Gustavo Benítez

Central University of Venezuela, Caracas, Capital, Venezuela

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Publications (16)3.65 Total impact

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    ABSTRACT: Technical skills assessment is considered an important part of surgical training. Subjective assessment is not appropriate for training feedback, and there is now increased demand for objective assessment of surgical performance. Economy of movement has been proposed as an excellent alternative for this purpose. The investigators describe a readily available method to evaluate surgical skills through motion analysis using accelerometers in Apple's iPod Touch device. Two groups of individuals with different minimally invasive surgery skill levels (experts and novices) were evaluated. Each group was asked to perform a given task with an iPod Touch placed on the dominant-hand wrist. The Accelerometer Data Pro application makes it possible to obtain movement-related data detected by the accelerometers. Average acceleration and maximum acceleration for each axis (x, y, and z) were determined and compared. The analysis of average acceleration and maximum acceleration showed statistically significant differences between groups on both the y (P = .04, P = .03) and z (P = .04, P = .04) axes. This demonstrates the ability to distinguish between experts and novices. The analysis of the x axis showed no significant differences between groups, which could be explained by the fact that the task involves few movements on this axis. Accelerometer-based motion analysis is a useful tool to evaluate laparoscopic skill development of surgeons and should be used in training programs. Validation of this device in an in vivo setting is a research goal of the investigators' team.
    Full-text · Article · Oct 2014 · JSLS: Journal of the Society of Laparoendoscopic Surgeons / Society of Laparoendoscopic Surgeons
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    ABSTRACT: Training models in laparoscopic surgery allow the surgical team to practice procedures in a safe environment. We have proposed the use of a 4-task, low-cost inert model to practice critical steps of laparoscopic common bile duct exploration. The performance of 3 groups with different levels of expertise in laparoscopic surgery, novices (A), intermediates (B), and experts (C), was evaluated using a low-cost inert model in the following tasks: (1) intraoperative cholangiography catheter insertion, (2) transcystic exploration, (3) T-tube placement, and (4) choledochoscope management. Kruskal-Wallis and Mann-Whitney tests were used to identify differences among the groups. A total of 14 individuals were evaluated: 5 novices (A), 5 intermediates (B), and 4 experts (C). The results involving intraoperative cholangiography catheter insertion were similar among the 3 groups. As for the other tasks, the expert had better results than the other 2, in which no significant differences occurred. The proposed model is able to discriminate among individuals with different levels of expertise, indicating that the abilities that the model evaluates are relevant in the surgeon's performance in CBD exploration. Construct validity for tasks 2 and 3 was demonstrated. However, task 1 was no capable of distinguishing between groups, and task 4 was not statistically validated.
    Full-text · Article · Aug 2012 · JSLS: Journal of the Society of Laparoendoscopic Surgeons / Society of Laparoendoscopic Surgeons
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    ABSTRACT: We present a case of a 32-year-old female patient with the diagnosis of gallstone disease and choledocholithiasis. Prior to in vivo surgery, we practiced the critical steps of the procedure using a proposed inert training model. We performed a robot-assisted laparoscopic common bile duct exploration, obtaining one stone. The operating time was 140min (console time: 120min) with no complications during the procedure. The patient was discharged 2days after the operation. Robot-assisted minimally invasive surgery of the common bile duct is a safe and effective procedure and seems to have some benefits over conventional laparoscopic surgery. KeywordsCholedocholithiasis–Robotic surgery–Laparoscopy–Training
    Full-text · Article · Jun 2010 · Journal of Robotic Surgery
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    ABSTRACT: To compare the effectiveness of laparoscopic common bile duct exploration in patients with failed endoscopic retrograde cholangiopancreatography (ERCP). This is a descriptive, comparative study. Patients with an indication of common bile duct exploration between February 2005 and October 2008 were included. We studied 2 groups: Group A: patients with failed ERCP who underwent LCBDE plus LC. Group B: patients with common bile duct stones managed with the 1-step approach (LCBDE + LC) with no prior ERCP. Twenty-five patients were included. Group A: 9 patients, group B: 16 patients. Success rate, operative time, and hospital stay were as follows: group A 66% vs group B 87.5%; group A 187 minutes vs 106 minutes; group A 4.5 days vs 2.3 days; respectively. Patients with failed ERCP should be considered as high-complex cases in which the laparoscopic procedure success rate decreases, and the conversion rate increases considerably.
    Full-text · Article · Apr 2010 · JSLS: Journal of the Society of Laparoendoscopic Surgeons / Society of Laparoendoscopic Surgeons
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    ABSTRACT: Training and experience of the surgical team are fundamental for the safety and success of complex surgical procedures, such as laparoscopic common bile duct exploration. We describe an inert, simple, very low-cost, and readily available training model. Created using a "black box" and basic medical and surgical material, it allows training in the fundamental steps necessary for laparoscopic biliary tract surgery, namely, (1) intraoperative cholangiography, (2) transcystic exploration, and (3) laparoscopic choledochotomy, and t-tube insertion. The proposed model has allowed for the development of the skills necessary for partaking in said procedures, contributing to its development and diminishing surgery time as the trainee advances down the learning curve. Further studies are directed towards objectively determining the impact of the model on skill acquisition. The described model is simple and readily available allowing for accurate reproduction of the main steps and maneuvers that take place during laparoscopic common bile duct exploration, with the purpose of reducing failure and complications.
    Full-text · Article · Jan 2010 · JSLS: Journal of the Society of Laparoendoscopic Surgeons / Society of Laparoendoscopic Surgeons
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    Full-text · Article · Jun 2009
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    ABSTRACT: Tumors of the small bowel are relative rare with an incidence of 5 %. These kinds lesions we find in the stoma gastrointestinal tumors, there are a group of neoplasm mesenquimal original. They are constitutive 0,1 % to 3 % of the digestive tract tumors. The clinical presentation is no specific generally the patients consult for superior digestive bleeding, pain or palpable mass. The market determination is important to the pathological confirmation and are sustention with immunohistochemestry studies based in the expression of CD117 (c-kit receptor), CD34, desmine and S100 protein, to be differential of another tumors how mesenchyme, neural, and neuroendocrines. The biological clinical courses of these kinds of tumors are difficult to predict. The surgical resection with free lesion margins is the treatment of choice for the localized lesions. .
    Full-text · Article · Dec 2008 · Revista Venezolana de Oncologia
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    Full-text · Article · Jun 2008
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    ABSTRACT: La presencia de tumor ovárico durante la gestación es un evento poco frecuente. Debido a los cambios anatómicos y fisiológicos producidos por la gravidez, su identificación es difícil, generalmente incidental. Los tumores de bajo potencial de malignidad representan 35 % de las lesiones ováricas malignas diagnosticadas durante la gestación; seguidos, en orden de frecuencia, por lesiones epiteliales invasivas (30%), los disgerminomas (17%), los tumores de la granulosa (15%) y los carcinomas indiferenciados (5%). El 15 % de los tumores ováricos diagnosticados en esta etapa, se identifican al momento de realizar una cirugía de emergencia por un embarazo ectópico. El advenimiento de recursos tecnológicos que hacen factible la evaluación y realización de procedimientos quirúrgicos oncológicamente óptimos a través de abordajes mínimamente invasivos, ha permitido que la cirugía laparoscópica pueda utilizarse en la actualidad como una herramienta prudente en el tratamiento de pacientes con lesiones malignas de ovario.
    Full-text · Article · Dec 2007 · Revista Venezolana de Oncologia

