[A current perspective of natural orifices transluminal endoscopic surgery (NOTES)]. / Perspectiva actual de la cirugía endoscópica transluminal por orificios naturales (CETON).

Natural orifice transluminal endoscopic surgery (NOTES) represents an alternative in surgical approach, combined with the progress and experience gained from conventional and endoscopic surgery. Bibliographic research in PubMed, Medline database from 2000 to 2015 and analysis of the literature reviews found. NOTES provides vision and natural orifice approach, it has optimized operating times as well as reduced complications and better cosmetic results. Small series of patients have been reported, but there is not a valid clinical multicenter study by evidence-based medicine. NOTES can help to improve the standard operations, complemented with laparoscopic surgery rather than replace it and thus develop tools for the resolution of various diseases that require surgical treatment. This option in current surgery is safe and presents satisfactory results in the reported cases. The development of this new approach of performing surgical procedures requires further study and development of new technology in order to increase the accessibility of these procedures and represent in a practical and sustained way, a better option to approach surgical pathology.

[Evaluación del desempeño de estudiantes de medicina de pregrado en cirugía abierta con proyección a realizar una especialidad quirúrgica]. / Open surgery performance evaluation in undergraduate medicine students with a projection to undergo a surgical specialty training.

OBJETIVO: Determinar el desarrollo de habilidades, los conocimientos y los niveles de confianza en el campo de la cirugía abierta en un grupo de estudiantes de pregrado de medicina que pretendan realizar una especialidad quirúrgica. MÉTODO: Se llevó a cabo un estudio en un grupo de estudiantes de sexto año de medicina con el enfoque de realizar una especialidad quirúrgica. Todos los participantes recibieron un entrenamiento teórico-práctico de habilidades en cirugía abierta. Se emplearon métodos de evaluación previamente validados. Se utilizó la prueba estadística t de Student para muestras pareadas. RESULTADOS: La media en la evaluación previa al entrenamiento fue del 28%, mientras que la media en la evaluación final del entrenamiento fue del 63%. Durante el procedimiento quirúrgico se empleó el método de evaluación OSATS (Objective Structured Assessment of Technical Skills), del cual se obtuvo un promedio del 70 ± 14%. De acuerdo con el nivel de confianza de los participantes, antes de haber recibido el entrenamiento el 60% se autopercibió como ligeramente confiado, y al finalizarlo, el 80% se autopercibió como muy confiado. CONCLUSIONES: La implementación de este tipo de entrenamientos en estudiantes de pregrado podría ser costo-efectiva y permitiría que los cirujanos en formación alcanzarán en menor tiempo las competencias necesarias. OBJECTIVE: To determine the development of skills, knowledge, and trust levels in the field of open surgery among a group of undergraduate students enrolled in the medicine curricula who intend to undergo further training in a surgical specialty. METHOD: A quasi-experimental study with a pre-post test design was performed upon a group of sixth-year medical students who intend to undergo surgical specialty training. All participants had previously received a 2-week theoretical and practical open-surgery skills training; previously validated evaluation methods were enforced. A paired sample T-test was used for this analysis. RESULTS: Median pre-training score for the 13 basic skills was 28%, whereas post-training median score was 63%. During the surgical procedure, OSATS (Objective Structured Assessment of Technical Skills) method was applied, with average results of 70 ± 14%. Regarding self-confidence levels among participants, 60% of the participants referred as being slightly confident before undergoing training, as opposed to an 80% of students perceiving themselves as highly confident after completing training. CONCLUSION: The implementation of skill training for undergraduate students could prove cost-effective in the medical environment, allowing surgeons-to-be to reach the necessary competences in less time in accordance to current study plans.

[The importance of master's degree and doctorate degree in general surgery]. / Importancia de la maestría y el doctorado en cirugía general.

BACKGROUND: The Doctor of Philosophy is the highest academic degree that can be obtained in universities. Graduate Education Program in Medicine in Mexico is divided into 2 major categories: Medical Specialty and Master studies/Doctor of Philosophy. The objective of this study was to demonstrate the importance of master's degrees and Doctor of Philosophy in general surgery. MATERIAL AND METHODS: A literature search in PubMed and Medline among others, from 1970 to 2015 with subsequent analysis of the literature reviews found. DISCUSSION: The physicians who conducted doctoral studies stand out as leaders in research, teaching and academic activities. Dual training with a doctorate medical specialty is a significant predictor for active participation in research projects within the best educational institutions. RESULTS: It is important to study a PhD in the education of doctors specialising in surgery, who show more training in teaching, research and development of academic activities. Currently, although there is a little proportion of students who do not finish the doctoral program, the ones who do are expected to play an important role in the future of medical scientific staff. It has been shown that most doctors with Doctor of Philosophy have wide range of career options. CONCLUSION: The importance of doctoral studies in the formation of general surgery is due to various reasons; the main one being comprehensively training physician scientists who can develop in clinical, teaching and research.