Browsing by Author "Varas, Julián"

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    A Cadaveric Porcine Model for Assessment in Laparoscopic Bariatric Surgery-a Validation Study
    (2013) Boza, Camilo; Varas, Julián; Buckel, Erwin; Achurra Tirado, Pablo; Devaud Jaureguiberry, Nicolás Andrés; Lewis, Trystan; Aggarwal, Rajesh
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    A Novel Ex Vivo Training Model for Acquiring Supermicrosurgical Skills Using a Chicken Leg
    (2016) Cifuentes, I.; Rodriguez, J.; Yañez, R.; Salisbury, M.; Cuadra, Á.; Varas, Julián; Dagnino, Bruno
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    A Novel Perforator Flap Training Model Using a Chicken Leg
    (2016) Cifuentes, I. J.; Yañez, R. A.; Salisbury, M. C.; Rodriguez, J. R.; Varas, Julián; Dagnino, Bruno
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    Allowing New Opportunities in Advanced Laparoscopy Training Using a Full High-Definition Training Box
    (2016) Achurra Tirado, Pablo; Lagos, Antonia; Ávila, Rubén; Tejos, Rodrigo; Buckel, Erwin; Alvarado, Juan; Boza, Camilo; Jarufe Cassis, Nicolás; Varas, Julián
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    Assessment of central venous catheterization in a simulated model using a motion-tracking device: an experimental validation study
    (2016) Varas, Julián; Achurra Tirado, Pablo; León, Felipe.; Castillo, Richard.; De La Fuente, Natalia.; Aggarwal, Rajesh.; Clede, Leticia.; Bravo, María P.; Corvetto Aqueveque, Marcia Antonia; Montaña Rodríguez, Rodrigo
    Abstract Background Central venous catheterization (CVC) is a basic requirement for many medical specialties. Simulated training in CVC may allow the acquisition of this competency but few reports have established a valid methodology for learning and acquiring procedural skills for CVC. This study aims to validate the use of a tracking motion device, the imperial college surgical assessment device (ICSAD), by comparing it with validated global rating scales (GRS) to measure CVC performance in a simulated torso. Methods Senior year medical students, first and last year residents (PGY1, LYR), and expert anesthesiologists performed a jugular CVC assessment in a simulated model (Laerdal IV Torso). A validated GRS for objective assessment of technical skills and motion analysis by ICSAD was used. Statistical analysis was performed through Mann–Whitney and Kruskal–Wallis tests for construct validity and Spearman correlation coefficients between the ICSAD and GRS scores for concurrent validity between both. Results 32 subjects were recruited (10 medical students, 8 PGY1, 8 LYR and 8 experts). Total path length measured with ICSAD and GRS scores were significantly different between all groups, except for LYR compared to experts (p = 0.664 for GRS and p = 0.72 for ICSAD). Regarding jugular CVC procedural time, LYR and experts were faster than PGY1 and MS (p < 0.05). Spearman correlation coefficient was −0.684 (p < 0.001) between ICSAD and GRS scores. Conclusions ICSAD is a valid tool for assessment of jugular CVC since it differentiates between expert and novice subjects, and correlates with a validated GRS for jugular CVC in a simulated torso.Abstract Background Central venous catheterization (CVC) is a basic requirement for many medical specialties. Simulated training in CVC may allow the acquisition of this competency but few reports have established a valid methodology for learning and acquiring procedural skills for CVC. This study aims to validate the use of a tracking motion device, the imperial college surgical assessment device (ICSAD), by comparing it with validated global rating scales (GRS) to measure CVC performance in a simulated torso. Methods Senior year medical students, first and last year residents (PGY1, LYR), and expert anesthesiologists performed a jugular CVC assessment in a simulated model (Laerdal IV Torso). A validated GRS for objective assessment of technical skills and motion analysis by ICSAD was used. Statistical analysis was performed through Mann–Whitney and Kruskal–Wallis tests for construct validity and Spearman correlation coefficients between the ICSAD and GRS scores for concurrent validity between both. Results 32 subjects were recruited (10 medical students, 8 PGY1, 8 LYR and 8 experts). Total path length measured with ICSAD and GRS scores were significantly different between all groups, except for LYR compared to experts (p = 0.664 for GRS and p = 0.72 for ICSAD). Regarding jugular CVC procedural time, LYR and experts were faster than PGY1 and MS (p < 0.05). Spearman correlation coefficient was −0.684 (p < 0.001) between ICSAD and GRS scores. Conclusions ICSAD is a valid tool for assessment of jugular CVC since it differentiates between expert and novice subjects, and correlates with a validated GRS for jugular CVC in a simulated torso.
