Kompetensi Kolegium Bedah Vaskular [PDF]

Citation preview

SURAT KETERANGAN KOMPETENSI BEDAH VASKULAR DAN ENDOVASKULAR Nomor : 08/KOLEGIUM-VASK & ENDO/IV/2019 Kategori Kewenangan Kewenangan klinis diberikan untuk memberikan pelayanan pengelolaan bidang vaskuler dan endovaskuler, Departemen Ilmu Bedah RSCM berdasarkan pada pelayanan yang dibutuhkan pasien. Kategori I Penyakit atau masalah kesehatan yang sederhana, tanpa penyulit, resiko pasien rendah. Dapat ditangani oleh dokter umum dengan pelatihan singkat/tanpa pelatihan namun sudah cukup berpengalaman. Jenis Pelayanan RINCIAN BERDASARKAN PENYAKIT Raynaud’s disease Arterial thrombosis Coarctation of the aorta Burger's disease Arterial embolism Atherosclerosis Subclavian steal syndrome Aortic aneurysm Dissecting aneurysm Claudicatio Cardiogenic shock Septic shock Hypovolemic shock Varices (primary, secondary) Obstructed venous return Deep vein thrombosis Thrombophlebitis Lymphangitis Lymphadenitis Lymphedema, primary and secondary Traumatic vessel injury RINCIAN KETRAMPILAN KLINIS Palpation of pulse Palpation of arterial pulses Detection of bruits Doppler examination Sclerotherapy for varicose veins Intravenous cannulation Trendelenburg test Perthes test Posture tests of arterial insufficiency and Ankle-Brachial Index Reactive hyperaemia test of arterial insufficiency Capillary refill Assessment and care external injuries (wounds, Bleeding, burns, distortion, dislocation, fractures) Stop bleeding (direct pressure, pressure point, Pressure bandage) First aid Apply a bandage Fluid rescucitation Arteriography Ct, mri, ulrasound



Diminta



Rekomendasi



1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1



1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1



1



1



1 1 1 1 1



1 1 1 1 1



Pre-operative preparation of operative field for Minor surgery, asepsis, antisepsis, local anaesthesia Preparation to watch/to assist in theatre scrub-up, Gown up, put on sterile gloves etc) Infiltration anaesthesia Local nerve block Incision and drainage of abscess Wound cleaning Wound debridement with scalpel and scissors Injection of varices with sclerosant To apply a dressing (sling, shoulder bandage, finger Bandage, hand bandage) Treatment of leg ulcers To apply a dressing (leg bandage, foot bandage, Ankle bandage, knee bandage)



1



1



1



1



1 1 1 1 1 1 1



1 1 1 1 1 1 1



1 1



1 1



Kategori II Termasuk kewenangan klinis kategori I. Penyakit/masalah kesehatan/prosedur yang kompleks namun tidak mengancam nyawa. Telah melewati stase Divisi Departemen Ilmu Bedah FKUI-RSCM; sedang menjalani pelatihan dan pendidikan spesialisasi di Departemen Ilmu Bedah FKUI-RSCM. Jenis Pelayanan Bedah Vaskuler: Brescia-Cimino fistula creation CDL for hemodialysis access, temporary and semipermanent Port A Cath / Celsite implantation for access in chemotherapy or nutrition Management in emergency major vascular trauma: Control Hemmorrhage Venous Cutdown in Vascular Access Peripheral Artery Cannulation Gradual External Compression in Vascular Disease Wound Management in Vascular Cases Anticoagulant Therapy in Vascular Cases Post Operative management in Vascular Patient Non-invasive Testing for Vascular Disease: ABI and TBI Sclerotherapy Splenectomy in portal hypertension Simple vascular recontruction in peripheral artery trauma. Debridement and Amputation in Diabetic Foot Emergency Trombectomy/Embolectomy in Peripheral Artery Hemangioma Excision Clinical and Diagnostic Evaluation of the Patient with Deep Venous Thrombosis Prevention and Medical Treatment of Acute Deep Venous Thrombosis Varicose Veins: Treatment by Intervention Including Sclerotherapy Phlebectomy Greater Saphenous Vein High Ligation, Stripping, Perforantes Ligation Superficial Thrombophlebitis: Diagnosis and Management Clinical and Diagnostic Evaluation of Patients with Chronic Venous Disorders Nonoperative Treatment of Chronic Venous Insufficiency Clinical diagnosis and evaluation of lymphedema Nonoperative management of chronic lymphedema Upper extremity amputation: Indication, Operative Technique and Perioperative Management Lower extremity amputation: : Indication, Operative Technique and Perioperative Management



