Multicentric Point of Care UltraSound by Surgeons Trial

Summary

Acute gallbladder pathology and acute diverticulitis are common conditions met in emergency departments and comprise the bulk of admissions throughout general surgical calls. Both entities need imagistic description to tailor further management, which may be not readily available at the moment of patient's presentation. These delays may lose the window of opportunity for timed, quality decision making and may induce increased length of stay and subsequent increased costs.

Ultrasound scanning has become very popular over the last half century and the equipment has become more compact, of a higher quality and less expensive, which has facilitated the growth of point-of-care ultrasonography - POCUS - that is, ultrasound performed and interpreted by the clinician at the bedside. The concept of an 'ultrasound stethoscope' is rapidly moving from theory to reality.

There are a number of studies and case reports that are highlighting the advantages of POCUS, but still common grounds need to be sought after. Some countries, like USA and Germany, incorporate basic ultrasound in their resident's curriculum among different specialties.

In the author's knowledge and based on the literature, there are a few-second-to-none studies regarding POCUS involving strictly the surgeons. The hypothesis of this study is that, surgeon performed ultrasound can be as accurate as the radiologists' findings for basic diagnostics in the aforementioned pathology, leading to real time decision making in the benefit of the patient.

The closing remark is that by learning and doing these procedures the surgeon performing POCUS doesn't undermine his/her radiologist colleague's authority and skill. The big picture is that some basic tasks are transferrable and if used in an appropriate and methodical manner the final common goal - the benefit of the patient - is readily achieved.

Conditions

• Biliary Disease
• Gallstone; Cholecystitis, Acute
• Diverticulitis, Colonic
• Abscess Pelvic

Interventions

DIAGNOSTIC_TEST

Point of Care Ultrasound by Surgeons (POCUSS)

POCUSS-1. To identify the gallbladder and it's contents, complications and perform measurements, elicit sonographic Murphy. POCUSS-2: To perform focused left lower quadrant sonography and identify bowel wall thickness, diverticulae, measure the colonic wall thickness, assess pericolic fat and detect possible complications; evaluate sensibility on graded compression.

DIAGNOSTIC_TEST

Radiology report

Radiologist report compared to the point of care ultrasound impression.

PROCEDURE

Surgery-Intra-operative findings

Intra-operative findings compared to the previously performed point of care ultrasound.

Sponsors & Collaborators

• Royal College of Surgeons, Ireland

  collaborator OTHER

• Modular UltraSound ESTES Course (MUSEC)

  collaborator UNKNOWN

• European Society for Trauma and Emergency Surgery

  collaborator OTHER

• Connolly Hospital Blanchardstown

  lead OTHER

Principal Investigators

• Thomas N Walsh, MCh MD FRCSI · Connolly Hospital Blanchardstown; Royal College of Surgeons in Ireland

• Gary A Bass, MBBCh MSc MRCS · Connolly Hospital Blanchardstown; Royal College of Surgeons in Ireland

• Daniel B Dumbrava, MBBCh · Connolly Hospital Blanchardstown; Royal College of Surgeons in Ireland

Eligibility

Min Age

18 Years

Max Age

110 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2015-10-01

Primary Completion

2019-04-30

Completion

2019-05-01

Countries

• Ireland
• Italy
• Portugal
• Spain

Study Locations