Background Robotics in bariatric surgery is a novel development in medical institutions in Chile. Revisional bariatric procedures have increased during the last years. There are no publications in our country related to the initial experience and results in robotic revisional bariatric surgery. The aim of this study is to describe the initial experience and short term outcomes with robotic revisional bariatric surgery. Study Design We conducted a retrospective study of all consecutive robotic revisional bariatric surgeries performed by a single surgeon in Clínica Santa María in Santiago, Chile. We analyzed demographic characteristics and surgical outcomes, morbidity, mortality and length of hospital stay. Results 59 revisional bariatric surgeries were performed, 11 reshaping of sleeve gastrectomy, 34 Roux in Y gastric bypass, 1 pouch reshaping of Roux in Y gastric bypass, 3 extractions of laparoscopic adjustable gastric banding, 1 of them with simultaneous sleeve gastrectomy, 5 laparoscopic adjustable gastric banding to patients with previous Roux in Y gastric bypass, 3 total gastrectomy, 1 resection of gastro-gastric fistula and 1 gastro enteral anastomosis. Mean age was 47.8 years. Average preoperative body mass index was 33.86 kg/m2. Mean surgical time was 101.63 minutes. Postoperative complications were observed in 3 patients (5.08%). In 2 (3.39%) of this patient, reoperation was required. There were no deaths in this group. Average length of hospital stay was 3.6 days. Conclusion Robotic revisional bariatric surgery is a novel technique that appears to be safe and effective.

Resumen Introducción La cirugía bariátrica robótica es una técnica novedosa y en desarrollo en Chile. Los procedimientos bariátricos revisionales han aumentado durante los últimos años. No existen publicaciones en nuestro país relacionadas con experiencias en cirugía bariátrica revisional robótica. El objetivo de este estudio es describir la experiencia inicial y los resultados a corto plazo con el uso de la cirugía robótica en estos procedimientos. Material y Métodos Realizamos una revisión retrospectiva de todos los pacientes sometidos a cirugía bariátrica revisional asistida por robot, en Clínica Santa María, de Santiago de Chile. Analizamos las características demográficas, resultados quirúrgicos, morbilidad, mortalidad y tiempo de estadía hospitalaria. Resultados Se realizaron un total de 59 cirugías bariátricas revisionales asistidas por robot, 11 remodelamientos de gastrectomía en manga, 34 bypass gástrico en Y-Roux, 1 remodelamiento del pouch gástrico en un bypass gástrico en Y-Roux, 3 extracciones de banda gástrica ajustable, 1 de ellas con gastrectomía en manga simultánea, 5 instalaciones de banda gástrica ajustable en pacientes con bypass gástrico en Y-Roux, 3 gastrectomías totales, 1 resección de fístula gastro-gástrica y una anastomosis gastroyeyunal. La edad promedio fue de 47,8 años. El Índice de Masa Corporal promedio preoperatorio fue de 33,86 kg/m2. El tiempo quirúrgico promedio fue de 101,63 min. Se observaron complicaciones postoperatorias en 3 pacientes (5,08%). En 2 (3,39%) de ellos, se requirió una reoperación. No hubo fallecidos. El tiempo promedio de estadía hospitalaria fue de 3,6 días. conclusión La cirugía bariátrica revisional asistida por robot es una técnica novedosa, que parece ser segura y efectiva.

Background Since its approval, robotic surgery has been growing as a useful, promising and probably superior technique for many surgeries. The aim of this study is to expose and evaluate the results of a 6-year experience, of a single surgeon, with robotic assisted surgery, used for different gastrointestinal procedures throughout this years. Study Design We conducted a retrospective revision of all consecutive robotic assisted gastrointestinal cases performed by a single gastrointestinal laparoscopic surgeon of the Bariatric Surgery Department and Robotics Surgery Department of Clínica Santa María of Santiago, Chile, between September 2011 and May 2017. Results A total of 290 patients underwent robotic gastrointestinal surgery during 6 years. All cases were performed by the same gastrointestinal surgeon. Primary procedures performed were totally hand sewn Roux-en-Y gastric bypass, sleeve gastrectomy, revisional bariatric and non-bariatric surgery, Nissen fundoplication, single port cholecystectomy, Heller myotomy with Dor fundoplication, hernia repairs, and other exceptional cases. A total of 512 procedures were performed in 290 patients. The majority of secondary procedures were cholecystectomies, hiatal hernia repairs and adhesiolysis. Average length of hospital stay was 3 days. Postoperative complications were observed in 27 (9.3%) patients. According to Clavien Dindo classification of surgical complications, 4 (1.4%) complications were Clavien I, 5 (1.7%) Clavien II, 18 (6.2%) Clavien III, 0 Clavien IV, 0 Clavien V. There were no deaths in this group. Mean operative time was 76 minutes. Mean surgical time was 64 minutes. Conclusion Robot assisted upper gastrointestinal surgery is a reliable and effective technique, that can be used in many diseases.