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    Effectiveness of Learning Advanced Laparoscopic Skills in a Brief Intensive Laparoscopy Training Program
    (2015) Castillo, Richard; Buckel, Erwin; Leon, Felipe; Varas, Julián; Alvarado, Juan; Achurra Tirado, Pablo; Aggarwal, Rajesh; Jarufe Cassis, Nicolás; Boza, Camilo
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    Growth vs. fixed: evaluating the mindset of future surgeons
    (2024) Valencia Coronel, Brandon; Silva Rojas, Adriana; Jarry, Cristián; Belmar, Francisca; Vial, María Elena; Selman Álvarez, Rafael; Figueroa Fernández, Úrsula; Cruz Mackenna, Enrique; Escalona, Gabriel; Varas, Julián
    Introduction: The pursuit of surgical specialization often requires a robust mindset given the high stakes and demanding nature of surgical practice. The mindset of surgical residents, specifically the dichotomy of fixed versus growth mindset, may significantly influence their learning trajectory and eventual performance. This study seeks to explore the prevailing mindsets of surgical residents, with the goal of fostering a conducive learning environment that promotes continuous growth and excellence. Methods: A modified cross-sectional survey based on Dr. Carol S. Dweck's mindset theory was applied to surgical residents at our center. The purpose of this survey was to classify the predominant mindset into 4 groups (strong growth mindset, growth mindset with some fixed ideas, fixed mindset with some growth ideas, and strong fixed mindset) and assess whether this influenced residents' perceptions of performance. However, this study did not directly examine the underlying factors influencing these mindsets. Results: A total of 38 surgical residents participated in the study with a response rate of 95%. The mean age of participants was 31.61 years (range 25–37 years), with 52.6% males and 47.4% females. Regarding surgical specialties, 63.16% were specializing in General Surgery, 10.53% in Pediatric Surgery, 10.53% in Digestive Surgery, 10.53% in Urology, and 5.26% in Colorectal Surgery. Combining the mindset groups, it was found that 89.47% of residents were in the growth mindset category and 10.53% were in the fixed mindset category. In the different types of mindsets of the residents, the findings revealed that in the subgroup categories of mindset, we found 50% of strong growth mindset, 39.47% of growth mindset with some fixed ideas, and 10.53% in fixed mindset with some growth idea. Conclusión: This study highlights the prevalence of a growth mindset among surgical residents, indicating a willingness to adapt and learn continuously. The absence of a strong fixed mindset in the surveyed group reinforces the evolving nature of surgical education that emphasizes adaptability and resilience. This study lays the groundwork for more extensive research to understand the factors that foster these mindsets and to develop strategies to promote a growth mindset in surgical education.
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    Hepatectomía laparoscópica
    (2013) Jarufe Cassis, Nicolás; Marambio Granic, Andrés Javier; De La Llera K. J; Varas, Julián; Sanhueza García, Marcel Paolo; Martínez Castillo, Jorge
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    High Frequency of Internal Hernias After Roux-en-Y Gastric Bypass
    (2015) Quezada Sanhueza, Nicolás; León, Felipe; Jones, Alex; Varas, Julián; Funke, Ricardo; Crovari Eulufi, Fernando; Raddatz Echavarría, Alejandro; Pérez Blanco, Gustavo Adolfo; Escalona, Alex; Boza, Camilo; Quezada Sanhueza, Nicolás; León, Felipe; Jones, Alex; Varas, Julián; Funke, Ricardo; Crovari Eulufi, Fernando; Raddatz, Alejandro; Pérez Blanco, Gustavo Adolfo; Escalona, Alex; Boza, Camilo
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    In the name of the user : social housing and the project of architectural heterogeneity
    (2016) Varas, Julián; Pérez de Arce Antoncich, Rodrigo; Pontificia Universidad Católica de Chile. Escuela de Arquitectura
