors of the endocrine pancreas: localization problems
- Surgical indications and surgical treatment of:
endocrine pancreas
g) tumors of the endocrine pancreas: localization problems

GENERAL SURGERY - MOD. 5

Code	GP004572
Location	PERUGIA
CFU	1
Learning activities	Caratterizzante
Area	Clinica generale medica e chirurgica
Academic discipline	MED/18
Type of study-unit	Obbligatorio (Required)

Cognomi A-L

CFU

1

Teacher

Francesco Barberini

Teachers

• Francesco Barberini

Hours

• 12.5 ore - Francesco Barberini

Language of instruction

Italian

Reference texts

R. Dionigi: Chirurgia. Basi teoriche e chirurgia generale-Chirurgia specialistica: 1-2 (ed. 2017)

Sabiston textbook of Surgery

Educational objectives

The students will be able to: know the surgical pathology and the treatment of surgical deseases

Teaching methods

Face-to-face

Learning verification modality

oral exam

Extended program

Benign and malignant pathology of the breast (general aspects, epidemiology, risk factors, pathological anatomy of lesions, histopathological classification, indications and description of surgical interventions with operating technique notes.)

Acute appendicitis (historical notes pathophysiology, classification, clinical symptoms and signs, laboratory and instrumental examinations, medical and surgical therapy)

Pathology of the biliary tract: cholelithiasis, acute cholecystitis, obstructive jaundice (pathophysiology, classification, clinical signs and symptoms, laboratory and instrumental examinations, medical and surgical therapy)

Acute abdomen: peritonitis, traumatic hemoteritoneum, visceral perforations, intestinal occlusion (pathophysiology, classification, clinical signs and symptoms, laboratory and instrumental examinations, medical and surgical therapy)

Surgical pathology of colon, rectum and anus: diverticulosis / diverticulitis, neoplasms, hemorrhoidal disease (pathophysiology, classification, clinical signs and symptoms, laboratory and instrumental examinations, medical and surgical therapy)

gastrointestinal bleeding : (pathophysiology, classification, clinical signs and symptoms, laboratory and instrumental examinations, medical and surgical therapy)

Surgical pathology of the stomach: (neoplasms, peptic disease, GERD, gastritis (pathophysiology, classification, clinical signs and symptoms, laboratory and instrumental examinations, medical and surgical therapy)

- Hernia and incisional hernia

Cognomi M-Z

CFU

1

Teacher

Annibale Donini

Teachers

• Annibale Donini

Hours

• 12.5 ore - Annibale Donini

Language of instruction

Italian

Contents

Surgical indications and surgical treatment of colorectal diseases.
- Malignant neoplasms clinical features surgical treatment: colorectal, trasversus, descending colon, sigmaid rectum.
- clinical feature and surgical problems : colon diverticular disease, rectal prolapse, hemorrhoids, fistulas and perianal abscesses, pilonidal disease, neoplasms of the anus.

Reference texts

Sabiston-"Textbook of Surgery"- 18th Edizione - Saunders.
Chirurgia- Dionigi

Educational objectives

Know the most important surgical nosologies, make a general abjective examination, specifically oriented towards pathologies of surgical interest, to distinguish the sign and the symptoms of the varions discases to understand the degree of severity of the varions pathologies.

Prerequisites

To the able to understand and face the course, the student must have successfully completed the preparatory exam described in the degree program regulation, in fact, the general knowledge of anatomy , physiology, biochemistry, pharmacology, pathological anatomy and radiodiagnostics are an indispensable prerequisite for the student who wants to follow the course successfully

Teaching methods

Lecture and pratical activities.
Meeting.

