Browsing by Author "Miguieles Schilling, Mariana"

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    Five-Year Experience Training Surgeons with a Laparoscopic Simulation Training Program for Bariatric Surgery: a Quasi-experimental Design
    (2023) Duran Espinoza, Valentina; Belmar Riveros, Francisca; Jarry Trujillo, Cristian; Gaete Danobeitia, Maria Ines; Montero Jaras, Isabella; Miguieles Schilling, Mariana; Valencia Coronel, Brandon; Escalona, Gabriel; Achurra Tirado, Pablo; Quezada, Nicolas; Crovari, Fernando; Varas Cohen, Julian
    Purpose Nearly 200,000 laparoscopic Roux-en-Y gastric bypass (LRYGB) are performed yearly. Reported learning curves range between 50 and 150, even 500 cases to decrease the operative risk. Simulation programs could accelerate this learning curve safely; however, trainings for LRYGB are scarce. This study aims to describe and share our 5-year experience of a simulated program designed to achieve proficiency in LRYGB technical skills.Materials and Methods A quasi-experimental design was used. All recruited participants were previously trained with basic and advanced laparoscopic simulation curriculum completing over 50 h of practical training. Ex vivo animal models were used to practice manual and stapled gastrojejunostomy (GJ) and stapled jejunojejunostomy (JJO) in 10, 3, and 4 sessions, respectively. The main outcome was to assess the manual GJ skill acquisition. Pre- and post-training assessments using a Global Rating Scale (GRS; max 25 pts), Specific Rating Scale (SRS; max 20 pts), performance time, permeability, and leakage rates were analyzed. For the stapled GJ and JJO, execution time was registered. Data analysis was performed using parametric tests.Results In 5 years, 68 trainees completed the program. For the manual GJ's pre- vs post-training assessment, GRS and SRS scores increased significantly (from 17 to 24 and from 13 to 19 points respectively, p-value < 0.001). Permeability rate increased while leakage rate and procedural time decreased significantly.Conclusion This simulated training program showed effectiveness in improving laparoscopic skills for manual GJ and JJO in a simulated scenario. This new training program could optimize the clinical learning curve. Further studies are needed to assess the transfer of skills to the operating room.
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    Train the trainers: a comparative analysis of medical students and residents as trainers for undergraduate med-school learners in surgical skills
    (2023) Duran Espinoza, Valentina; Montero Jaras, Isabella; Miguieles Schilling, Mariana; Valencia Coronel, Brandon; Belmar Riveros, Francisca; Jarry, Cristian; Cruz, Enrique; Jeffrey, Wiseman; Escalona Vives, Gabriel; Villagrán Gutiérrez, Ignacio Andrés; Corvetto, Marcia; Varas Cohen, Julian