Diminta



Rekomendasi



1 1 1



1 1 1



1



1



1 1 1 1 1 1 1 1 1 1 1 1 1 1



1 1 1 1 1 1 1 1 1 1 1 1 1 1



1 1 1 1 1 1



1 1 1 1 1 1



1 1 1 1



1 1 1 1



1



1



Kategori III Termasuk kewenangan klinis kategori I dan II. Penyakit/masalah kesehatan/prosedur yang kompleks dan potensial mengancam nyawa. Telah menyelesaikan pelatihan dan pendidikan spesialisasi di Departemen Ilmu Bedah FKUIRSCM. Jenis Pelayanan Bedah Vaskular: Brescia-Cimino fistula creation CDL for hemodialysis access, temporary and semipermanent Port A Cath / Celsite implantation for access in chemotherapy or nutrition Management in emergency major vascular trauma: Control Hemmorrhage Venous Cutdown in Vascular Access Peripheral Artery Cannulation Gradual External Compression in Vascular Disease Wound Management in Vascular Cases Anticoagulant Therapy in Vascular Cases Post Operative management in Vascular Patient Non-invasive Testing for Vascular Disease: ABI and TBI Sclerotherapy Splenectomy in portal hypertension Simple vascular recontruction in peripheral artery trauma. Debridement and Amputation in Diabetic Foot Emergency Trombectomy/Embolectomy in Peripheral Artery Hemangioma Excision Clinical and Diagnostic Evaluation of the Patient with Deep Venous Thrombosis Prevention and Medical Treatment of Acute Deep Venous Thrombosis Varicose Veins: Treatment by Intervention Including Sclerotherapy Phlebectomy Greater Saphenous Vein High Ligation, Stripping, Perforantes Ligation Superficial Thrombophlebitis: Diagnosis and Management Clinical and Diagnostic Evaluation of Patients with Chronic Venous Disorders Nonoperative Treatment of Chronic Venous Insufficiency Clinical diagnosis and evaluation of lymphedema Nonoperative management of chronic lymphedema Upper extremity amputation: Indication, Operative Technique and Perioperative Management Lower extremity amputation: : Indication, Operative Technique and Perioperative Management



Diminta



Rekomendasi



1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1



1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1



1 1 1 1 1 1



1 1 1 1 1 1



1 1 1 1



1 1 1 1



1



1



Kategori IV Termasuk kewenangan klinis kategori I, II dan III. Penyakit/masalah kesehatan/prosedur yang khusus atau kompleks dan potensial mengancam nyawa di bidang Divisi Vaskuler dan Endovaskuler. Telah menyelesaikan pelatihan dan pendidikan subspesialisasi di Departemen Ilmu Bedah FKUI-RSCM. Jenis Pelayanan Diagnosis dan Tata Laksana Penyakit Aneurisma Termasuk: Aortic dan Iliac Artery Aneurysms Peripheral Artery Aneurysms Extra-cranial Carotid Aneurysms Subclavian/Axillary Artery Aneurysms Femoral/Popliteal Artery Aneurysms Splanchnic dan Renal Artery Aneurysms Thoracoabdominal Aortic Aneurysms Thoracic Aortic Aneurysms Thoracic/Abdominal Aortic Dissection Diagnosis dan Tata Laksana Penyakit Sumbatan Arteri Ekstremitas (Extremity Arterial Occlusive Disease) Termasuk: Aortoiliac Occlusive Disease Femoral-Popliteal-Tibial Occlusive Disease Upper Extremity Occlusive Disease Combined Aortoiliac dan Infrainguinal Occlusive Disease Arterial Bypass Graft Surveillance Failing Arterial Bypass Graft Ischemic Foot Lesions Diagnosis dan Tata Laksana Penyakit Sumbatan Arteri Renalis (Renal Artery Occlusive Disease) Termasuk: Renovascular Hypertension Ischemic Nephropathy Renal Artery Surgery Renal Angioplasty Diagnostic Studies to Detect Functionally Significant Renal Artery Stenosis Tambahan yang Penting/Topik Kurikulum Non-Inti: Renal Arteriovenous Fistulae Diagnosis dan Tata Laksana Iskhemi Pembuluh Darah Visceral Termasuk: Chronic Visceral Ischemia Acute Visceral Ischemia Non-Occlusive Mesenteric Ischemia Mesenteric Venous Occlusive Disease Tambahan yang Penting/Topik Kurikulum Non-Inti: Celiac/SMA Compression Diagnosis dan Tata Laksana Penyakit Sumbatan Arteri Karotis (Carotid Artery Occlusive Disease) Termasuk: Atherosclerotic Carotid Artery Disease Carotid Artery Fibromuscular Dysplasia Carotid Artery Coils dan Kinks Carotid Artery Radiation Injury Carotid Body Tumor Tata Laksana Stroke Komprehensif Spontaneous Carotid Artery Dissection Atherosclerotic Aortic Arch Disease Leading to Proximal Carotid Artery Stenosis Diagnosis dan Tata Laksana Penyakit Arteri Innominate, Subclavian dan Vertebrobasilar Termasuk: Stenotic dan Embolic Innominate Artery Disease Stenotic dan Embolic Vertebral Artery Disease Stenotic dan Embolic Subclavian Artery Disease Subclavian Steal Syndrome Tambahan yang Penting/Topik Kurikulum Non-Inti: Vertebral Arteriovenous Fistulae Diagnosis dan Tata Laksana Thoracic Outlet Syndrome Termasuk:



Diminta



Rekomendasi



1



1



1



1



1



1



1



1



1



1



1



1



1



1



Cervical Rib/Abnormal First Rib Arterial Complications Venous Complications Neurogenic Complications Diagnosis dan Tata Laksana Sumbatan Arteri Akut Termasuk: Acute Thrombotic Disease Atheroembolic Disease Thromboembolectomy Techniques Thrombolysis: Percutaneous & Intraoperative Komplikasi Sistemik pada Reperfusion Injury Compartment Syndrome Diagnosis dan Tata Laksana Permasalahan Kaki Diabetik (Diabetic Foot Problems) Termasuk: Pathophysiology Ischemia, Neuropathy dan Infection Antibiotic Treatment Amputation Types Wound Management Foot Care Tambahan yang Penting/Topik Kurikulum Non-Inti: Orthotic Management Diagnosis dan Tata Laksana Komplikasi Tindakan Vaskular Termasuk: Pseudoaneurysms Aortoenteric Fistulae/Erosions Vascular Graft Infections Colon Ischemia after Aortic Surgery Chronic Perigraft Seromas Occluded Prosthetic Grafts Prosthetic Graft Dilation Diagnosis dan Tata Laksana Trauma Vaskular Termasuk: Aortic Trauma Carotid Trauma Brachiocephalic Trauma Visceral Arterial Trauma Extremity Trauma Venous Trauma Diagnosis Vascular Trauma - Arteriography/Duplex Nonoperative Therapy Traumatic A-V Fistulas Iatrogenic Vascular Trauma Tambahan yang Penting/Topik Kurikulum Non-Inti: Associated Neural Injury Diagnosis dan Tata Laksana Penyakit Tromboemboli Vena (Venous Thromboembolic Disease) Termasuk: Deep Venous Thrombosis Deep Venous Thrombosis Prophylaxis Pulmonary Emboli Caval Interruption Subclavian/Axillary Thrombosis Venous Thrombectomy/Thrombolytic Therapy Anticoagulation Tambahan yang Penting/Topik Kurikulum Non-Inti: Acute Caval Thrombosis Syndrome Pulmonary Embolectomy (open & catheter based) Renal Vein Thrombosis Budd-Chiari Syndrome Diagnosis dan Tata Laksana Insufisiensi Vena Kronik (Chronic Venous Insufficiency) Termasuk: Noninvasive Diagnosis Medical Treatment Sclerotherapy Surgical Reconstruction including Subfascial Ligation Perforators, Valvular Congenital Causes Diagnosis dan Tata Laksana Limfedema Indications dan Techniques for Extremity Amputation Termasuk:



1



1



1



1



1



1



1



1



1



1



1



1



1 1



1 1



Determination Amputation Level Tambahan yang Penting/Topik Kurikulum Non-Inti: Post-Amputation Care Prosthetic Management Rehabilitation Phantom Pain Symptoms Techniques for the Diagnosis Peripheral Vascular Disease Termasuk: Hemodynamic Assessment Arterial dan Venous Disease Duplex Evaluation Carotid, Venous, Mesenteric, Renal and Extremity Vascular Disease Arteriography Computerized Tomography MRI/MRA Intraoperative Duplex Evaluation Tambahan yang Penting/Topik Kurikulum Non-Inti: Intravascular Ultrasound Penggunaan Terapi Endovaskuler pada Tata Laksana Penyakit Pembuluh Darah Perifer Termasuk: Lytic Therapy Balloon Angioplasty Endoluminal Stents Stent Grafts Angioscopy Endoluminal Ultrasound Embolization Stratifikasi Risiko pada Pasien dengan Penyakit Pembuluh Darah Perifer Termasuk: Cardiac Risk Evaluation Pulmonary Risk Evaluation Atherosclerotic Risk Factor Assessment Lipid Disorder Evaluation dan Tata Laksana Diagnosis dan Tata Laksana Gangguan Koagulasi pada Pasien Penyakit Pembuluh Darah Perifer Termasuk: Bleeding Disorders/Intraoperative Bleeding Heparin Associated Thrombocytopenia Hypercoagulable States Low Molecular Weight Heparin Antiplatelet Agents Including Ticlopidine Diagnosis dan Tata Laksana Berbagai Permasalahan Umum Vaskulogenik Termasuk: Vasospastic Diseases Neurogenic Thoracic Outlet Syndrome Causalgia/Reflex Sympathetic Dystrophy Tambahan yang Penting/Topik Kurikulum Non-Inti: Vasculogenic Impotence Pediatric Vascular Disorders Frostbite Diagnosis dan Tata Laksana Penyakit Vaskuler Non-Atherosclerotic Termasuk: Systemic Vasculitis Giant Cell Arteritis Takayasu’s Disease Radiation Induced Arterial Disease Arterial Infections Adventitial Cystic Disease Popliteal Entrapment Syndrome Buerger’s Disease Congenital Problems Coarctation Persistent Sciatic Artery Aberrant Subclavian Artery Arteriopathies Marfan’s Syndrome Ehlers-Danlos Syndrome



1



1



1



1



1



1



1



1



1



1



1



1



Arterial Magna Syndrome Cystic Medical Necrosis Behcet’s Disease Homocystinuria Intra-Arterial Drug Induced Injury Diagnosis dan Tata Laksana Arterial Venous Malformations Termasuk: Manajemen Surgical, Catheter dan Nonoperative Angiodysplasias Indikasi dan Teknik Akses Vaskuler Termasuk: Vascular Access for Hemodialysis Ischemic Hdan After Vascular Access Peripheral Dialysis Access Indikasi dan Hasil pada Simpatektomi pada Pasien dengan Penyakit Arteri Perifer Diagnosis dan Tata Laksana Portal Hypertension Medical Management of PAD/PVD Endovascular Treatment of Aortic Aneurysms Ruptured Abdominal Aortic Aneurysms Thoracoabdominal Aortic Aneurysm Aortic Dissection: Perspectives for the Vascular/Endovascular Surgeon Lower Extremity Aneurysms Upper Extremity Aneurysms Splanchnic Artery Aneurysms Infected Aneurysms Diagnostic Evaluation of Arteriovenous Fistulas and Vascular Anomalies Arteriovenous Fistulas of the Aorta and Its Major Branches Traumatic Arteriovenous Fistulas: Diagnosis and Management Vascular Tumors and Malformations in Childhood Surgical Management of Vascular Malformations Endovascular Treatment of Vascular Anomalies Primary Tumors of Major Blood Vessels: Diagnosis and Management Complex AV fistula or AVG fistula in Vascular Access for Hemodialysis Venous Transpositions in the Creation of Arteriovenous Access Management of Thrombosed Dialysis Access Nonthrombotic Complications of Arteriovenous Access for Hemodialysis: Diagnosis and management Physiology and Diagnosis of Splanchnic Arterial Occlusion Treatment of Acute Intestinal Ischemia Caused by Arterial Occlusions Diagnosis and Treatment of Nonocclusive Mesenteric Ischemia Chronic Mesenteric Ischemia: Diagnosis and Management Intestinal Ischemia Caused by Venous Thrombosis: Diagnosis and Management Portal Hypertension: Surgical Management of Its Complications Renal Artery Fibrodysplasia and Renovascular Hypertension: Diagnosis and Management Atherosclerotic Renovascular Disease and Ischemic Nephropathy: Diagnosis and Management Endovascular Treatment of Renovascular Disease Open Surgical Repair of Renovascular Disease Renal Artery Aneurysms and Arteriovenous Fistulae: Diagnosis and Management Acute Renovascular Occlusive Events: Diagnosis and Management Diagnostic Evaluation and Medical Management of Patients with Ischemic Cerebrovascular Disease Noninvasive Studies in the Diagnosis and Management of Cerebrovascular Disease Indications, Surgical Technique, and Results for Repair of Extracranial Occlusive Lesions Carotid Angioplasty and Stenting Vertebrobasilar Ischemia: Indications, Techniques, and Results of Surgical Repair Endovascular and Surgical Management of Extracranial Carotid Fibromuscular Arterial Dysplasia Aneurysms of the Extracranial Carotid Artery: diagnosis and management