    Entre el fin de la Segunda Guerra Mundial y comienzos de la década de 1980 tuvo lugar lo que, sin dudas, fue el último capítulo en la historia de la arquitectura moderna. Una particular conjunción entre los intereses de la arquitectura y los del estado y un volumen de producción material sin precedentes, derivado de esa convergencia, caracterizaron un período que ha llevado distintos rótulos: los Treinta Gloriosos en Francia, el Keynesianismo como común denominador económico en el noratlántico, el Desarrollismo en América Latina, la Guerra Fría como fenómeno económico, militar y geopolítico global, o simple y abarcativamente, la Posguerra. Como consecuencia de la destrucción que sembró la Segunda Guerra Mundial, de los esfuerzos que emprendieron las distintas naciones para la reconstrucción a partir de 1945, y del boom económico que comenzó en la década de 1950, el legado arquitectónico de este período es enorme y diverso. Sin embargo, no son los monumentos, edificios públicos, palacios, o viviendas privadas, los que emblematizan la singularidad de la Posguerra, sino los emprendimientos estatales pensados para transformar las sociedades europeas, americanas, y de otras regiones mediante la provisión de viviendas accesibles para nuevas comunidades urbanas. Muchos de estos emprendimientos tuvieron un carácter verdaderamente épico, y algunos, además, fueron capaces de articular icónicamente un programa de reinserción social de la arquitectura. Este trabajo trata sobre los emprendimientos canónicos de ese período y su contexto disciplinar. Su hipótesis es que, a partir de 1960 y durante aproximadamente dos décadas, la disciplina arquitectónica hizo converger una agenda de heterogeneidad formal que ya tenía al menos 15 años de maduración, con demandas socio-culturales y socio-políticas para que se prestara atención a la nueva figura del usuario, entendido como una configuración activa del sujeto humano, de carácter irreductiblemente complejo y convenientemente ambiguo, que desafiaba las concepciones mecanicistas y conductistas que venían operando en el campo de la arquitectura, el urbanismo y la cultura en general desde comienzos del siglo 20. Paradójicamente, las mejores versiones de estos esfuerzos lograron, en nombre de los valores de la individuación social, material y urbana, construir nuevas y monumentales máquinas de sociabilidad. Reflexionando sobre la emergencia, definición y vicisitudes de la figura del usuario en relación con la práctica de la arquitectura en el contexto de la producción de la vivienda, la tesis rastrea los orígenes y las distintas fases a través de las cuales fue evolucionando esa relación y sugiere que la idea de usuario es en realidad la punta de un iceberg de significación cuyo extremo opuesto se hunde literalmente hasta los orígenes de la arquitectura como disciplina autónoma en occidente. Durante la posguerra el usuario tuvo funciones precisas en la consolidación y supervivencia de la disciplina arquitectónica luego de la crisis del modernismo, funciones que le sirvieron de soporte vital para atravesar las difíciles décadas de 1960 y 1970 durante las cuales un amplio arco de críticos, activistas e historiadores denunció activamente la responsabilidad de la arquitectura en los principales conflictos urbanísticos de la época, y auguró su ocaso, o en el mejor de los casos, su remplazo por dispositivos presuntamente más democráticos de administración de los problemas socio-espaciales. Durante este período el usuario tuvo aplicaciones variadas y hasta opuestas: fue invocado como herramienta para apoyar la legitimación y producción de proyectos abiertos, democráticos e indeterministas como los de Yona Friedman, Nicholas Negroponte o Cedric Price, pero también se lo desplegó como instrumento útil para sobre-determinar la forma arquitectónica. Tal fue el caso de Giancarlo de Carlo, y aún más, de Ralph Erskine. Si la segunda posguerra se puede visualizar como un período de redefinición de múltiples valores y de reconfiguración de nuestras representaciones de lo humano en manos de la cibernética, la filosofía, las ciencias humanas y sociales, la literatura, el cine y las artes plásticas en general, las décadas de 1960 y 1970 se erigen como el momento en que estos desarrollos impactan en la arquitectura obligándola a conducirse hacia un lugar de mayor relevancia socio-cultural. Para algunos arquitectos la complejidad y sofisticación formal fue un objetivo que en un contexto de sospecha hacia su rol, al que se concebía crecientemente como déspota, tecnócrata o marioneta, no hubiera sido posible sin la intermediación de un conjunto preciso de operaciones técnicas y discursivas. A través de la lectura cercana de dos proyectos que se ubican en los extremos del arco temporal estudiado, la investigación demuestra cómo esas operaciones en torno al usuario fueron una herramienta fundamental para la supervivencia de la disciplina y para la continuidad de su aporte al proceso de organización espacial de la sociedad occidental tardo-moderna.
