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  1. Book ; Thesis: Paradoxe Kinesien bei Patienten mit idiopathischem Parkinson-Syndrom

    Distler, Michael

    die Erwartung zeitlicher Zwänge als kritischer Auslöser ; eine klinisch-experimentelle Studie der paradoxen Kinesie

    2017  

    Author's details vorgelegt von Michael Distler
    Language German ; English
    Size 19 Blätter, Illustrationen, 30 cm
    Publishing place Erlangen-Nürnberg
    Publishing country Germany
    Document type Book ; Thesis
    Thesis / German Habilitation thesis Dissertation, Friedrich-Alexander-Universität Erlangen-Nürnberg, 2017
    Note Enthält Sonderabdruck aus Zeitschrift in englischer Sprache
    HBZ-ID HT019458211
    Database Catalogue ZB MED Medicine, Health

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    In stock of ZB MED Cologne/Königswinter

    Shelf markLoan statusLocation
    2017 E 1608 order for loan Magazin

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  2. Book ; Thesis: Analyse der palliativen Therapie bei Patienten mit Pankreaskopfkarzinom oder Karzinom der distalen Gallenwege

    Distler, Marius

    2007  

    Author's details vorgelegt von Marius Distler
    Language German
    Size 91 Bl., Ill., graph. Darst.
    Publishing country Germany
    Document type Book ; Thesis
    Thesis / German Habilitation thesis Dresden, Techn. Univ., Diss., 2007
    HBZ-ID HT015501406
    Database Catalogue ZB MED Medicine, Health

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    In stock of ZB MED Cologne/Königswinter

    Shelf markLoan statusLocation
    2008 E 225 order for loan Magazin

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  3. Article ; Online: Highlights der Pankreaschirurgie: erweiterte Indikationen bei neuroendokrinen Tumoren des Pankreas.

    Oehme, F / Hempel, S / Distler, M / Weitz, J

    Chirurgie (Heidelberg, Germany)

    2022  Volume 93, Issue 8, Page(s) 751–757

    Abstract: Advanced pancreatic neuroendocrine tumors (paNET) are mostly characterized by infiltration of vascular structures and/or neighboring organs. The indications for resection in these cases should be measured based on the possibility of an R0 resection. ... ...

    Title translation Highlights of pancreatic surgery: extended indications in pancreatic neuroendocrine tumors.
    Abstract Advanced pancreatic neuroendocrine tumors (paNET) are mostly characterized by infiltration of vascular structures and/or neighboring organs. The indications for resection in these cases should be measured based on the possibility of an R0 resection. Although the data situation for this rare entity is limited, small case series have shown a significant survival advantage in patients who underwent a radical resection in locally advanced stages of paNET. Both vascular reconstruction and multivisceral resection, when performed at experienced centers, should be considered as curative treatment options. The very special biological behavior of the paNET and the often young patient age justify a much more aggressive approach compared to the pancreatic ductal adenocarcinoma.
    MeSH term(s) Carcinoma, Pancreatic Ductal/surgery ; Humans ; Neuroendocrine Tumors/surgery ; Pancreatectomy ; Pancreatic Neoplasms/surgery ; Pancreaticoduodenectomy
    Language German
    Publishing date 2022-07-05
    Publishing country Germany
    Document type Journal Article ; Review
    ISSN 2731-698X
    ISSN (online) 2731-698X
    DOI 10.1007/s00104-022-01646-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Robotische Ösophaguschirurgie.

    Merboth, Felix / Distler, Marius / Weitz, Jürgen

    Chirurgie (Heidelberg, Germany)

    2023  Volume 94, Issue 9, Page(s) 812–820

    Abstract: Robot-assisted minimally invasive esophagectomy (RAMIE) is increasingly becoming established as a standard procedure in surgical centers for esophagectomy in cases of cancer. To date, RAMIE has been shown to have fewer postoperative complications and at ... ...

