Colonic Electrical Stimulation for Chronic Constipation: A Perspective Review.

Chronic constipation affects around 20% of the population and there is no efficient solution. This perspective review explores the potential of colonic electric stimulation (CES) using neural implants and methods of bioelectronic medicine as a therapeutic way to treat chronic constipation. The review covers the neurophysiology of colonic peristaltic function, the pathophysiology of chronic constipation, the technical aspects of CES, including stimulation parameters, electrode placement, and neuromodulation target selection, as well as a comprehensive analysis of various animal models highlighting their advantages and limitations in elucidating the mechanistic insights and translational relevance for CES.

[Validity studies in laparoscopic simulation. Methodology and design considerations.].

Objectives: To describe a roadmap of the most representative milestones and considerations in the validation of surgical simulators, especially those of laparoscopic surgery. And additionally, help determine when in this process a simulator can be considered as validated.

Methods: A non-systematic review was carried out searching terms like simulation, validation, training, assessment, skills and learning curve, as well as providing the experience accumulated by our center.

Comparison of the use of fresh-frozen canine cadavers and a realistic composite ex vivo simulator for training in small animal flexible gastrointestinal endoscopy.

OBJECTIVE To compare the usefulness of fresh-frozen canine cadavers (FFCCs) and a validated canine simulator model for training veterinary students in basic gastrointestinal endoscopic procedures. DESIGN Randomized trial. SAMPLE 48 veterinary students in their final year of training.

[Training in basic and advanced laparoscopy: Evaluation of a 30-year experience in a training program in Spain.].

The lack of globally established standards for learning urological laparoscopy has not prevented laparoscopic techniques from evolution and continuous development. Laparoscopy coexists with robotic surgery today, and in the last decade there have been many techniques that have undergone a boom with the use of a laparoscopic approach (total and partial nephrectomy, pyeloplasty, colposacropexy, etc.).

Muscle activity and hand motion in veterinarians performing laparoscopic training tasks with a box trainer.

Objective: To evaluate muscle activity and hand motion in veterinarians performing a standard set of laparoscopic training tasks.

Sample: 12 veterinarians with experience performing laparoscopic procedures.

Procedures: Participants were asked to perform peg transfer, coordination, precision cutting, and suturing tasks in a laparoscopic box trainer.

Common swine models of cardiovascular disease for research and training.

Cardiovascular diseases are a major health concern and therefore an important topic in biomedical research. Large animal models allow researchers to assess the safety and efficacy of new cardiovascular procedures in systems that resemble human anatomy; additionally, they can be used to emulate scenarios for training purposes. Among the many biomedical models that are described in published literature, it is important that researchers understand and select those that are best suited to achieve the aims of their research, that facilitate the humane care and management of their research animals and that best promote the high ethical standards required of animal research.

Assessment of Laparoscopic Skills in Veterinarians Using a Canine Laparoscopic Simulator.

The aim of the present study was to assess the content and construct validity of the Canine Laparoscopic Simulator (CLS). Forty-two veterinarians were assigned to experienced (n=12), control (n=15), and training (n=15) groups, which were assessed while performing four laparoscopic tasks on the CLS. The initial and final assessments of all tasks were performed blindly by two experienced surgeons using the Global Operative Assessment of Laparoscopic Skills (GOALS) and a task-specific checklist.

[Pyramid training model in laparoscopic surgery].

Background: Minimally invasive surgery implementation requires a regulated and orderly learning process.

Methods: Jesús Usón Minimally Invasive Surgery Centre promotes a pyramid training model structured into four levels: training of basic and advanced skills in physical simulator (level 1), training of anatomical protocols and advanced skills with animal models (level 2) training advanced procedural skills with tele-surgical applications (level 3), and training in the operating room (level 4). Training provided at levels 1 and 2 is described and evaluated.

Development and evaluation of a canine laparoscopic simulator for veterinary clinical training.

Human laparoscopic simulators have been used in medical education for minimally invasive surgery (MIS) in the past years. Simulator-based laparoscopic training has attracted much interest because unique skills have to be learned not only by surgeons in training but also by surgeons in practice. MIS forces the surgeon to adapt to monocular vision and decreased tactile sensation and entails training and improving hand-eye and hand-hand coordination.

