A prospective study was carried out to evaluate the sensitivity of ultrasonography in diagnosis of peritonsillar abscess (Quinsy). In 1986 through 1989 all cases of doubtful peritonsillitis were subjected to B-mode ultrasonography of tonsils before tonsillectomy was carried out. 36 patients were included in this clinical study. In cases of clinically uncertain peritonsillar abscesses the sensitivity of the method was 82%. However, only four false positive cases ("abscess in the scan but no pus during surgery") occurred.
As a rule, curative operations require the patient's consent. Determined by the expansion of surgical possibilities, the kind and frequency of specific complications are subjected to constant changes. The physician is encouraged to explain therapeutic methods as well as the probability of complications within the patient's grasp. It has been investigated to what extent methods of artificial intelligence (AI) are suited for assisting the physician in this task. For this purpose, a comprehensive list of surgical complications as reported in research literature has been compiled. The list has been transferred into a hierarchical structure which can be depicted as a rule tree classified according to topographic aspects. In each otolaryngological operation, the reported complications can be classed with these rules. By employing an expert system (Fig. 1), the physician is capable of compiling an individualized document of agreement (Fig. 2) which serves as a basis for the explanatory talk with the patient.
A new surgical sewing device for continuous sutures of gastrointestinal anastomoses with needle and suture material was used for the first time to construct a latero-lateral enterostomy (functional end-to-end anastomosis) in the small intestine of pigs. In ten animals the course was mainly uneventful during the observation period of 10 days. One animal developed a postoperative anastomotic leakage. In five cases adhesions between the anastomotic region and the small intestine were found on postmortem examination, but there was no evidence of any slight leakage. On the whole, the sewing device operated faultlessly. At present, clinical use seems possible for long sutures, which are time-consuming when sewn manually, but it is still premature. One major disadvantage of the device is its size, which restricts its application to extra-abdominal tasks. Nonetheless, the principle of a mechanical device for running sutures should be investigated further.
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