Universiẗat (TH), Diss.--Karlsruhe, 2007.

Zugl.: Karlsruhe, Univ., Diss., 2007 / Hergestellt on demand. - Auch im Internet unter der Adresse http://uvka.ubka.uni-karlsruhe.de/shop/isbn/978-3-86644-210-8 verfügbar

Zugl.: Aachen, Techn. Hochsch., Diss., 2009

Zugl.: Karlsruhe, Universiẗat, Diss., 2007.

Techn. Universiẗat, Diss., 2004--Berlin.

Leckagen im oberen Gastrointestinaltrakt sind mit zahlreichen und schwerwiegendsten Komplikationen verbunden. Mortalität, Morbidität und die Liegezeit im Krankenhaus konnten, trotz verbesserter chirurgischer Technik, bislang nicht wesentlich gesenkt werden. Inzwischen gibt es ein weites Spektrum an Therapiemöglichkeiten, die die konservativ-zuwartende Therapie unter Breitbandantibiose und Drainage bis hin zur operativen Revision, umfassen. Die chirurgische Intervention galt früher als Goldstandard, ist aber mit Operationsrisiken und verlängerter Rekonvaleszenz, insbesondere bei septischen und multimorbiden Patienten, verbunden. Bedingt durch eine unzureichende Studienlage kann das therapeutische Vorgehen bei einer Leckage im oberen Gastrointestinaltrakt nicht leitliniengerecht und evidenzbasiert erfolgen, sondern beruft sich auf situative Entscheidungen und die Erfahrungswerte der behandelnden Ärzte. In dem letzten Jahrzehnt haben die endoskopischen Therapieoptionen als Alternative zunehmend an Bedeutung gewonnen. Primäres Studienziel war es, die endoskopische Vakuumtherapie als eine Therapiemöglichkeit bei Leckagen im oberen Gastrointestinaltrakt zu beschreiben, Ergebnisse zu bewerten und in den Kontext derzeitiger Studien in der Literatur zu setzen. Es wurden 45 Patienten retrospektiv, die im Zeitraum von 2012-2017 in dem Universitätsklinikum Würzburg mit der endoskopischen Vakuumtherapie behandelt wurden, untersucht. 31 Patienten mit einer Anastomoseninsuffizienz, 6 Patienten mit einer Perforation, 4 Patienten mit einer iatrogenen Perforation, 2 Patienten mit einer Nahtinsuffizienz und 2 Patienten mit einem Ulcus wurden endoskopisch vakuumtherapeutisch behandelt. Die Behandlungsdauer betrug im Durchschnitt 20 Tage und die Liegezeit 36 Tage. Die Abheilungsrate lag bei 91,1% bei einer Gesamtmortalität von 6,67%. Mit der Studie gelang es zu zeigen, dass sich die endoskopische Unterdrucktherapie, trotz langer stationärer Behandlungsdauer, zur Therapie der Wahl bei Leckagen im oberen Gastrointestinaltrakt entwickeln kann. Es ist eine suffiziente und komplikationsarme Behandlungsmethode mit einer niedrigen Mortalitäts- und Morbiditätsrate. Es zeigt sich als eine vielversprechende Alternative zu primärverschließenden endoskopischen Interventionen (Fibrinkleber und Over-the-scope-Clips). / Leakages in the upper gastrointestinal tract are associated with numerous and most serious complications. Despite improved surgical technology, mortality, morbidity and the time spent in hospital have not yet been significantly reduced. There is a wide range of therapy options, which include conservative therapy and antibiosis and drainage, and surgical revision. Surgical intervention used to be the standard, but is associated with surgical risks and prolonged convalescence, especially in septic and multimorbid patients. Due to lack of studies concerning therapeutic options in the event of a leakage in the upper gastrointestinal tract, the treatments are not based on evidence, but rely on empirical decisions and the experience of the treating physician. In the past decade, endoscopic therapy options have become increasingly important as an alternative. The primary goal of the study was to describe the endoscopic vacuum therapy as a treatment option for leaks in the upper gastrointestinal tract, to evaluate results and comparing the results with current studies in the literature. 45 patients were retrospectively examined who were treated with endoscopic vacuum therapy at the University Hospital Würzburg from 2012-2017. 31 patients with anastomotic leakage, 6 patients with perforation, 4 patients with iatrogenic perforation, 2 patients with suture insufficiency and 2 patients with ulcerations were endoscopically treated with vacuum therapy. The average duration of treatment was 20 days and the hospital stay was 36 days. The healing rate was 91.1% with a total mortality of 6.67%. The study succeeded in showing that endoscopic negative pressure therapy can become the treatment of choice for leaks in the upper gastrointestinal tract, despite long hospital stay. It is a sufficient method and associated with low complication and with a low mortality and morbidity rate.

