Browsing by Author "Salas Ocaranza, Roberto Ignacio"

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    Development of a simulation-based laparoscopic ventral rectopexy module: skills training for minimally invasive pelvic surgery
    (2025) Zuñiga González, Hernán Felipe; Jarry Trujillo, Cristian Ignacio; Salas Ocaranza, Roberto Ignacio; Machuca Neira, Eduardo Andrés; Larach Kattan, José Tomás; Molina Pezoa, María Elena; Varas Cohen, Julian Emanuel
    Background Laparoscopic pelvic surgery presents significant technical challenges due to anatomical constraints such aslimited working space and proximity to neurovascular structures. Laparoscopic ventral mesh rectopexy (LVMR) was selectedas the procedural framework for model design and validation, given its complexity and relevance as a representative pelvicprocedure. This study aimed to develop and validate a synthetic and reproducible simulation model with structural andfunctional fidelity to support the acquisition of laparoscopic skills in anatomically restricted pelvic environments.Methods A synthetic pelvic model was developed through iterative prototyping, integrating 3D-printed bone structures andplatinum-cured silicone. Face validity and user reaction were initially assessed by eleven surgeons with varying expertise.Construct validity was then evaluated through performance in a simulated LVMR, using modified Objective StructuredAssessment of Technical Skills (OSATS) and a Procedure-Specific Rating Scale (SRS). Surgical time was recorded byprocedural steps. Data were analyzed using non-parametric methods.Results Experts achieved significantly higher OSATS scores (median 20.5 [20.38–21]) than non-experts (16 [14.75–17.25];p=0.01), and higher SRS scores (16.25 [16–16.88] vs. 13.5 [13.25–15]; p=0.009). Step-specific advantages were observed insurgical flow (p=0.025) and knot tying (p=0.018). Although global operative time was shorter in experts (29.3 vs. 52.8 min),it was not statistically significant (p=0.073). Most participants described the model as realistic, useful, and representativeof actual surgical conditions.Conclusion This validated, reusable model provides strong educational value for advanced laparoscopic pelvic training andstructured skill acquisition.
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    Plasminogen activator inhibitor type 1 serum levels and 4G/5G gene polymorphism in morbidly obese Hispanic patients with non-alcoholic fatty liver disease
    (Elsevier España, 2011) Espino Espino, Alberto Antonio; Villagran Torres, Andrea Alejandra; Vollrath Reyes, Valeska Yolanda; Hanckes Mayo, Maria Paulina; Salas Ocaranza, Roberto Ignacio; Farah Samaan, Andrea Catherina; Solis, Nancy; Pizarro Rojas, Margarita Alicia; Escalona Perez, Alex Gamaliel; Boza Wilson, Camilo; Perez, Gustavo; Carrasco, Gonzalo; Padilla, Orlando; Francisco Miguel, Juan; Nervi Oddone, Flavio; Chavez Tapia, Norberto C.; Arab Verdugo, Juan Pablo; Alvarez Lobos, Manuel Marcelo; Arrese Jimenez, Marco Antonio; Riquelme Perez, Arnoldo Javier
    Background. The plasminogen activator inhibitor type-1 (PAI-1) has been implicated in the regulation of fibrinolysis and extracellular matrix components. The single base pair guanine insertion/deletion polymorphism (4G/5G) within the promoter region of the PAI-1 gene influences PAI-1 synthesis and may modulate hepatic fibrogenesis. Aim. To evaluate the influence of PAI-1 serum levels and 4G/5G polymorphism on the risk of liver fibrosis associated to non-alcoholic fatty liver disease (NAFLD) in morbidly obese patients. Material and methods. Case-control study of 50 obese patients undergoing bariatric surgery and 71 non-obese subjects matched by age and sex. Anthropometric and biochemical measurements were performed, including PAI-1 serum levels. Genomic DNA was obtained to assess the presence of 4G/5G polymorphism. Results. BMI, insulinemia, triglycerides, HOMA-IR, hypertension and diabetes were significantly higher in obese patients compared to control subjects. PAI-1 serum levels observed in obese patients were significantly lower (10.63 +/- 4.82) compared to controls (14.26 +/- 11.4; p < 0.05). No differences were observed in the PAI-1 4G/5G promoter genotypes frequencies (p = 0.12). No differences were observed in PAI-1 plasma levels among obese patients with liver fibrosis (10.64 +/- 4.35) compared to patients without liver fibrosis (10.61 +/- 5.2; p = 0.985). PAI-1 4G/5G promoter genotypes frequencies were similar in patients with or without liver fibrosis associated to NASH (p = 0.6). Conclusions. Morbidly obese patients had significantly Lower PAI-1 serum levels with similar PAI-1 4G/5G genotypes frequencies compared to non-obese subjects. The frequency of 4G/5G genotypes in Chilean Hispanic healthy subjects was similar to that described in other populations. No association was found between PAI-1 serum levels or 4G/5G genotype with liver fibrosis in obese patients.