Post Graduate Certificate in Ultrasound for General Surgery
Over 3 semesters, the program covers the Fundamentals of Ultrasound scanning and 6 essential modalities encountered in General Surgery including:
- eFAST
- Abdominal Aortic Aneurysm (AAA)
- Hepatobiliary
- Renal
- US guided vascular access and interventional
- Soft tissue and GI
Generic Information
• Limited to 10 candidates per course for effective mentorship
• Blend of online lectures/webinars and in-person practice
• Segmented online lectures aid self-paced learning
• Online portal for resources, mentor interaction, and submissions
• Each candidate is assigned an experienced mentor for year-long guidance
• Facilitation of access to practice machines
• 6-8 in-person intensive practice days per course
• Mandatory practice logbook with scans and pathologies
• Final exam with practical and theoretical elements for course completion.
Learning Outcomes
At the end of the course the candidate should be able to:
• Appreciate the fundamental physics principles relating to ultrasound including the piezoelectric effect, the factors that influence imaging as well as the recognition and differentiation of various artefacts
• Recognise the importance of frequency and the way it impacts probe selection and machine settings
• Understand and utilise the proper terms to annotate images and report scans
• Utilise the various functions on US machines to optimise the scan
• Hold and manipulate the probe effectively being mindful of ergonomics
• Appreciate the anatomy and sonoanatomy of 4 anatomical spaces which will be interrogated for free fluid including the right and left pleural spaces, peritoneum and pericardium. Identify the presence of free fluid in these spaces
• Appreciate the anatomy and sonoanatomy of the pleura. Understand the rationale for lung sliding and the other pleural artefacts. Identify the lung point and its value in sizing a pneumothorax
• Understand the indications, sensitivity and limitations of eFAST scanning. Recognise when to refer for further imaging
• Evaluate the right and left pleural space, peritoneum and pericardium for the presence of free fluid
• Evaluate the pleura to identify a pneumothorax
• Issue a report
• Pathophysiology, epidemiology and anatomy of the abdominal aorta and its branches
• Identify the abdominal aorta, IVC and vertebral body
• Identify the upper abdominal peri-aortic anatomy including the liver, pancreas, portal vein
• Understand the strengths and limitations of Ultrasound in scanning for AAA
• Integrate ultrasound into the management pathway for AAA
• Evaluate the abdominal aorta in both transverse (TS) and longitudinal planes (LS)
• Identify the main branches
• Measure the abdominal aorta correctly in both TS and LS
• How to scan the difficult patient
• Issue a report
• Recognise the sonoanatomy of the hepatobiliary system including the liver, gallbladder, biliary ducts and pancreas. Understand how different approaches and patient positions may optimise the views
• Use a structured approach to interrogate the various hepatobiliary structures including the liver, gallbladder, common duct and pancreas
• Understand and identify the pathologies that affect these structures
• Recognise the limitations of the scan and know when to refer for further imaging.
• Evaluate the liver for pathology
• Diagnose hepatic pathology including lesions, cysts and cirrhosis
• Recognise dilated intra and extra hepatic bile ducts
• Identify and measure the Common Bile Duct
• Recognise gallbladder pathology including calculi, acute and chronic cholecystitis and gallbladder polyps
• Identify and measure the pancreatic duct
• Diagnose pancreatic lesions
• Issue a report
• Appreciate the anatomy and normal sonoanatomy of the renal system including the kidneys, ureters and bladder
• Appreciate and Identify normal anatomical variants
• Use a structured approach to diagnose the more common pathology
• Recognise the limitations of the scan and know when to refer for further imaging.
• Diagnose perinephric collections, renal and bladder lesions, cysts and calculi
• Diagnose and grade hydronephrosis
• Measure bladder wall thickness, bladder and prostate volume
• Issue a report
• Recognize the evidence base underpinning the use of US in interventional procedures vs a landmark approach
• Infection control measures and sterility
• Evaluate the venous anatomy of the upper limb venous system using ultrasound
• Assess vein suitability using the WASPS approach
• Differentiate veins, arteries, nerves, muscles and tendons
• Optimising probe alignment for intervention
• Utilise in-plane and out-of-plane approaches for guided vascular access and interventions such as aspiration
• Use ultrasound to confirm successful cannulation
• Appreciate the sonoanatomy of normal soft tissue
• Recognise the appearance of normal and abnormal lymph nodes
• Diagnose lipomas and differentiate between cellulitis and abscess
• Anatomy, sonoanatomy and pathophysiology of appendicitis
• Alternative differential diagnosis for RIF pain inc ilieitis and adenitis
• Sonoanatomy of small and large intestine
• Pathophysiology and sonoanatomy of intestinal obstruction, enteritis and diverticulitis
• Issue a report