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Federico A Corica

Publications and source records attributed to Federico A Corica.

6 recordsLinked to original sources
PubMed2006

Short-term impact of a laparoscopic "mini-residency" experience on postgraduate urologists' practice patterns.

BACKGROUND: To assist practicing urologists incorporate laparoscopic urology into their practice, a 5-day mini-residency (M-R) program with a mentor, preceptor, and proctor experience was established at the University of California, Irvine, and we report the initial results. STUDY DESIGN: Thirty-two urologists underwent laparoscopic ablative (n=17) or laparoscopic reconstructive (n=15) training, including inanimate model skills training, animal laboratory, and operating room observation. A questionnaire was mailed 1 to 15 months (mean, 8 months) after their M-R program, and responses were reviewed. RESULTS: A 100% response rate was achieved. The mean M-R participant age was 49 years (range 31 to 70 years). The majority of the participants (72%) had laparoscopic experience during residency training and had performed between 5 and 15 laparoscopic cases before attending the M-R program. Within 8 months after M-R, 26 participants (81%) were practicing laparoscopic surgery. Participants were performing laparoscopic radical nephrectomy (p=0.008), nephroureterectomy (p<0.0005), and pyeloplasty (p=0.008) at substantially higher rates after training. At the same time, fewer of the M-R participants were performing hand-assisted laparoscopic surgery after training (p=0.008) compared with before the M-R. Ninety-two percent of the participants indicated that they would recommend this training program to a colleague. CONCLUSIONS: A 5-day intensive laparoscopic ablative and reconstructive surgery course seems to encourage postgraduate urologists, already familiar with laparoscopy, to successfully expand the scope of their procedures to include more complex laparoscopic techniques such as nephrectomy, nephroureterectomy, and pyeloplasty into their clinical practice.

Adult↗
PubMed2006

Construct validity testing of a laparoscopic surgical simulator.

BACKGROUND: We present initial data on the construct, content, and face validity of the LAPMentor (Simbionix), virtual reality laparoscopic surgical simulator. STUDY DESIGN: Medical students (MS), residents and fellows (R/F), and experienced laparoscopic surgeons (ES), with < 30 laparoscopic cases per year (ES<30) and those with > 30 laparoscopic cases per year (ES>30), were tested on 9 basic skill tasks (SK) including manipulation of 0-degree and 30-degree cameras (SK1, SK2), eye-hand coordination (SK3), clipping (SK4), grasping and clipping (SK5), two-handed maneuvers (SK6), cutting (SK7), fulguration (SK8), and object-translocation (SK9). RESULTS: Mean MS (n=23), R/F (n=24), ES<30 (n=26), and ES>30 (n=30) ages were 26 years (range 21 to 32 years), 31 years (range 27 to 39 years), 49 years (range 31 to 70 years) and 47 years (range 34 to 69 years), respectively. In the lower level skill tasks (SK3, SK4, SK5, and SK6) the ES>30, ES<30, and R/F had similar scores, but were all substantially better than the MS scores. In the higher level skill tasks (SK7, SK8, and SK9), the ES>30 scores tended to be better than the R/F and ES<30, which were similar, and these, in turn, were markedly better than the MS. The ES>30 had notably higher SK8 scores than the R/F and ES<30, who had similar scores, and these had notably better scores than the MS. CONCLUSIONS: The noncamera skills (SK3 to 9) of the LAPMentor surgical simulator can distinguish between laparoscopically naive and ES. SK8 showed the highest level of construct validity, by accurately differentiating among the MS, R/F, ES<30 and ES>30.

Adult↗
PubMed2006

Comparison of basic elements of human performance scores between urologists with various extents of experience.

