[Simulation of endoscopic procedures: an innovation to improve laparoscopic technical skills]

Laparoscopic surgery is a technically more demanding procedure compared to open surgery. Safe realistic training and unbiased quantitative assessment of technical skills are required for laparoscopic surgery. Virtual reality [VR simulators may he useful tools for training and assessing basic and advanced surgical skills and procedures to assess the acquisition of laparoscopic skills using virtual reality simulators systematic review of the literature. The simulator can be used to objectively assess the laparoscopic skills of surgeons and distinguish between novices and experienced laparoscopic surgeons. [Evidence level III-B]. 2. The target group as well as the benefit of a three-day poetical course for laparoscopic surgery can be determined by the simulator [Evidence level III-C]. 3. Novices in laparoscopic surgery seem to benefit mostly from simulation training [Evidence level III-B]. 4. Steepness and plateau of a learning curve may be more dependent on the level of performance required by the particular training session rather than the number of repetitions during a training session. [Evidence level III-B]. 5. Clinical background and understanding of the clinical value of a training program lead to faster acquisition and improvement of laparoscopic skills. As performed on the laparoscopy simulator [Evidence level III-B]. 6. Non technical skills such as visual-spatial perception and stress coping positively correlates with virtual laparoscopic skills [Evidence level III-B]. To date, the best method for teaching laparoscopic surgery has not been defined. However. the use of virtual simulators for laparoscopy training is useful when learning basic techniques allow the surgeon to improve hand dexterity and coordination in laparoscopic surgery

La onda P300 por estimilación visual en pacientes con psicosis epilética / The wave P300 of the visual estimulation in epilethic psicosis patients

En este trabajo, después de hacer algunas consideraciones teórico-metodológicas en ralación com la onda P300, son estudiados 30 pacientes con epilepsia: 15 con psicosis crónica interictal y 15 sin psicosis asociada, procedentes de la consulta externa de epilepsia, que funciona en el Departamento de Tratamientos Especializados (DTE). El diagnóstico de epilepsia fue formulado conforme con los criterios de la Liga Internacional contra la Epilepsia (ILAE), y el de psicosis interictal según los conceptos de trimble y del Manuel de Diagnóstico y Estadística (DSM-III-R). A los pacientes incluidos en la muestra, e les hizo el registro de la onda P300 por estimulación visual en un equipo MEDICID-)3M, los resultados fueron comparados estadísticamente mediante el uso de métodos paramétricos (análisis de varianza, t - Student) y no paramétricos (Mann Whitney, Kruskal Wallis y Wald Waldfowitz). Observamos que los pacientes con psicosis crónicas interictal presentaban latencias más prolongadas de la onda P300 y la amplitud promedio se encontró disminuida en los dos grupos