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    Microsurgery Workout : A Novel Simulation Training Curriculum Based on Nonliving Models
    (2016) Rodriguez, J.; Cifuentes, I.; Varas, Julián; Dagnino, Bruno; Yanez, R.
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    Programa pionero de simulación en sutura para estudiantes de medicina de pregrado
    (2015) Alvarado, Juan; Henríquez R., Juan Pablo; Castillo R., Richard; Sosa B., Javiera; León F., Felipe; Varas, Julián; Camus Appuhn, Mauricio Gonzalo; Riquelme Pérez, Arnoldo; Crovari Eulufi, Fernando; Martínez Castillo, Jorge; Boza, Camilo; Jarude C., Nicolás; Alvarado, Juan; Henríquez R., Juan Pablo; Castillo R., Richard; Sosa B., Javiera; León F., Felipe; Varas, Julián; Camus Appuhn, Mauricio Gonzalo; Riquelme Pérez, Arnoldo; Crovari Eulufi, Fernando; Martínez Castillo, Jorge; Boza, Camilo; Jarude C., Nicolás
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    Resección hepática laparoscópica
    (2013) Marambio Granic, Andrés Javier; Llera Martin, Juan Carlos de la; Varas, Julián; Sanhueza García, Marcel Paolo; Martínez Castillo, Jorge; Guerra Castro, Juan Francisco; Jarufe Cassis, Nicolás
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    Simulation in laparoscopic surgery
    (2015) León Ferrufino, Felipe; Varas, Julián; Buckel Schaffner, Erwin; Crovari Eulufi, Fernando; Pimentel Muller, Fernando; Martínez Castillo, Jorge; Jarufe Cassis, Nicolás; Boza, Camilo; León Ferrufino, Felipe; Varas, Julián; Buckel Schaffner, Erwin; Crovari Eulufi, Fernando; Pimentel Muller, Fernando; Martínez Castillo, Jorge; Jarufe Cassis, Nicolás; Boza, Camilo
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    Simulation-trained junior residents perform better than general surgeons on advanced laparoscopic cases
    (2017) Boza, Camilo; León, Felipe; Buckel, Erwin; Riquelme Pérez, Manuel Antonio; Crovari Eulufi, Fernando; Martínez Castillo, Jorge; Aggarwal, Rajesh; Grantcharov, Teodor; Jarufe Cassis, Nicolás; Varas, Julián; Boza, Camilo; León, Felipe; Buckel, Erwin; Riquelme Pérez, Manuel Antonio; Crovari Eulufi, Fernando; Martínez Castillo, Jorge; Aggarwal, Rajesh; Grantcharov, Teodor; Jarufe Cassis, Nicolás; Varas, Julián
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    Surgical training scalability through AI-based innovations
    (2025) Jarry Trujillo, Cristián Ignacio; Vela Ulloa, Javier Ignacio; Durán Espinoza, Valentina Alexandra; Van Leeuwen, Matthew; Varas, Julián
    Training scalability in surgical education is challenged by the limited availability of expert instructors and the need for personalized feedback. The integration of artificial intelligence (AI) into surgical training offers promising solutions to these challenges. This narrative review examines how AI-based tools enhance surgical training scalability, focusing on automated assessments, feedback delivery, and simulation-based education. A comprehensive literature search identified relevant studies on AI applications in surgical training. The review discusses the educational foundations of simulation training, defines AI and its subsets (machine learning and deep learning), and explores the significance of phase/task segmentation in surgical procedures. It critically analyzes current AI applications in automated assessment and feedback, highlighting impediments to scalability such as the specificity of AI models to particular procedures and the need for new models across different domains. The findings suggest that while AI holds significant potential for improving surgical education, challenges remain in generalizing models and integrating AI tools into diverse training contexts.