    Title translation Robotic esophageal surgery.
    Abstract Robot-assisted minimally invasive esophagectomy (RAMIE) is increasingly becoming established as a standard procedure in surgical centers for esophagectomy in cases of cancer. To date, RAMIE has been shown to have fewer postoperative complications and at least equivalent oncological outcomes compared with open resection. Compared with classical minimally invasive resection, there seem to be fewer cases of postoperative pneumonia after RAMIE. In addition, a higher number of harvested lymph nodes could lead to better oncological long-term outcomes. The learning curve for this complex surgical procedure is relatively shallow but can be greatly reduced at high-volume centers through special training and proctoring programs. Robotic surgical approaches have also been described for other esophageal diseases; however, no clear superiority compared to laparoscopic surgery has so far been shown.
    MeSH term(s) Humans ; Robotic Surgical Procedures/adverse effects ; Robotic Surgical Procedures/methods ; Robotics ; Esophageal Neoplasms/surgery ; Esophagectomy/adverse effects ; Esophagectomy/methods
    Language German
    Publishing date 2023-03-13
    Publishing country Germany
    Document type English Abstract ; Journal Article
    ISSN 2731-698X
    ISSN (online) 2731-698X
    DOI 10.1007/s00104-023-01829-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: How we do it-the use of peritoneal patches for reconstruction of vena cava inferior and portal vein in hepatopancreatobiliary surgery.

    Radulova-Mauersberger, O / Distler, M / Riediger, C / Weitz, J / Welsch, T / Kirchberg, J

    Langenbeck's archives of surgery

    2022  Volume 407, Issue 8, Page(s) 3819–3831

    Abstract: Purpose: Extended resections in hepatopancreatobiliary (HPB) surgery frequently require vascular resection to obtain tumor clearance. The use of alloplastic grafts may increase postoperative morbidity due to septic or thrombotic complications. The use ... ...

    Abstract Purpose: Extended resections in hepatopancreatobiliary (HPB) surgery frequently require vascular resection to obtain tumor clearance. The use of alloplastic grafts may increase postoperative morbidity due to septic or thrombotic complications. The use of suitable autologous venous interponates (internal jugular vein, great saphenous vein) is frequently associated with additional incisions. The aim of this study was to report on our experience with venous reconstruction using the introperative easily available parietal peritoneum, focusing on key technical aspects.
    Methods: All patients who underwent HPB resections with venous reconstruction using peritoneal patches at our department between January 2017 and November 2021 were included in this retrospective analysis with median follow-up of 2 months (IQR: 1-8 months). We focused on technical aspects of the procedure and evaluated vascular patency and perioperative morbidity.
    Results: Parietal peritoneum patches (PPPs) were applied for reconstruction of the inferior vena cava (IVC) (13 patients) and portal vein (PV) (4 patients) during major hepatic (n = 14) or pancreatic (n = 2) resections. There were no cases of postoperative bleeding due to anastomotic leakage. Following PV reconstruction, two patients showed postoperative vascular stenosis after severe pancreatitis with postoperative pancreatic fistula and bile leakage, respectively. In patients with reconstruction of the IVC, no relevant perioperative vascular complications occurred.
    Conclusions: The use of a peritoneal patch for reconstruction of the IVC in HPB surgery is a feasible, effective, and low-cost alternative to alloplastic, xenogenous, or venous grafts. The graft can be easily harvested and tailored to the required size. More evidence is still needed to confirm the safety of this procedure for the portal vein regarding long-term results.
    Language English
    Publishing date 2022-09-22
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1423681-3
    ISSN 1435-2451 ; 1435-2443
    ISSN (online) 1435-2451
    ISSN 1435-2443
    DOI 10.1007/s00423-022-02662-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Der digitale Operationssaal : Chancen und Risiken künstlicher Intelligenz.