Other information

Learning verification modality

The exam includes an oral test consisting of a discussion-interview of about 30 minutes long aimed to ascertaining the level of knowledge and the capacity of understanding acquired by the student , judging also the properties of language and exposure

Extended program

Surgical indications and surgical treatment of colorectal disease:
chronic inflammatory intestinal diseases, clinical features.
- Elective and Emergency surgical treatment , ileostomies, ileoananastomoses. The pouch and its complications. Polyposis polyps and syndromes.
- Malignant neoplasmsclinical features, surgical treatment: colorectal, transverse, descending colon, sigma, rectum, colorectal cancer follow:
treatmen of relapses and and hepatic metastases.
- Clinical characteristics and surgical problems of: diverticular disease of the colon, rectal prolapse, hemonrrhoids fistulae and perianal accesses,
pilonidal disease, neoplasms of the anus.

GENERAL SURGERY - MOD. 6

Code	GP004573
Location	PERUGIA
CFU	1
Learning activities	Caratterizzante
Area	Clinica generale medica e chirurgica
Academic discipline	MED/18
Type of study-unit	Obbligatorio (Required)

Cognomi A-L

CFU

1

Teacher

Piero Covarelli

Teachers

• Piero Covarelli

Hours

• 12.5 ore - Piero Covarelli

Language of instruction

Italian (english explanation available on demand)

Contents

The basis of the surgical oncology (staging systems, Prognostic assessment and integrated treatments)

The most common non-oncological diseases of surgical relevance

Reference texts

Sabiston Textbook of Surgery, The Biological Basis of Modern Surgical Practice, 20th Edition

Sabiston Textbook of Surgery, 18 Edizione in lingua italiana, Saunders Company, Philadephia

Educational objectives

To know the most important surgical nosology, to do a general objective examination, specifically oriented to the pathologies of surgical interest, to distinguish the signs and symptoms of the various affections, to understand the degree of severity of the different pathologies.

Prerequisites

To be able to understand the course, the student must have successfully passed the preparatory examinations as described in the course rule book.
The knowledge of general notions of anatomy, pathology and radiology is a prerequisite for the student who wants to follow the course with profit.

Teaching methods

face to face
Operating room attendance
Distance online didactic using the platform Microsoft Teams

Other information

Site of the course:
Facoltà di Medicina e Chirurgia, Building B, Floor -2, S.Andrea delle Fratte, Perugia

Learning verification modality

The exam provides an oral test that consists of a discussion aimed at assessing the level of knowledge, comprehension and synthesis achieved by the student as well as checking the acquisition of method, language and exposure properties.
The interview takes place in the various thematic areas that characterize teaching with a duration of about 15/30 min, varying in relation to the evolution of the test itself

For information on support services for students with disabilities and / or SLD, visit the page http://www.unipg.it/disabilita-e-dsa

Extended program

Colon and rectum neoplasms
Gastric cancer
Shocks and hydro-electrolytic imbalances
Acute and chronic pancreatitis, pancreatic tumors.
Spleen diseases.
Thyroid diseases
Adrenal disorders of surgical interest
Portal hypertension
Neoplasms of the liver
Ileal neoplasmas; Merkel diverticula diseases.
Transplants

Cognomi M-Z

CFU

1

Teacher

Annibale Donini

Teachers

• Roberto Cirocchi (Codocenza)

Hours

• 12.5 ore (Codocenza) - Roberto Cirocchi

Language of instruction

Italian

Contents

The aim of the course is to offer at the students a clinical summary of digestive surgery.

Reference texts

Minni F. Chirurgia generale. Casa Editrice Ambrosiana. 2019

Educational objectives

The aim of the course is to provide students with a general overview of the diagnostic-therapeutic pathways in digestive surgery. In addition, the student should be know the main symptoms and clinical signs related to different digestive diseases.

Prerequisites

Basic knowledge is need in anatomy, pathophysiology, semeiotic and surgical pathology.

Teaching methods

Front-end lessons using powerpoint projections. The lesson material (except copyright-protected illustrations) is always made available to students electronically (file in pdf) the day before the lesson on the ateneum platform: https://www.unistudium.unipg.it/unistudium/login/index.php.

Other information

Learning verification modality

Interview

Extended program

Acute appendicitis and their complications
Diverticular disease and their complications
Internal and external abdominal hernia
The gallbladder lithiasis and its complications.
Acute and chronic pancreatitis and its complications.
The complicated peptic ulcer.

