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  1. Article ; Online: Influence of previous experience on the benefits of laparoscopic surgical training based on simulation.

    Toledo Martínez, Enrique / Martín Parra, Jose Ignacio / Magadán Álvarez, Cristina / López Useros, Antonio / Fernández Santiago, Roberto / Regaño Díez, Sara / Ruiz Gómez, José Luis / Rodriguez Sanjuan, Juan Carlos / Manuel Palazuelos, Carlos

    Cirugia espanola

    2019  Volume 97, Issue 6, Page(s) 314–319

    Abstract: Introduction: Surgical training based on simulation seeks the acquisition of skills in novice participants and ongoing sill development in experts. The aim of this study is to assess the evolution of students in an intensive laparoscopic anastomosis ... ...

    Title translation Influencia de la experiencia previa en los beneficios del entrenamiento quirúrgico laparoscópico basado en la simulación.
    Abstract Introduction: Surgical training based on simulation seeks the acquisition of skills in novice participants and ongoing sill development in experts. The aim of this study is to assess the evolution of students in an intensive laparoscopic anastomosis course and to analyse their results depending on their level and previous experience.
    Methods: The students of all the anastomosis courses conducted during 30 months in the Valdecilla virtual hospital (Santander) were analysed. Manual side-to-side intestinal anastomoses with porcine 'ex vivo' viscera were performed in a laparoscopic endotrainer. The technical and quality differences between the first and the last anastomoses were analyzed and the progression between residents and specialists was compared.
    Results: We analyzed 45 participants, 22 of them residents and 23 specialists. A statistically significant improvement of 80.5% was observed in all procedural parameters (94.8% residents vs. 67.3% specialists). The time was reduced by 48.1% in the residents and 43.2% in the specialists (p<.001). In terms of quality, significant improvements were obtained in the group of residents: an increase of 90% in adequate tension, and a reduction of 75% of everted edges and 60% of leaks. In addition, they obtained results comparable to the specialists (27.3% leak in the last anastomosis vs. 34.8% by the specialists, p=.59), which presented improvement without statistical significance.
    Conclusions: The group of residents presented a major and significant improvement in procedural skills and in the quality of the technique, reaching the level of the specialists after completion of the course.
    MeSH term(s) Adult ; Anastomosis, Surgical/education ; Animals ; Clinical Competence ; Educational Status ; Female ; Humans ; Internship and Residency/methods ; Laparoscopy/education ; Male ; Models, Anatomic ; Problem-Based Learning/methods ; Simulation Training/methods ; Swine
    Language Spanish
    Publishing date 2019-01-29
    Publishing country Spain
    Document type Journal Article
    ISSN 2173-5077
    ISSN (online) 2173-5077
    DOI 10.1016/j.ciresp.2018.12.004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Laparoscopic and robot-assisted laparoscopic digestive surgery: Present and future directions.

    Rodríguez-Sanjuán, Juan C / Gómez-Ruiz, Marcos / Trugeda-Carrera, Soledad / Manuel-Palazuelos, Carlos / López-Useros, Antonio / Gómez-Fleitas, Manuel

    World journal of gastroenterology

    2016  Volume 22, Issue 6, Page(s) 1975–2004

    Abstract: Laparoscopic surgery is applied today worldwide to most digestive procedures. In some of them, such as cholecystectomy, Nissen's fundoplication or obesity surgery, laparoscopy has become the standard in practice. In others, such as colon or gastric ... ...