    Wierick, Ann / Schulze, André / Bodenstedt, Sebastian / Speidel, Stefanie / Distler, Marius / Weitz, Jürgen / Wagner, Martin

    Chirurgie (Heidelberg, Germany)

    2024  

    Abstract: At the central workplace of the surgeon the digitalization of the operating room has particular consequences for the surgical work. Starting with intraoperative cross-sectional imaging and sonography, through functional imaging, minimally invasive and ... ...

    Title translation The digital operating room : Chances and risks of artificial intelligence.
    Abstract At the central workplace of the surgeon the digitalization of the operating room has particular consequences for the surgical work. Starting with intraoperative cross-sectional imaging and sonography, through functional imaging, minimally invasive and robot-assisted surgery up to digital surgical and anesthesiological documentation, the vast majority of operating rooms are now at least partially digitalized. The increasing digitalization of the whole process chain enables not only for the collection but also the analysis of big data. Current research focuses on artificial intelligence for the analysis of intraoperative data as the prerequisite for assistance systems that support surgical decision making or warn of risks; however, these technologies raise new ethical questions for the surgical community that affect the core of surgical work.
    Language German
    Publishing date 2024-03-05
    Publishing country Germany
    Document type English Abstract ; Journal Article ; Review
    ISSN 2731-698X
    ISSN (online) 2731-698X
    DOI 10.1007/s00104-024-02058-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: One model to use them all: training a segmentation model with complementary datasets.

    Jenke, Alexander C / Bodenstedt, Sebastian / Kolbinger, Fiona R / Distler, Marius / Weitz, Jürgen / Speidel, Stefanie

    International journal of computer assisted radiology and surgery

    2024  

    Abstract: Purpose: Understanding surgical scenes is crucial for computer-assisted surgery systems to provide intelligent assistance functionality. One way of achieving this is via scene segmentation using machine learning (ML). However, such ML models require ... ...

    Abstract Purpose: Understanding surgical scenes is crucial for computer-assisted surgery systems to provide intelligent assistance functionality. One way of achieving this is via scene segmentation using machine learning (ML). However, such ML models require large amounts of annotated training data, containing examples of all relevant object classes, which are rarely available. In this work, we propose a method to combine multiple partially annotated datasets, providing complementary annotations, into one model, enabling better scene segmentation and the use of multiple readily available datasets.
    Methods: Our method aims to combine available data with complementary labels by leveraging mutual exclusive properties to maximize information. Specifically, we propose to use positive annotations of other classes as negative samples and to exclude background pixels of these binary annotations, as we cannot tell if a positive prediction by the model is correct.
    Results: We evaluate our method by training a DeepLabV3 model on the publicly available Dresden Surgical Anatomy Dataset, which provides multiple subsets of binary segmented anatomical structures. Our approach successfully combines 6 classes into one model, significantly increasing the overall Dice Score by 4.4% compared to an ensemble of models trained on the classes individually. By including information on multiple classes, we were able to reduce the confusion between classes, e.g. a 24% drop for stomach and colon.
    Conclusion: By leveraging multiple datasets and applying mutual exclusion constraints, we developed a method that improves surgical scene segmentation performance without the need for fully annotated datasets. Our results demonstrate the feasibility of training a model on multiple complementary datasets. This paves the way for future work further alleviating the need for one specialized large, fully segmented dataset but instead the use of already existing datasets.
    Language English
    Publishing date 2024-04-27
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2365628-1
    ISSN 1861-6429 ; 1861-6410
    ISSN (online) 1861-6429
    ISSN 1861-6410
    DOI 10.1007/s11548-024-03145-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 6615: Show issues Location:
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  8. Article ; Online: Das Ampullenkarzinom – prognostische und therapeutische Unterschiede zum duktalen Adenokarzinom des Pankreas.

    Giehl-Brown, Esther / Weitz, Jürgen / Distler, Marius

    Zentralblatt fur Chirurgie

    2022  Volume 147, Issue 2, Page(s) 160–167

    Abstract: Ampullary carcinoma belongs to the cluster of periampullary cancers and is a rare, but increasing form of gastrointestinal malignancy. Due to the location of the tumour, occurrence of biliary obstruction is common. Symptoms due to the compression of the ... ...

