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    Impact of insufflator/aspirator versus exclusive insufflator during robotic radical prostatectomy: a comparative prospective cohort study
    (2023)
    Hugo Otaola-Arca  
    ;
    Orlando Mejías
    ;
    Juan Cristóbal Bravo
    ;
    Rodrigo Pinochet
    ;
    Pablo Bernier
    <jats:sec> <jats:title>Background:</jats:title> <jats:p>New generation devices that combine high-flow insufflation with smoke aspiration using continuous gas recirculation ]so-called Insufflator/aspirator systems (IAS)] have recently been developed to generate pneumoperitoneum. The use of an IAS could have an impact on surgical compared to conventional insufflation systems (CIS). The present study aimed to compare the clinical effectiveness/safety, healthorganizational, and pathological/oncological outcomes of the CIS versus IAS during robot-assisted radical prostatectomy (RARP).</jats:p> </jats:sec> <jats:sec> <jats:title>Methods:</jats:title> <jats:p>Comparative retrospective cohort study including patients with non-metastatic prostate cancer treated with RARP by four expert surgeons at a robotic referral centre between January 2020 and December 2021. A CIS was used until 15 March 2021, and the IAS thereafter. Data were extracted from the Institutional Review Board-approved (#1064) retro and prospective institutional database.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p>The final analysis included 299 patients (143 CIS; 156 IAS). We found no statistically significant differences in demographic data and preoperative results, allowing adequate group comparison. The rate of complications of any degree (9.1% and 1.9%, <jats:italic toggle="yes">P</jats:italic>&lt;0.05) and major complications (4.2% and 0.6%, <jats:italic toggle="yes">P</jats:italic>&lt;0.05) were lower in the IAS group. Accordingly, the hospital stay was shorter in the IAS group (<jats:italic toggle="yes">P</jats:italic>&lt;0.05); however, the small size of this statistically significant difference probably lacks clinical value (1.9±1.6 vs. 1.6±0.8 days). There was no significant difference in surgical time, bleeding, pathological findings, or oncological results.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions:</jats:title> <jats:p>Data from this large group of patients showed that the rate of overall complications, the rate of major complications, and the length of stay were lower in the IAS group. Implementing the IAS in RARP patients increased the occurrence of SCE and affected our daily practice of transversus abdominis plane block. Interpretation of the results should be made with caution since the design of this study did not allow for the identification of a causal relationship.</jats:p> </jats:sec>
      8Scopus© Citations 3
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    New Highly Portable Simulator (SECMA) Based on Virtual Reality for Teaching Essential Skills in Minimally Invasive Surgeries
    (2023)
    GUZMAN MONTOTO, JOSE IGNACIO  
    ;
    HERRERA MARÍN, MAURICIO RENÉ  
    ;
    RODRÍGUEZ BELTRÁN, CAMILO IGNACIO  
    <jats:p>This study presents a new minimal access surgery training system, SECMA, and its constructive validation to determine its usefulness for training basic laparoscopic skills. SECMA is an affordable, highly portable, mobile virtual reality training tool for laparoscopic techniques that integrates the Oculus Quest with a mechanical interface for surgeon simulation of forceps using the hand controllers of these devices. It allows the execution of structured activities (supported by virtual scenarios simulating operating rooms developed in Unity), performance evaluation, and real-time data capture. Two experiments were carried out: 1) coordination; and 2) capture and transport, with a total of 21 individuals divided into two groups: a novice group (inexperienced) of 10 participants and an expert group (&gt;100 endoscopic procedures) of 11 participants. Total task time score, right-hand speed, path length, and other metrics from several consecutive runs on the simulator were compared between experts and novices. Data automatically recorded by SECMA during the experiments were analyzed using hypothesis tests, linear regressions, analysis of variance, principal component analysis, and machine learning-supervised classifiers. In the experiments, the experts scored significantly better than the novices in all the parameters used. The tasks evaluated discriminated between the skills of experienced and novice surgeons, giving the first indication of construct validity for SECMA. </jats:p>
    Scopus© Citations 2  11
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    5,926 hysterectomies: complications described by Clavien–Dindo classification
    (2021)
    Rodrigo I. Alliende
    ;
    Álvaro M. Carrasco
    ;
    Marco Levancini
    ;
    Elias Kovoor
    ;
    GUZMAN ROJAS, RODRIGO ARTURO  
    Scopus© Citations 15  3
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      1Scopus© Citations 4
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    Calidad de vida posterior a gastrectomia total laparoscópica versus abierta en cáncer gástrico
    (2022)
    NAVARRETE CABELLO, JORGE ANDRES  
    ;
    Kristel Werner
    ;
    Claudia Meza M
    ;
    Roberto Humeres A
    <jats:p>Introducción: En los últimos años la gastrectomía laparoscópica ha aparecido como una técnica quirúrgica con resultados oncológicos comparables a la técnica abierta, pero existe poca evidencia en cuanto a la calidad de vida postoperatoria de estos pacientes. Objetivo: Evaluar la calidad de vida postoperatoria de pacientes sometidos a gastrectomía total laparoscópica (GTL) en comparación a gastrectomia total abierta (GTA) en cáncer gástrico. Materiales y Método: Estudio retrospectivo, observacional en Hospital Militar de Santiago, entre enero de 2015 y junio de 2020. Se les aplicó 2 encuestas validadas para Chile: EORTC QLQ-30 y EORTC QLQ-OG25. Resultados: Se obtuvieron  60 pacientes; 30 sometidos a GTL y 30 a GTA. Promedio edad fue 66,3 +/-11 años para GTL y 68,2 +/-11 años en GTA (p=0,5). Se obtuvo un score en GTL versus GTA: global 83,3 y 80,2 (p=0,6), sintomático 17,1 y 25,5 (p=0,2) y score funcional 87,9 y 70,9 (p= 0,03). Posterior a eso obtuvimos en funcionalidad GTL versus GTA;  física 92,2 versus GTA 73,1 (p=0,04), emocional 84,1 versus 78,5 (p=0,6), cognitiva 84,9 versus 79,0 (p=0,3) y social 80,9 versus 72,2 (p=0,4). Al analizar síntomas destaco; fatiga 14,6 versus 33,1 (p= 0,04) y dolor 13,4 versus 24,3 (p= 0,05). Finalmente en síntomas digestivos altos obtuvimos en disfagia 0,84 GTL versus 17,3 GTA (p=0,04). Conclusión: La GTL logra resultados comparables a GTA en calidad de vida e incluso ofrece ventajas significativas en funcionalidad física como también en síntomas como dolor, fatiga y disfagia.  </jats:p>
      18Scopus© Citations 1
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    A simple and noninvasive method to reidentify the left ureter during laparoscopic colorectal surgery – a video vignette
    (2021)
    Ernesto Melkonian
    ;
    Eduardo Mordojovich
    ;
    Leonardo Espíndola
    ;
    Christian Jensen
    ;
    Aldo Cuneo
      5
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      1Scopus© Citations 1  5
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      2
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    Rotura esplénica espontánea secundaria a mononucleosis infecciosa
    (2021)
    Consuelo Gatica
    ;
    SOFFIA SANCHEZ, PABLO RICARDO  
    ;
    Roberto Charles
    ;
    Andrés Vicentela
    Scopus© Citations 3  2
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    Perioperative management of paragangliomas and pheochromocytomas
    (2020)
    Magdalena Fermandois
    ;
    Jaime Altamirano
    ;
    ROJAS, FELIPE
    ;
    Cristóbal Román
    ;
    Iván Pinto
      12Scopus© Citations 2