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    Telemedicine for postoperative follow-up, virtual surgical clinics during COVID-19 pandemic
    (2020) Inzunza A., Martín; Muñoz Claro, Rodrigo Edgardo; Quezada Sanhueza, Nicolás; Gabrielli Nervi, Mauricio; Dib Marambio, Martín Javier; Urrejola Schmied, Gonzalo Ignacio; Varas, Julián; Valderrama Chang, Sebastián Matías; Crovari Eulufi, Fernando; Achurra Tirado, Pablo; Irarrázaval Llona, Manuel José; Brañes A.; Soto P.; Inzunza Agüero, Martín Alejandro; Muñoz Claro, Rodrigo; Quezada Sanhueza, Nicolás; Gabrielli Nervi, Mauricio; Dib Marambio, Martín Javier; Urrejola Schmied, Gonzalo Ignacio; Varas, Julián; Valderrama Chang, Sebastián Matías; Crovari Eulufi, Fernando; Achurra Tirado, Pablo; Irarrázaval Llona, Manuel José; Brañes A.; Soto P.
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    Transgastric repair of transfixing gastroesophageal junction gunshot wound: video case report
    (2021) Vela, Javier; Contreras, Caterina; Varas, Julián; Ottolino, Pablo; Ramos, Juan Pablo; Escalona, Gabriel; Díaz, Alfonso; Achurra, Pablo; Ceroni, Marco
    Abstract Managing traumatic injuries of the gastroesophageal junction (GEJ) is infrequent due to associated lesions of adjacent highly vascularized organs. Its anatomical localization in the upper abdomen makes the repair challenging to perform. A stable 23-year-old male was presented at the emergency department with two thorax gunshot wounds. Computed tomography revealed air in the periesophageal space and right hemopneumothorax with no injury of the major vessels. A chest tube was placed and the patient was transferred hemodynamically stable to the operating. Abdominal exploration identified injuries to the left diaphragm; liver lateral segment; 1-cm transfixing perforation of the GEJ and right diaphragmatic pillar. Primary repair of the GEJ was performed and patched with a partial fundoplication. The diaphragm was repaired and the liver bleeding controlled. Finally, drains and a feeding jejunostomy were placed. The patient had an uneventful early postoperative course and was discharged home on the 12th postoperative day.
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    Validación de un modelo simulado inanimado basado en impresión 3d de ureterorrenoscopía flexible
    (2020) Neira S., Rodrigo ; Varas, Julián; Astroza Eulufi, Gastón Maximiliano
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    Video-based guided simulation without peer or expert feedbackis not enough : a randomized controlled trial of simulation based training for medical students
    (2021) Tejos, Rodrigo; Crovari Eulufi, Fernando; Achurra Tirado, Pablo; Ávila, Rubén; Inzunza, Martín; Jarry, Cristián; Martínez C., Jorge; Riquelme Pérez, Arnoldo; Alseidi, Adnan; Varas, Julián
    Background Feedback is a pivotal cornerstone and a challenge in psychomotor training. There are different teaching methodologies; however, some may be less effective. Methods A prospective randomized controlled trial was conducted in 130 medical students to compare the effectiveness of the video-guided learning (VLG), peer-feedback (PFG) and the expert feedback (EFG) for teaching suturing skills. The program lasted 4 weeks. Students were recorded making 3-simple stitches (pre-assessment and post-assessment). The primary outcome was a global scale (OSATS). The secondary outcomes were performance time, specific rating scale (SRS) and the impact of the intervention (IOI), defined as the variation between the final and initial OSATS and SRS scores. Results No significant differences were found between PFG and EFG in post-assessment results of OSATS, SRS scores or in the IOI for OSATS and SRS scores. Post-assessment results of PFG and EFG were significantly superior to VLG in OSATS and SRS scores [(19.8 (18.5–21); 16.6 (15.5–17.5)) and (20.3 (19.88–21); 16.8 (16–17.5)) vs (15.7 (15–16); 13.3 (12.5–14)) (p \0.05)], respectively. The results of PFG and EFG were significantly superior to VLG in the IOI for OSATS [7 (4.5–9) and 7.4 (4.88–10) vs 3.5 (1.5–6) (p \0.05)] and SRS scores [5.4 (3.5–7) and 6.3 (4–8.5) vs 3.1 (1.13–4.88) (p \0.05)], respectively. Conclusion The video-guided learning methodology without any kind of feedback is not enough for teaching suturing skills compared to expert or peer feedback. The peer feedback methodology appears to be a viable alternative to handling the emerging demands in medical education.