Validation of a realistic simulator for veterinary gastrointestinal endoscopy training.

This article reports on the face, content, and construct validity of a new realistic composite simulator (Simuldog) used to provide training in canine gastrointestinal flexible endoscopy. The basic endoscopic procedures performed on the simulator were esophagogastroduodenoscopy (EGD), gastric biopsy (GB), and gastric foreign body removal (FBR). Construct validity was assessed by comparing the performance of novices (final-year veterinary students and recent graduates without endoscopic experience, n=30) versus experienced subjects (doctors in veterinary medicine who had performed more than 50 clinical upper gastrointestinal endoscopic procedures as a surgeon, n=15).

Growing cava vein anastomosis: comparison of cross-clamping and suture times using VCS metallic clips, interrupted nonabsorbable, or continuous absorbable suturing techniques.

Background: The latest generation in titanium clip application systems, the AnastoClip Vessel Closure System (VCS; LeMaitre Vascular, Burlington, MA), allows surgeons to perform vascular anastomosis more easily and faster than conventional sutures. This system may become the option of choice for vascular reconstruction in pediatric surgery where, as in the case transplant surgery, decreasing vascular occlusion times may influence outcome. The aim of this study was to determine whether VCS metallic clips would allow shorter anastomosis times than conventional interrupted polypropylene or running polyglycolic acid suturing in end-to-end anastomosis performed in the abdominal cava of young pigs.

Ergonomic analysis of muscle activity in the forearm and back muscles during laparoscopic surgery: influence of previous experience and performed task.

Purpose: The first aim of this study is to analyze the muscle activity in back and forearm muscles in surgeons during laparoscopic dissection and suturing maneuvers. The second aim is to determine the influence of the surgeons' previous experience in laparoscopic surgery.

Methods: A total of 30 laparoscopic surgeons were divided in 3 groups: novice suturing, novice dissecting, and experts suturing.

Heterotopic renal transplantation in piglets using vascular closure stapler metallic clips or conventional suturing techniques: comparison of vessel growth and macroscopical study.

Background/purpose: Our aim was to perform a macroscopic and imaging (ultrasonographic and angiographic) evaluation of vascular closure stapler (VCS) metallic clips for renal transplantation in growing piglets to assess their role for transplantation surgery in young children. If these techniques are to be useful, it is necessary to prove that their use avoids one of the main pitfalls of conventional sutures in this setting, namely lack of growth in the suture line.

Methods: Twenty-four piglets were used for this study.

[Preliminary validation of the Simulap(®) physical simulator and its assessment system for laparoscopic surgery].

Introduction: Our aim is to assess the face and content validities of the physical simulator Simulap(®), as well as the construct validity of its assessment method.

Material And Methods: Five novice surgeons (G1) and five experts (G2) performed seven basic tasks and one suturing exercise on Simulap(®), which were assessed through an exam based on mistakes and performance time. Face and content validations were carried out by novice surgeons and expert surgeons, respectively.

[Ergonomics in laparoscopic surgery and its importance in surgical training].

Despite the many advantages that laparoscopic surgery has for patients, it involves a series of risks for the surgeon. These are related to the reduced freedom of movement and forced postures which lead to greater muscle fatigue than with conventional surgery. In laparoscopic surgery there are few references on the introduction of training programs in ergonomics, despite the numerous advantages demonstrated in other disciplines.

Construct and face validity of SINERGIA laparoscopic virtual reality simulator.

Purpose: Laparoscopic techniques have nowadays become a gold standard in many surgical procedures, but they imply a more difficult learning skills process. Simulators have a fundamental role in the formative stage of new surgeons. This paper presents the construct and face validity of SINERGIA laparoscopic virtual reality simulator in order to decide whether it can be considered as an assessment tool.

[Ultrasonographic histological study on the evolution of a canine model of hormone-induced benign prostatic hyperplasia].

Introduction: Despite exhibiting histological differences from the human process, canine hormone-induced benign prostatic hyperplasia (BPH) is still the most widely used animal model for evaluating treatment strategies.

Objectives: The aim of this study is to determine the optimal moment for starting a therapeutic trial in this animal model.