    Abstract Laparoscopic surgery is applied today worldwide to most digestive procedures. In some of them, such as cholecystectomy, Nissen's fundoplication or obesity surgery, laparoscopy has become the standard in practice. In others, such as colon or gastric resection, the laparoscopic approach is frequently used and its usefulness is unquestionable. More complex procedures, such as esophageal, liver or pancreatic resections are, however, more infrequently performed, due to the high grade of skill necessary. As a result, there is less clinical evidence to support its implementation. In the recent years, robot-assisted laparoscopic surgery has been increasingly applied, again with little evidence for comparison with the conventional laparoscopic approach. This review will focus on the complex digestive procedures as well as those whose use in standard practice could be more controversial. Also novel robot-assisted procedures will be updated.
    MeSH term(s) Diffusion of Innovation ; Digestive System Surgical Procedures/adverse effects ; Digestive System Surgical Procedures/methods ; Digestive System Surgical Procedures/trends ; Evidence-Based Medicine ; Forecasting ; Humans ; Laparoscopy/adverse effects ; Laparoscopy/trends ; Postoperative Complications/etiology ; Risk Factors ; Robotic Surgical Procedures/adverse effects ; Robotic Surgical Procedures/trends ; Treatment Outcome
    Language English
    Publishing date 2016-01-07
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2185929-2
    ISSN 2219-2840 ; 1007-9327
    ISSN (online) 2219-2840
    ISSN 1007-9327
    DOI 10.3748/wjg.v22.i6.1975
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Robotic Assisted Transanal Polypectomies: Is There Any Indication?

    Gómez Ruiz, Marcos / Cagigas Fernández, Carmen / Alonso Martín, Joaquín / Cristobal Poch, Lidia / Manuel Palazuelos, Carlos / Barredo Cañibano, Francisco Javier / Gómez Fleitas, Manuel / Castillo Diego, Julio

    Cirugia espanola

    2017  Volume 95, Issue 10, Page(s) 601–609

    Abstract: Objectives: Robotic assisted transanal polipectomy may have advantages compared with the conventional transanal minimally invasive surgery technique. We evaluate the safety, feasibility and advantages of this technique.: Methods: Between February ... ...

    Title translation Polipectomía transanal asistida por robot: ¿tiene alguna indicación?
    Abstract Objectives: Robotic assisted transanal polipectomy may have advantages compared with the conventional transanal minimally invasive surgery technique. We evaluate the safety, feasibility and advantages of this technique.
    Methods: Between February 2014 and October 2015, 9patients underwent robotic transanal polypectomy. We performed a retrospective study in which we analyse prospectively collected data regarding patient and tumor characteristics, perioperative outcomes, pathological report, morbidity and mortality.
    Results: A total of 5 male and 4 female patients underwent robotic TAMIS. Lesions were 6,22cm from the anal verge. Mean size was 15,8cm
    Conclusions: Robotic TAMIS is useful to treat complex rectal lesions. Our transanal platform allowed a wider range of movements of the robotic arms and to perform all procedures in the lithotomy position.
    MeSH term(s) Aged ; Aged, 80 and over ; Anal Canal ; Digestive System Surgical Procedures/methods ; Female ; Humans ; Intestinal Polyps/surgery ; Male ; Middle Aged ; Rectal Neoplasms/surgery ; Retrospective Studies ; Robotic Surgical Procedures/methods ; Treatment Outcome
    Language Spanish
    Publishing date 2017-11-14
    Publishing country Spain
    Document type Journal Article
    ZDB-ID 730701-9
    ISSN 1578-147X ; 0009-739X
    ISSN (online) 1578-147X
    ISSN 0009-739X
    DOI 10.1016/j.ciresp.2017.09.006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Efecto de la simulación quirúrgica en la implementación clínica de procedimientos colorrectales laparoscópicos.

    Manuel Palazuelos, Carlos / Alonso Martín, Joaquín / Martín Parra, José I / Gómez Ruiz, Marcos / Maestre, José M / Redondo Figuero, Carlos / Castillo Diego, Julio / Gómez Fleitas, Manuel

    Cirugia espanola

    2014  Volume 92, Issue 2, Page(s) 100–106

    Abstract: Introduction: Advanced laparoscopic surgery requires supplementary training outside the operating room. Clinical simulation with animal models or cadavers facilitates this learning.: Objective: We measured the impact on clinical practice of a ... ...