PROFESSIONALISING TRAINING IN GENERAL SURGERY I

Code	GP005571
Location	PERUGIA
CFU	1
Learning activities	Altro
Area	Tirocini formativi e di orientamento
Academic discipline	MED/18
Type of study-unit	Obbligatorio (Required)

Cognomi A-L

CFU

1

Teacher

Carlo Boselli

Teachers

• Carlo Boselli

Hours

• 25 ore - Carlo Boselli

Language of instruction

Italian

Contents

Initial evaluation and first surgical therapies in politrauma. Kinds of trauma

Reference texts

Sabiston "Textbook of Surgery" 18th edition

Educational objectives

The student will be able to know the most important surgical pathologies, to perform a correct clinical examination and specifically a surgical-oriented examination, to distinguish the signs and symptoms of the different affections and finally to uderstand the severity degree of every single disease

Prerequisites

nobody

Teaching methods

Departmental activities frequency

Learning verification modality

Oral exam

Extended program

Trauma: -initial evaluation and first surgical therapies in politrauma.
-trauma in children, adult and pregnant patients
-Kinds of trauma:
a) cranial and spinal
b) cervical and thoracic
c) abdominal and perineal
d) retroperitoneal
e) Non operative treatment of close abdominal trauma

Cognomi M-Z

CFU

1

Teacher

Annibale Donini

Teachers

• Annibale Donini

Hours

• 25 ore - Annibale Donini

Language of instruction

Italian

Contents

- Attending surgical visits in Surgical Surgery
- Attend the visit to the ward.
- Completions Forms of informed consent
- Compilation of the Clinical Folder
- Preparation of a sterile field for minor surgery

Reference texts

Educational objectives

To know and be able to fill in motivated requests for diagnostic, laboratory and instrumental investigations, providing relevant clinical information, explaining the methods of execution, motivations and risks to the patient.
Knowing how to fill in a medical record, know how to perform surgical prophylaxis procedures.
Knowing how to perform sterilization procedures for surgical field preparation for outpatient surgery

Prerequisites

Teaching methods

Frequency in Department and Surgery Clinic

Other information

Learning verification modality

Exercises

Extended program

- Perform an objective examination of the abdomen.
- Knowing how to complete the informed consent form. Compilation of the clinical record.
- Prepare a sterile field for minor surgery
- Perform dressings of external lesions and removal of sutures.

PROFESSIONALISING TRAINING IN GENERAL SURGERY II

Code	GP005572
Location	PERUGIA
CFU	1
Learning activities	Altro
Area	Tirocini formativi e di orientamento
Academic discipline	MED/18
Type of study-unit	Obbligatorio (Required)

Cognomi A-L

CFU

1

Teacher

Piero Covarelli

Teachers

• Piero Covarelli

Hours

• 25 ore - Piero Covarelli

Cognomi M-Z

CFU

1

Teacher

Annibale Donini

Teachers

• Annibale Donini

Hours

• 25 ore - Annibale Donini

Language of instruction

Italian

Contents

- Attending surgical visits in Surgical Surgery
- Attend the visit to the ward.
- Completions Forms of informed consent
- Compilation of the Clinical Folder
- Preparation of a sterile field for minor surgery

Reference texts

Educational objectives

To know and be able to fill in motivated requests for diagnostic, laboratory and instrumental investigations, providing relevant clinical information, explaining the methods of execution, motivations and risks to the patient.
Knowing how to fill in a medical record, know how to perform surgical prophylaxis procedures.
Knowing how to perform sterilization procedures for surgical field preparation for outpatient surgery

Prerequisites

Teaching methods

Frequency in Department and Surgery Clinic

Other information

Learning verification modality

Exercises

Extended program

- Perform an objective examination of the abdomen.
- Knowing how to complete the informed consent form. Compilation of the clinical record.
- Prepare a sterile field for minor surgery
- Perform dressings of external lesions and removal of sutures.