The ACPGBI 2012 annual conference will be held at the Convention Centre Dublin, Dublin, Ireland from Sunday, 1 - Tuesday, 3 July 2012.
In conjunction with the ACPGBI a group of interested colorectal surgeons and radiologists are intending to set up and run a coordinated training programme for anal ultrasound. This is not meant to replace existing courses but to supplement and augment existing training. Initially the scheme will purely involve educational material on the ACPGBI website with free access to any ACPGBI member. It is hoped that with time the website will grow to include interactive components and self assessment. Eventually an element of assessment may be added to enable trainees to be assessed but it is not intended that this programme / facility will “accredit” surgeons in the interpretation of anal ultrasound.
Initially it is not intended that rectal ultrasound or ano-rectal physiology are included in the syllabus but once the anal scanning component is embedded then these can be added at a later date
Phases of Development
Initial
1. A syllabus has been developed and is posted below.
2. The training will be based upon the B and K platform, but will focus on interpretation of images rather than nuances particular to any company or scanner.
3. Initially the available teaching material will be relatively basic comprising of PowerPoint lectures and “flash” internet based presentations.
4. There will be AVI files to simulate a full examination to enable scroll through the anal canal.
5. A list of available anal ultrasound courses will be compiled, with links to register.
6. A list of interested participants will be kept to allow audit of the results and tracking of progress of the programe.
Intermediate Phase
1. To build up a library of good scans to cover the full curriculum, possibly making these available to applicants on disc via the ACPGBI.
2. To try to standardise the content of national courses in keeping with the curriculum.
3. Further develop the educational material on website to make more interactive (web based learning rather than just presentations).
Later Phase
1. Introduce a form of on line assessment to allow participants to assess their progress.
2. Extend the program to rectal staging scanning.
3. Extend the program to include physiology and functional assessment
AES Training Syllabus
Chapter 1
Principles of ultrasound
What is ultrasound?
What creates the image?
Types of reflection
Relationship between frequency and depth of image
Image resolution
Machine settings
Basic frequency changes
Probe selection / types / frequency selection
TGC settings
Changing preferred settings / setting up favourites
Safety using Ultrasound
Basic facts
Dangers of ultrasound
Getting the best from your machine
3D scanning settings
Reviewing / loading datasets
3D manipulation
Basic volume rendering
Probe sterilisation / cleaning
Chapter 2
Pelvic Floor Anatomy
Pelvic Floor
Levator Ani
EAS
IAS
Longitudinal Muscle
Pubo analis
The perineal body
Transverse perineii
Bulbospongiosus
Gender Differences
Chapter 3
Normal Anal Endosonographic Anatomy
Rectum
Puborectalis
EAS
Longitudinal layer
IAS
Subepithelium
Gender Differences
Puborectalis
EAS (size, shape, reflectivity)
3D Anatomy
Coronal
Sagittal
Oblique Slicing of Volume
Chapter 4
Abnormal Anal Endosonographic Anatomy
Subepithelium
Piles
Thickening / prolapse
Fissure
IAS
Thickening
Thinning
LIAS
Post surgical lay open
Implants
EAS
Atrophy
Asymmetry
Post surgical lay open
Chapter 5
Obstetric Sphincter Damage
Ancillary Muscle damage,
Transverse Perineii
Pubo Analis
Bulbospongiosus
EAS tears
IAS tears
Post repair appearances
Classification of injuries
Scar
Fragmentation
Defect
Cloacal defect
Chapter 6
Anal Sepsis / Fistulae
Internal opening
Intersphincteric abscess
Transphincteric fistula
Appearances with seton
Secondary collections
Horseshoe extension
High ischio-anal sepsis
Supra levator sepsis
Features of Crohns sepsis
The use of hydrogen peroxide
Measuring fistula length
(Volume rendering, 3D manipulation?)
For more information contact Mr Andrew Williams, consultant colorectal surgeon, St Thomas Hospital, London
Tel: 020 7188 2560
This page was last updated on 26-10-2011