Resumen Introducción Desde su aprobación, la cirugía robótica ha crecido como una técnica útil, prometedora y probablemente superior en muchas cirugías. El objetivo de este estudio es exponer y evaluar los resultados de 6 años de experiencia, en cirugía digestiva asistida por robot, utilizada en diferentes procedimientos gastrointestinales, a lo largo de estos años. Material y Método Realizamos una revisión retrospectiva de todos los pacientes consecutivos sometidos a cirugía asistida por robot, realizada por un cirujano digestivo del Departamento de Cirugía Bariátrica y Departamento de Cirugía Robótica de la Clínica Santa María, de Santiago de Chile, entre septiembre de 2011 y mayo de 2017. Resultados Un total de 290 pacientes fueron sometidos a cirugía digestiva asistida por robot durante 6 años. Todos los pacientes fueron operados por el mismo cirujano digestivo. Los procedimientos primarios realizados fueron bypass gástrico en Y-Roux con anastomosis manual, gastrectomía en manga, cirugía revisional bariátrica y no bariátrica, fundoplicatura de Nissen, colecistectomía con puerto único, miotomía de Heller con fundoplicatura de Dor, hernioplastías, y otros casos excepcionales. La mayoría de los procedimientos secundarios fueron colecistectomías, hernioplastías hiatales y adherenciolisis. La estadía hospitalaria promedio fue de 3 días. Se observaron complicaciones postoperatorias en 27 (9,3%) pacientes. De acuerdo a la clasificación de Clavien Dindo, 4 (1,4%) complicaciones fueron Clavien I, 5 (1,7%) Clavien II, 18 (6,2%) Clavien III, 0 Clavien IV, 0 Clavien V. No hubo mortalidad en este grupo. El tiempo total promedio de los procedimientos fue de 76 min. El tiempo quirúrgico promedio fue de 64 min. Conclusión La cirugía digestiva asistida por robot es una técnica confiable y segura, que se puede utilizar para muchas enfermedades.

O desempenho reprodutivo de exemplares selvagens de beijupirá capturados no litoral de Pernambuco e aclimatados ao cativeiro foi avaliado durante 10 meses. Um plantel composto por duas fêmeas (peso de 14 a 16kg) e quatro machos (cerca de 12kg) mantidos em um único tanque de 70t produziu 48,7 milhões de ovos no período de outubro a junho. As fêmeas foram capazes de desovar 21 vezes, com uma frequência média (±DP) de uma desova a cada 11,9 dias (±2,9). Em média, cada desova produziu 2,4 milhões de ovos, com fertilização de 52,4%, o que resultou em aproximadamente 1,0 milhão de larvas por desova. Os resultados demonstram a viabilidade da metodologia empregada na formação do plantel e no manejo de reprodutores e confirmam a relativa facilidade de obtenção de desovas espontâneas do beijupirá em cativeiro. Também foi confirmado que o período reprodutivo dessa espécie em cativeiro se estende além do observado na natureza. Este é o primeiro relato sobre o desempenho reprodutivo do beijupirá em cativeiro no Brasil.

The reproductive performance of wild cobia caught off the coast of Pernambuco, northeastern Brazil, was assessed. Six breeders (two females with 14-16kg and four males with approximately 12kg each) were maintained in a 70 ton tank from October to June and produced 48.7 million eggs. Females were able to spawn every 11.9 days (±2.9), which resulted in 21 spawns. On average each spawn produced 2.4 million eggs with a fertilization of 52.4%, which resulted in approximately 1.0 million larvae per spawn. The present results demonstrate the feasibility of the methodology employed here in the formation and management of a cobia breeding stock and confirm the ease of spawning cobia in captivity. It was also confirmed that the spawning season may be extended under captivity when compared to the wild stock. This is the first report on the reproductive performance of cobia in captivity in Brazil.

Background: The use of a dye and radiocolloid to detect sentinel lymph nodes in breast cáncer increases the detection rates. However the use of either method alone does not modify the false negative rate. Therefore there is no formal contraindication for the exclusive use of dye to detect nodes. Aim: To repon a prospective analysis of the exclusive blue dye technique for sentinel node biopsy in patients with early breast cáncer Patients and methods: We analyzed the first 100 women with pathologically proven breast cáncer who met the inclusión criteria. Patent blue dye was used as colorant. In the first 25 cases sentinel node was identified using radiocolloid and blue dye an then an axillary dissection perfomed. In the next 25 women, blue dye was used exclusively for detection and an axillary dissection was perfomed. In the next 50 cases, blue dye was used and only isolated sentinel node biopsy was perfomed. Results: In 92 of the 100 women a sentinel node was successfully detected. In the first 50 women, the false negative rate of sentinel lymph node detection was 6.9%. No complications occurred. During follow-up, lasting three to 29 months, no axillary relapse was observed. Conclusions: Sentinel node biopsy in patients with early breast cáncer using exclusively blue dye is feasible and safe.