No description available.

Leakage in a vacuum system causes the pressure to rise if it is not compensated like in case the supply energy carriers fail. This leads to the workpiece to be dropped. So in order to design vacuum gripping systems that can withstand a failure of the supply energy carriers over a predefined amount of time, it is crucial to know the influences and effects of leakage. In previous examinations the behavior of leakage has been examined on the basis of a closed fluidic reservoir with a hole in its wall. But the only impacts taken into account here are the volume of the reservoir, the diameter of the hole and the pressure difference. Whereas when it comes to vacuum gripping systems, the leakage has significantly more influencing factors as it is neither a single component nor a closed system. In vacuum gripping systems leakage mostly occurs at the interface between the suction cups and the workpiece. So in this contribution the focus is on the impact of the properties of those components, and how the variation of these properties affects leakage. To achieve this, a theoretical description is done based on the aforementioned research, which is expanded in order to the relevant characteristics of a vacuum gripping system. After that the description is evaluated on a test bench. The goal is to be able to make a statement about the leakage rate for a vacuum gripping system composed of standard components. This can then be used in the design process of such gripping systems, which have to fulfil the requirement of compensating leakage in case the energy supply fails.

Two - stage servovalves, despite being widely used in aircraft and industry because of their reliability and high performance, have a few disadvantages that are still unsolved at the state of the art, such as the power consumption caused by the quiescent flow (internal leakage) in the pilot stage, and the complexity and high number of parts of the torque motor assembly of the pilot stage. The solution to these problems can help to reduce costs, weight, power consumption, and to enhance the reliability and producibility as well as the performance of these valves. This paper presents a novel configuration of servovalve, which has the potential to overcome the above-mentioned issues. The proposed servo-valve includes a novel architecture for the pilot stage by using two piezo-electric actuators (ring benders). In this paper, the performance of this novel pilot stage is assessed. To this end, a valve prototype has been constructed and tested; the experimental results are also used to validate a numerical model obtained with the software Simscape Fluids. The results show that, acting on specific parameters, the performance of the piezo-valve can be very competitive, while ensuring very low internal leakage and complexity.

Background The number of liver resections is constantly rising over the last decades. Despite the reduction of overall mortality and morbidity in liver surgery, biliary leakage is still a relevant postoperative complication that can lead to a fatal postoperative course. Aim of this analysis is the identification of specific risk factors for postoperative biliary complications after liver resections and the development of a predictive biliary leakage risk score. Methods A single-center, retrospective analysis of 844 liver resections performed in the Department of Visceral, Thoracic and Vascular Surgery, Technische Universität Dresden, between 1/2013 and 12/2019 is conducted to identify risk factors for postoperative biliary leakage and a risk score for biliary leakage after hepatectomy is established based on multivariate regression. The score has been validated by an independent validation cohort consisting of 142 patients. Results Overall morbidity is 43.1% with 36% surgical complications and an overall mortality of 4.3%. Biliary leakage occurred in 15.8% of patients. A predictive score for postoperative biliary leakage based on age, major resection, pretreatment with FOLFOX/cetuximab and operating time is created. Patients are stratified to low (< 15%) and high (> 15%) risk with a sensitivity of 67.4% and a specificity of 70.7% in development cohort and a specificity of 68.2% and sensitivity of 75.8% in validation cohort. Conclusions The presented score is robust and has been validated in an independent patient cohort. Depending on the calculated risk, prevention or early treatment can be initiated to avoid bile leakage and to improve postoperative course.