  • No preview · Article · Jun 2007
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    ABSTRACT: Los quistes esplénicos verdaderos constituyen una rareza, es por ello que presentamos el caso de una paciente de 21 años de edad tratada por un quiste esplénico gigante (30 cm) con elevación del Ca 19-9 (1670U/mL) a quien se le realizó esplenectomía con evolución satisfactoria y sin complicaciones. La biopsia definitiva reportó quiste esplénico verdadero, siendo estas lesiones poco frecuentes, más aun cuando cursan con elevación del Ca 19-9, encontramos que se han publ
    Full-text · Article · Jan 2007

  • No preview · Article · Dec 2004
  • G Benítez · A París · R Saade · F Obregón · E García · R Scorzza Q · E Nakhal

    No preview · Article · Jun 2004
  • E García · G Benítez · F Obregón · R Saade · A Sánchez · J González

    No preview · Article · Jun 2004
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    ABSTRACT: The aggressive angiomixoma is a benign, less frequent myofibroblastic tumor, not encapsulated his nature was very invasive and his recurrences are often present. It is more common in the women at the fertile age. It is usually located in the pelvis and the perinea. At this moment there have been reported only 310 cases of this type of tumor. We presented and study a clinical case of 51 year old female patient who consults with palpable mass in left gluteus, and urinary compressive symptoms with difficult to evacuate. We decided the surgical resection for abdominal and gluteus way was performed and the evolution of the patient was satisfactory.
    No preview · Article · · Revista Venezolana de Oncologia
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    ABSTRACT: RESUMEN La presencia de tumor ovárico durante la gestación es un evento poco frecuente. Debido a los cambios anatómicos y fisiológicos producidos por la gravidez, su identificación es difícil, generalmente incidental. Los tumores de bajo potencial de malignidad representan 35 % de las lesiones ováricas malignas diagnosticadas durante la gestación; seguidos, en orden de frecuencia, por lesiones epiteliales invasivas (30 %), los disgerminomas (17 %), los tumores de la granulosa (15 %) y los carcinomas indiferenciados (5 %). El 15 % de los tumores ováricos diagnosticados en esta etapa, se identifican al momento de realizar una cirugía de emergencia por un embarazo ectópico. El advenimiento de recursos tecnológicos que hacen factible la evaluación y realización de procedimientos quirúrgicos o n c o l ó g i c a m e n t e ó p t i m o s a t r a v é s d e a b o r d a j e s mínimamente invasivos, ha permitido que la cirugía laparoscópica pueda utilizarse en la actualidad como una herramienta prudente en el tratamiento de pacientes con lesiones malignas de ovario. SUMMARY The presence of ovarian tumor during the pregnancy is an event less frequent. For the anatomic and the fisiologic changes in the pregnancy his identification is to difficult and frequent is incidental. The low malignant potential tumor represents the 35 % of the ovarian malignant le-sions; they diagnostic true the pregnancy; follow in fre-quency order for the epithelial invasive lesions (30 %), and the dysgerminoma and (17 %) granulose tumor (15 %) and the undifferentiated carcinoma (5 %). The 15 % of ovarian tumors diagnostic in these phase were founded just in the moment to undergo an emergency surgery for the diagnostic of ectopic pregnancy. The new technological recourses let us the evaluation and realiza-tion of a surgical procedure type optimal oncological, true minimal invasive approach, these let us a laparoscopic surgery procedure they has actually utilized how a pru-dent tools, in the treatment of patients with malignant ovarian lesions.
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