Insulinoma is the most common neuroendocrine tumor. Its clinical manifestations are frequently confounded with neuropsychiatric symptoms, and definitive diagnosis can be delayed for a long time. These tumors are usually small, of less than 2 cm. Thus, their preoperative localization is difficult. We report two patients with a clinical diagnosis of insulinoma, in whom the preoperative imaging study was negative. Both fulfilled diagnostic criteria, with high serum insulin levels in the presence of a blood glucose of less than 45 mg/dl. The imaging study, including abdominal computed tomography and pancreatic endoscopic ultrasonography did not disclose the location of the tumor. A pancreatic angiography with selective stimulation with intra arterial calcium and venous sampling for insulin measurements, was performed in both patients. This test allowed the exact localization of the tumors and their successful excision. A review of other localization diagnostic tests is done (Rev Méd Chile 2004; 132: 71-5).

Avaliou-se a eficiência de fertilizantes foliares, contendo Ca e B, na nutrição e produção do pimentão cv. Mayata e do tomate cv. Carmem, cultivados em estufas. O delineamento experimental foi de blocos ao acaso com seis tratamentos, três e quatro repetições, respectivamente, para o tomateiro e pimentão. Os tratamentos foram a água de retortagem de xisto (100; 78; 3,0; 12,5; 3,0; 12,5; 4,0 e 0,2 g.L-1 de N, K, S, Ca, Mg, B, Mn e Mo, respectivamente) a 0,1; 0,25; 0,5 e 1%; os sais ácido bórico (170 g.kg-1 de B) a 0,15% mais cloreto de cálcio a 0,15% e o quelato de cálcio (200 g.kg-1 de Ca) a 0,1% e boro orgânico (10 g.kg-1 de B) a 0,15%. A aplicação de água de retortagem de xisto a 0,5% via foliar aumentou em 27,4% a produção de frutos de pimentão e os teores foliares de Mg e S em relação à aplicação desse fertilizante a 0,1%. Para o tomateiro, as pulverizações com água de retortagem de xisto a 0,5 e 1% elevaram em 60,5 e 93,8% a produção de frutos em comparação à menor dose desse fertilizante. Os maiores teores de B nas folhas de pimentão e de tomate foram obtidos com as aplicações de sais e resultaram em sintomas visuais de toxicidade de B no início do desenvolvimento das culturas.

The efficiency of foliar fertilizers was evaluated on nutrition and yield of sweet pepper cv. Mayata and tomato cv. Carmem, cultivated in plastic greenhouse. For the two experiments the experimental design consisted of randomized blocks with three and four replications for tomato and sweet pepper, respectively, and six treatments (schist retortage water 0.1; 0.25; 0.5 and 1%; boric acid 0.15% plus clorate calcium 0.15% and quelate Ca 0.1% plus organic B 0.15%). The foliar application of schist retortage water 0.5% increased 27.4% the sweet pepper fruit yield and foliar concentrations of Mg and S compared to this fertilizer 0.1%. For tomato, the application of schist retortage water 0.5 and 1% increased 60.5 and 93.8% the fruit yield as compared to this fertilizer 0.1%. The higher levels of boron in sweet pepper leaves and in tomato leaves were obtained with salt applications and resulted in visual symptoms of boron toxicity on initial development of cultures.

Avaliaram-se os efeitos de três tipos de materiais orgânicos associados com a aplicação de fertilizante mineral NPK sobre a nutrição e produção do pimentão cv. Mayata, cultivado em estufa, na região de Piracicaba (SP). O delineamento experimental foi de blocos casualizados com quatro repetições e seis tratamentos (150 g cova-1 de húmus de turfa + 100% do NPK; 150 g cova-1 de húmus de turfa + 70% do NPK; 100 g cova-1 de húmus de casca de pinus + 100% do NPK; 100 g cova-1 de húmus de casca de pinus + 70% do NPK; 100 g cova-1 de esterco de galinha + 100% do NPK e 100% do NPK). A dose 100% do NPK correspondeu a 100 g cova-1 da fórmula 04-14-08, equivalente a 130-458-262 kg ha-1 de N - P2O5 - K2O. O esterco de galinha + 100% do NPK proporcionou, de modo geral, o maior peso médio de frutos e teor de fósforo nas folhas em relação à adição dos outros materiais orgânicos associados com a adubação mineral. A aplicação dos materiais orgânicos associados com fertilizante mineral NPK não aumentou o peso médio e a produção de frutos em relação à adubação NPK isolada.

This experiment was carried out in Piracicaba, Brazil, to evaluate the effects of three types of organic materials in association with chemical fertilizers on the nutrition and yield of pepper cv. Mayata cultivated in plastic greenhouse. The experimental design consisted of randomized blocks with four replications and six treatments (150 g hole-1 of peat compost plus 100% NPK; 150 g hole-1 of peat compost plus 70% NPK; 100 g hole-1 of pinus chip compost plus 100% NPK; 100 g hole-1 of pinus chip compost plus 70% NPK; 100 g hole-1 of poultry manure plus 100% NPK; 100% NPK). The NPK rate was 100 g cave-1 of 04-14-08 mineral fertilizer, corresponding to 130-458-262 kg ha-1 of N-P2O5-K2O, respectively. The poultry manure plus 100% do NPK increased the fruits weight and leaf P compared to other organic materials plus 100% or 70% of NPK. The organic compost with mineral fertilization did not increase the fruits weight and yield when compared to mineral fertilization alone.