    Title translation Ampullary Carcinoma-prognostic and Therapeutical Contrast to Pancreatic Ductal Adenocarcinoma.
    Abstract Ampullary carcinoma belongs to the cluster of periampullary cancers and is a rare, but increasing form of gastrointestinal malignancy. Due to the location of the tumour, occurrence of biliary obstruction is common. Symptoms due to the compression of the biliary tract facilitate early diagnosis, evoking a better prognosis. Adenomas of the ampulla of Vater and major duodenal papilla are precursor lesions and possess a risk of 30-40% to progress into a malignancy. Therefore, en-bloc resection is warranted for all ampullary adenomas. Endoscopic papillectomy is aggravated by extension into the pancreatic duct or common bile duct. Surgical resection is indicated whenever endoscopic resection is incomplete or infiltrative growth is suspected. Transduodenal ampullectomy is an alternative to extensive oncological resection in the absence of malignancy. Pancreatoduodenectomy (or Whipple procedure) with systemic lymphadenectomy and mesopancreas excision is the standard procedure of all ampullary carcinomas and incompletely excised adenomas by minimally invasive procedures. The indication for extensive surgical resection includes suspicion of infiltration in endoscopic ultrasound or evidence of malignancy in frozen section during transduodenal ampullectomy. Negative prognostic indicators are implicated by the pancreatobiliary subtype, lymph node metastases and perineural invasion. Differentiation of the different histopathological subtypes thereby increases in clinical relevance. Evidence based guidelines for the clinical practice of neoadjuvant and adjuvant treatment for ampullary carcinoma have yet to be defined. According to the literature available, patients with the pancreatobiliary subtyp or association with other negative prognostic factors seem to benefit from systemic therapy. Further studies are warranted.
    MeSH term(s) Adenocarcinoma/pathology ; Ampulla of Vater/pathology ; Ampulla of Vater/surgery ; Carcinoma, Pancreatic Ductal/diagnosis ; Carcinoma, Pancreatic Ductal/surgery ; Humans ; Pancreatic Neoplasms/diagnosis ; Pancreatic Neoplasms/pathology ; Pancreatic Neoplasms/surgery ; Prognosis
    Language German
    Publishing date 2022-04-04
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 200935-3
    ISSN 1438-9592 ; 0044-409X
    ISSN (online) 1438-9592
    ISSN 0044-409X
    DOI 10.1055/a-1775-9024
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.MO 95: Show issues

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  9. Article ; Online: Reply to: Letter to the Editor: More is More? Total Pancreatectomy for Periampullary Cancer as an Alternative in Patients with High-Risk Pancreatic Anastomosis: A Propensity Score-Matched Analysis, by Marchegiani, Giovanni et al.

    Hempel, Sebastian / Oehme, Florian / Weitz, Jürgen / Distler, Marius

    Annals of surgical oncology

    2022  Volume 29, Issue 6, Page(s) 3519–3520

    MeSH term(s) Anastomosis, Surgical ; Duodenal Neoplasms/surgery ; Humans ; Pancreas/surgery ; Pancreatectomy ; Pancreatic Neoplasms/surgery ; Propensity Score
    Language English
    Publishing date 2022-02-25
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 1200469-8
    ISSN 1534-4681 ; 1068-9265
    ISSN (online) 1534-4681
    ISSN 1068-9265
    DOI 10.1245/s10434-022-11468-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Roboter-Assistenz bei Ösophagusresektionen - Verbesserung von Morbidität und Mortalität

    Merboth, F. / Hasanovic, J. / Distler, M. / Weitz, J.

    Krebs im Focus

    2021  Volume 14, Issue -, Page(s) 13

    Language German
    Document type Article
    ZDB-ID 2761631-9
    Database Current Contents Medicine

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