Harmonic scalpel explained

The harmonic scalpel is a surgical instrument that (unlike electrosurgery) uses ultrasonic vibrations to cut and cauterize tissue.

Medical use

The harmonic scalpel may be superior to electrosurgery in that it can cut through thicker tissue, creates less toxic surgical smoke, and poses somewhat less of a risk for electrocution or other potentially fatal complications.^[1]

Mechanism

A harmonic scalpel cuts via vibration. The scalpel surface itself cuts through tissue by vibrating in the range of 55,500 Hz. The high frequency vibration of tissue molecules generates stress and friction in tissue, which generates heat and causes protein denaturation. This technique causes minimal energy transfer to surrounding tissue, potentially limiting collateral damage.^[2]

Manufacture

The Harmonic brand is manufactured in Mexico and distributed by Ethicon Endo-Surgery a subsidiary of Johnson & Johnson.

See also

• Instruments used in general surgery

Further reading

• Msika S, Deroide G, Kianmanesh R, etal . Harmonic scalpel in laparoscopic colorectal surgery . Dis. Colon Rectum . 44 . 3 . 432–6 . March 2001 . 11289292 . 10.1007/bf02234745. 13391713 .
• Awwad JT, Isaacson K . The harmonic scalpel: an intraoperative complication . Obstet Gynecol . 88 . 4 Pt 2 . 718–20 . October 1996 . 8841266 . 10.1016/0029-7844(96)00075-0. 41706390 .
• Siperstein AE, Berber E, Morkoyun E . The use of the harmonic scalpel vs conventional knot tying for vessel ligation in thyroid surgery . Arch Surg . 137 . 2 . 137–42 . February 2002 . 11822946 . 10.1001/archsurg.137.2.137. free .

Notes and References

1. Fitzgerald JE, Malik M, Ahmed I . 2012 . A single blind controlled study of electrocautery and ultrasonic scalpel smoke plumes in laparoscopic surgery . https://archive.today/20130203043700/http://www.springerlink.com/content/d38j6322621730v0/ . dead . 2013-02-03 . Surgical Endoscopy . 26 . 2. 337–342 . 10.1007/s00464-011-1872-1 . 21898022 . 10211847 .
2. Book: Sabiston Textbook of Surgery. 2012. 978-1-4377-1560-6. 236. Sabiston. David C.. Daniel Beauchamp. R.. Evers. B. Mark. Mattox. Kenneth L..