Implementation of a Canine Ergonomic Abdominal Simulator for Training Basic Laparoscopic Skills in Veterinarians.

The validity of the CALMA Veterinary Lap-trainer simulator (CVLTS) for training basic veterinary laparoscopic skills was assessed and compared to a simple collapsible mobile box trainer. Ten veterinarian surgeons with no experience in laparoscopic surgery and four experts with at least two years of experience in minimally invasive surgery (MIS) were included. The training curriculum included object transfer, non-woven gauze cutting with curved scissors, and interrupted and continuous intracorporeal sutures, which were practiced on the CVLTS. The initial and final assessments were carried out in both the CVLTS and in a collapsible mobile simulator. These were video-recorded and evaluated by external experts using the Objective Structured Assessment of Technical Skills (OSATS) and a specific scale evaluation in a double-blinded schedule. The time, angular displacement, number, and movement smoothness were recorded using a hands movement assessment system (HMAS). Through a survey, the face validity and content were evaluated. The data were analyzed by a Pearson's proportions comparison or Mann Whitney U test and a bilateral Student's t-test. The experimental group OSATS, specific scores, and HMAS values, with the exception of the smoothness of movements, significantly improved after training, with no statistically significant differences compared to the expert group. No differences were found between the two simulators. The experts' and experimental participants' CVLTS mean score was 4.8. Our data support the CVLTS validations for laparoscopic surgery basic skills training.

Hybrid revascularization vs. coronary bypass for coronary artery disease: a systematic review and meta-analysis.

INTRODUCTION: Coronary artery bypass graft is the mainstay of treatment for multivessel coronary artery disease and is superior to percutaneous coronary intervention. Combined approaches such as hybrid coronary revascularization integrate coronary artery bypass grafting with percutaneous coronary intervention during the same procedure or weeks apart. These attempt to improve surgical morbidity and long-term outcomes. EVIDENCE ACQUISITION: Per PRISMA criteria, a systematic review of keywords "Hybrid Revascularization," "Hybrid Coronary Revascularization," "Surgical," "Surgery," "Treatment," "CABG," "HCR" and "PCI" was conducted in PubMed, EMBASE and SCOPUS. Studies comparing this technique's performance on either single or two-stage approach against traditional multiple vessel coronary artery bypass grafting were screened and analyzed for our review. EVIDENCE SYNTHESIS: Twenty-two studies totaling 6981 participants were ultimately included for analysis. Mean differences in operative time, bleeding, ventilator time and length of stay were significantly lower in the hybrid coronary revascularization group. Odds ratios in transfusions and in-hospital myocardial infarction were also lower in the hybrid coronary revascularization group. Results for in-hospital and all-cause mortality, major adverse cardiac events (MACE), stroke, reintervention, and complete revascularization were not significantly different. CONCLUSIONS: Our analysis shows hybrid coronary revascularization is a feasible alternative to traditional coronary artery bypass grafting. Short-and long-term outcomes including mortality, MACE, and postoperative morbidity are similar between both groups, while hybrid approaches are associated with decreased perioperative morbidity.

A new species and new records of Pachychernes Beier, 1932 from Colombia (Pseudoscorpiones, Chernetidae).

In Colombia, the status of the Neotropical genus Pachychernes Beier, 1932 is unknown. The only available data in literature to support the presence of this genus is an adult of P. aff. subrobustus, possibly female, from copal resin without specific locality data, and a record at generic level from Northern Colombia. In this study, we extend the distribution of Pachychernes by describing a new species, P. florezi sp. n. and several reporting individuals of P. zehorum Muchmore, 1997 from Montes de Mara and the Caribbean coast of the country. These species are clearly differentiated from one another by the sexual dimorphism in the latter species, with a depression on the tarsus I in males. We also present an updated key for all species of the genus.