Ultrasonic energy in endoscopic surgery

ABSTRACT

The Harmonic Scalpel made by Ultracision is a system for endoscopic cutting. The energy source is vibration. The power box is attached to a forceps or blade, and the vibrational frequency of the blade approaches 55,500 cycles/second. This causes a knife-like action of the blade through tissue, with enough heating to create coagulation of small vessels. When this vibration energy is applied to the forceps configuration, coagulation occurs. By rotating the bottom blade of the forceps, the instrument becomes like a pair of scissors, and the tissue can divide. The Harmonic Scalpel allows the operator to cut using a tactile tissue. No smoke is created, only microaromized water droplets which are rapidly absorbed by the peritoneak surface. The instrument is extremely safe in that only tissue which is touched is cut; the energy source cannot travel through air, such as can happen with electrosurgery and laser surgery.