Material And Methods: Six male beagle dogs over one year of age were used in this study.

[Titanium metallic clips: easier and faster than conventional suturing for heterotopic renal autotransplant in growing pigs].

Introduction: When performing vascular reconstruction in growing elements, specifically in paediatric transplant surgery, where a short vascular occlusion time is mandatory, master and easily handled suturing methods are needed. Thus the present study compares conventional continuous suturing with polypropylene and dexon versus easier and faster to apply titanium clips in heterotopic renal autotransplants.

Material And Methods: 24 growing pigs were used for this study.

[Training design and improvement of technical skills in the transvaginal cholecystectomy (NOTES)].

Introduction: The current surgical scenario of the surgery through natural orifices or <> requires acquiring new technical skills by the surgeon. We introduce the initial experience of the Minimally Invasive Surgery Centre Jesús Usón (MISCJU) in the design and setting-up of a surgical training programme using the the natural orifices approach for the acquisition of surgical skills and abilities, based on the preliminary trials in simulators and a pig model.

Material And Methods: After initial training, using a laparoscopic pelvic-trainer, 7 female pigs, with weights between 35-40 kg, were operated on.

Physiological responses to different ischemic periods during laparoscopic infrarenal aortic cross-clamping: evaluation in an experimental animal model.

Our aim was to study the physiological repercussions of varying ischemic times during laparoscopic aortic surgery. After quarantine, laparoscopy was performed in 24 healthy pigs, which were randomly allocated to four study groups: group I (n=6), laparoscopic infrarenal abdominal aortic surgery with 30 min of crossclamping; group II (n=6), laparoscopic infrarenal abdominal aortic surgery with 60 min of cross-clamping; group III (n=6), laparoscopic infrarenal abdominal aortic surgery with 120 min of cross-clamping; group IV (n=6), 120 min pneumoperitoneum in the absence of aortic cross-clamping (control group). Hematological, biochemical, hormone, hemodynamic, and ventilatory studies were conducted during and after surgery; and a postoperative neurological evaluation was performed 10 days after surgery.

Physiologic Responses to Infrarenal Aortic Cross-Clamping during Laparoscopic or Conventional Vascular Surgery in Experimental Animal Model: Comparative Study.

The aim of this study was to compare the hemodynamic and ventilatory effects of prolonged infrarenal aortic cross-clamping in pigs undergoing either laparotomy or laparoscopy. 18 pigs were used for this study. Infrarenal aortic crossclamping was performed for 60 minutes in groups I (laparotomy, n = 6) and II (laparoscopy, n = 6).

New dental simulator for microsurgical training preliminary overview.

Objective: To present a new simulator designed at the Minimally Invasive Surgery Centre (Cáceres) which offers an integral, effective and viable training system that can be used for learning microsurgical techniques.

Study Design: A square methacrylate block was used. Animal jaws were fixed to the sides by means of butterfly screws.

Angiographic, ultrasonographic, and macroscopic assessment of aortic growth after VCS clips, interrupted polypropylene, or running polyglycolic acid anastomosis.

Background/purpose: Lack of growth after surgery is still an unsolved issue in growing vessels. Aortic surgery is an integral part of vascular pediatric surgery. As an alternative to address this lack of growth in this scenario, we propose the use of titanium clips for vascular anastomosis.

The application of microscopic surgery in dentistry.

The use of the microscope as a tool for practising Medicine, especially in surgical specialisations, has been established for decades. The microscope was first used in OdontologyDentistry back to the 1970s and 1980s, and was introduced more widely (although it was still far from being in general use) during 1990s. The purpose of this article is to describe the main applications of the microscope in OdontologyDentistry today, as well as providing odontologists and stomatologists, whether specialists or in general practice, with information about microscopic OdontologyDentistry for better patient care.

Evaluation of the effects of temporary covered nitinol stent placement in the prostatic urethra: short-term study in the canine model.

Purpose: To evaluate the effect of temporary stent placement on the canine prostatic urethra.

Methods: Retrievable PTFE-covered nitinol stents were placed in the prostatic urethras of 8 beagle dogs under fluoroscopic guidance. Retrograde urethrography was obtained before and after stenting.