BACKGROUND AND PURPOSE: An objective evaluation of innate ability and its ability to predict potential success as a surgical trainee is an appealing concept for the selection process of residency applications. The objective of this study was to evaluate whether basic elements of performance (BEP) could discriminate among resident applicants and urologists with various extents of surgical experience. SUBJECTS AND METHODS: One hundred forty-five participants were divided into four study groups: group A, 57 urology residency applicants to the 2002 and 2003 interview process; group B, 8 post-internship urology residents; group C, 19 urologists tested with BEP within 10 years of graduation from their residency training program; and group D, 61 urologists who had graduated from their residency training program more than 10 years prior to testing. The BEP measures consisted of 13 basic performance resources (BPR) including visual-information processing speed, visual-spatial immediate-recall capacity, and neuromotor channel capacity. RESULTS: The four study groups differed significantly in their mean age: group A=27.6 years, group B=29.1 years, group C=37.1 years, and group D=48.9 years (P<0.0005). There was essentially no significant difference between the groups with regard to immediate-recall memory, reaction time simple, or reaction time complicated. The younger participants (groups A and B) were faster than the older surgeons (groups C and D) (P<0.02). However, the older surgeons (groups C and D) were significantly more accurate than the younger groups (A and B) (P<0.0005). The only sex differences noted were in hand-grip strength and shoulder-strength scores, which were all higher in the men. CONCLUSIONS: There generally appears to be a lack of direct correlation between innate abilities and surgical experience. Urology resident applicants with no surgical experience and urology residents with limited surgical experience are faster but less accurate in innate skills testing than experienced practicing urologists.

Adult↗
PubMed2006

Robot-assisted laparoscopic radical cystoprostatectomy and totally intracorporeal ileal neobladder.

PURPOSE: To describe robot-assisted laparoscopic radical cystoprostatectomy and intracorporeal orthotopic ileal neobladder construction. METHODS: With the use of the daVinci Surgical System (Intuitive Surgical, Sunnyvale, CA), we performed laparoscopic radical cystectomy and intracorporeal construction of an orthotopic ileal neobladder (modified W pouch). RESULTS: The total operative time was 12 hours, and the estimated blood loss was 100 mL. There were no intraoperative or postoperative complications, and the patient?s hospital stay was 5 days. At early follow-up, oncologic and functional results are good. CONCLUSION: Robot-assisted laparoscopic radical cystoprostatectomy with intracorporeal ileal neobladder construction is technically feasible. However, its role in the management of invasive bladder cancer remains to be defined.

Aged↗
PubMed2003

Intraepithelial and stromal lymphocytes in the normal human prostate.

BACKGROUND: The distribution and significance of lymphocytes in the normal human prostate is uncertain. It may be important as a determinant of the immune response, playing a role in hyperplasia and carcinogenesis. METHODS: We studied 28 normal autopsy prostates from patients between 1 and 64 years of age. Cases with nodular hyperplasia, intraepithelial neoplasia, cancer, and florid prostatitis were excluded. Each prostate was routinely processed to paraffin and immunohistochemically stained for CD20, CD45, and CD45RO. Three frozen samples obtained from these cases were stained for CD8 and CD4. One low power field (25 x magnification, 50 mm(2)) was randomly chosen for examination from each anatomic zone of the prostate, namely the peripheral, transition, and central zone. Lymphocytes were visually counted in the stroma and epithelium of each zone. Lymphocyte counts were converted to number of cells per square millimeter based on the area of the slide per field and the percentage of field that was glandular. RESULTS: Stromal lymphocytes were more numerous than epithelial lymphocytes (mean, 7.32 and 2.04 cells/mm(2), respectively). They were mostly T cells (stromal lymphocytes: 93% CD45RO +; epithelial lymphocytes: 99% CD45RO +). Helper/inducer (CD4 +) T cells predominated in the stroma, whereas those in epithelium were chiefly cytotoxic/suppressor (CD8 +). No difference was found in the number of stromal and epithelial T or B cells according to patient age, race, or location within the prostate (peripheral, central, and transition zones) (all P > 0.05), although the number of lymphocytes in the peripheral zone tended to exceed that in the other zones after correcting for gland:stroma ratio. CONCLUSIONS: The immune response in the prostate is primarily cell-mediated. Cell distribution is constant according to patient age, race, and anatomic zonal location within the prostate. The greatest concentration is in the stroma with a small but significant number of intraepithelial cells. The inverted CD4/CD8 ratio in the intraepithelial compartment suggests that cytotoxic/suppressor T cells are the first line of defense against luminal foreign agents reaching the prostate through retrograde flow.

Adolescent↗