1



1



1



1



1



1



1 1 1 1



1 1 1 1



1 1 1 1 1 1 1 1 1 1 1 1 1



1 1 1 1 1 1 1 1 1 1 1 1 1



1 1



1 1



1 1 1 1 1



1 1 1 1 1



1 1



1 1



1



1



1 1 1



1 1 1



1



1



1



1



1



1



1 1



1 1



1



1



1



1



Uncommon Disorders Affecting the Carotid Arteries: diagnosis and management Complications Following Carotid Endarterectomy and Perioperative Management Catheter-Based Interventions for Acute Deep Venous Thrombosis Surgical Thrombectomy for Acute Deep Venous Thrombosis Vena Caval Interruption Procedures Management of Perforator Vein Incompetence The Surgical Treatment of Deep Venous Valvular Incompetence Surgical treatment of chronic occlusions of iliac vein and inferior vena cava Endovascular treatment of chronic occlusions of iliac vein and inferior vena cava Endovascular treatment of vena cava occlusion Evaluation and management of malignant tumors of inferior vena cava Surgical treatment of superior vena cava syndrome Surgical treatment of chronic lymphedema and primary chylous disorders Angioplasty Angioplasty/Stenting for Mesenteric Artery Stenosis Angioplasty/Stenting for Renal Artery Stenosis Angioplasty/Stenting of PAD/PVD Angioplasty/Stenting of Subclavian Artery Angioplasty/Stenting of Vertebral Artery Aorta Surgery Aortofemoral Bypass Grafting Atherectomy for PAD Atherectomy Branched Aortic Stentgraft Repairs Bypass Surgery for Venous Disease Carotid Angiography Carotid Artery Dissection Carotid Stenting Carotid-Subclavian Bypass Catheter-Directed Thrombolysis Complex Aorta Surgery Diagnostic Angiography Embolisation of Carotid Body Tumours Endovascular Repair of Abdominal Aortic Aneurysms Endovascular Repair of Thoracic Aortic Aneurysms Endovascular Repair of Thoracoabdominal Aortic Aneurysms Endovascular Surgery Endovenous Laser Therapy Fenestrated Aortic Stentgraft Repairs First Rib Resection IVC Filter Placement Laser atherectomy for PAD/PVD Minimally Invasive Aortic Surgery Percutaneous Mechanical Thrombolysis Repair of Venous Aneurysms Resection of Carotid Body Tumours Resection of Congenital Vascular Lesions Surgery for Peripheral Arterial Disease (PAD) Surgery for Peripheral Vascular Disease (PVD) Surgery for Portal Hypertension Surgery for Thoracic Outlet Syndrome (TOS) Vascular Ultrasound Venous angioplasty/stenting Venous Thrombolysis Jakarta, 18 April 2019 Ketua Kolegium Bedah Vaskular dan Endovaskular Dr. Hilman Ibrahim, SpB(K)V



1



1



1



1



1 1 1 1



1 1 1 1



1 1



1 1



1 1 1 1 1 1 1 1 1 1 1



1 1 1 1 1 1 1 1 1 1 1



1 1 1 1 1 1 1 1 1 1 1 1 1



1 1 1 1 1 1 1 1 1 1 1 1 1



1 1 1 1 1 1 1 1 1 1 1 1 1



1 1 1 1 1 1 1 1 1 1 1 1 1



1 1 1 1 1



1 1 1 1 1