    Title translation Effects of surgical simulation on the implementation of laparoscopic colorectal procedures.
    Abstract Introduction: Advanced laparoscopic surgery requires supplementary training outside the operating room. Clinical simulation with animal models or cadavers facilitates this learning.
    Objective: We measured the impact on clinical practice of a laparoscopic colorectal resection training program based on surgical simulation.
    Material and methods: Between March 2007 and March 2012, 163 surgeons participated in 30 courses that lasted 4 days, of 35 hours (18 h in the operating room, 12h in animal models, and 4h in seminars). In May 2012, participants were asked via an on-line survey about the degree of implementation of the techniques in their day-to-day work.
    Results: Seventy surgeons (47%) from 60 different hospitals answered the survey. Average time elapsed after the course was 11.5 months (2-60 months). A total of 75% initiated or increased the number of surgeries performed after the training. The increase in practice was>10 cases/month in 19%, and<5 cases/month in 56% of surgeons. 38% of participants initiated this surgical approach.
    Conclusions: Seventy five percent of the surveyed surgeons increased the clinical implementation of a complicated surgical technique, such as laparoscopic colorectal surgery, after attending a training course based on clinical simulation.
    MeSH term(s) Adult ; Colorectal Surgery/education ; Colorectal Surgery/methods ; Colorectal Surgery/statistics & numerical data ; Computer Simulation ; Female ; Humans ; Laparoscopy/education ; Longitudinal Studies ; Male ; Middle Aged ; Surveys and Questionnaires
    Language Spanish
    Publishing date 2014-02
    Publishing country Spain
    Document type English Abstract ; Journal Article ; Multicenter Study ; Observational Study
    ZDB-ID 730701-9
    ISSN 1578-147X ; 0009-739X
    ISSN (online) 1578-147X
    ISSN 0009-739X
    DOI 10.1016/j.ciresp.2013.03.004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Evaluación del entrenamiento de residentes en cirugía laparoscópica en el laboratorio basado en un modelo de anastomosis digestivas.

    Rodríguez-Sanjuán, Juan Carlos / Manuel-Palazuelos, Carlos / Fernández-Díez, María José / Gutiérrez-Cabezas, José Manuel / Alonso-Martín, Joaquín / Redondo-Figuero, Carlos / Herrera-Noreña, Luis Antonio / Gómez-Fleitas, Manuel

    Cirugia espanola

    2010  Volume 87, Issue 1, Page(s) 20–25

    Abstract: Background: The complexity of laparoscopic surgery makes specific training out of the operating rooms necessary to shorten learning curves and to minimise morbidity rates. Our aim was to analyse the increase in laparoscopic skills after completion of a ... ...

    Title translation Assessment of resident training in laparoscopic surgery based on a digestive system anastomosis model in the laboratory.
    Abstract Background: The complexity of laparoscopic surgery makes specific training out of the operating rooms necessary to shorten learning curves and to minimise morbidity rates. Our aim was to analyse the increase in laparoscopic skills after completion of a laboratory training program.
    Material and methods: Prospective study of surgical resident training based on anastomosis performance on an "endotrainer". The program consisted of 4 weeks per year (20h per week) between 2004 and 2007. The outcome measures were the time and number of anastomosis necessary to perform a proper anastomosis. Upon completion, the anastomosis was checked by both trainee and evaluator and quality was assessed. Time and technical failures (loose suture, edge eversion, leakage) were recorded.
    Results: Twelve surgical residents were trained. They performed 189 jejuno-jejunal anastomoses (JJA), mean 15.8 per resident and 197 gastro-jejunal anastomoses (GJA), mean 16.4 per resident. The performance mean time was 72.7 min for JJA and 87.2 for GJA. There was a marked reduction in time from the beginning to completion of training. The percentage of flawed anastomosis decreased with training: 26.6%, 21.8%, 17.1%, 17%, 16.1% and 10.5% after 20, 40, 60, 80, 100 and 120 h, respectively. Bearing in mind reduction in both performance time and flawed anastomosis rate, it appears that after 70 h of training the learning curve reaches a plateau zone.
    Conclusions: Intestinal anastomosis (either JJA or GJA) performed in "endotrainer" is a suitable model for laparoscopic training, without the need of live animals. After a training period of 70 hours, the improvement seems of little benefit.
    MeSH term(s) Anastomosis, Surgical/education ; Internship and Residency ; Jejunum/surgery ; Laparoscopy ; Models, Anatomic ; Prospective Studies ; Stomach/surgery
    Language Spanish
    Publishing date 2010-01
    Publishing country Spain
    Document type English Abstract ; Journal Article
    ZDB-ID 730701-9
    ISSN 0009-739X
    ISSN 0009-739X
    DOI 10.1016/j.ciresp.2009.08.003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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