Determination of temperature elevation in tissue during the application of the harmonic scalpel

Koch, Christian; Friedrich, Thomas; Metternich, F. U.; Tannapfel, Andrea; Reimann, H.; Eichfeld, U

doi:10.1016/s0301-5629(02)00727-5

Cited by 96 publications

(76 citation statements)

References 24 publications

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“…A titanium knife blade is driven by a high-power ultrasound transducer that oscillates longitudinally with a displacement amplitude of 10 to 50 µm. At the interface between the blade and tissue, high temperatures and cavitation occur and coagulation of the tissue provides closure of the vascular structures, in addition to cutting capabilities [11] . Ultrasonic dissection works at a temperature below 80 ℃, compared with the 100 ℃ generated during electrosurgery, and consequently, the risk of thermal damage to adjacent structures is reduced [5] .…”

Section: Dissection By Ultrasonic Coagulating Shearsmentioning

confidence: 99%

Literature review of the energy sources for performing laparoscopic colorectal surgery

Hotta¹,

Takifuji²,

Yokoyama³

et al. 2012

WJGS

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Laparoscopic surgery for colorectal disease has become widespread as a minimally invasive treatment. This is important because the increasing availability of new devices allows us to perform procedures with a reduced length of surgery and decreased blood loss. We herein report the results of a literature review of energy sources for laparoscopic colorectal surgery, focused especially on 6 studies comparing ultrasonic coagulating shears (UCS) and other instruments. We also describe our laparoscopic dissection techniques using UCS for colorectal cancer. The short-term outcomes of surgeries using UCS and Ligasure for laparoscopic colorectal surgery were superior to conventional electrosurgery. Some authors have reported that the length of surgery or blood loss when Ligasure was used for laparoscopic colorectal surgery is less than when UCS was used. On the other hand, a recent study demonstrated that there were no significant differences between the short-term outcomes of UCS and Ligasure for laparoscopic colorectal surgery. It is therefore suggested that the choice of technique used should be made according to the surgeon's preference. We also describe our laparoscopic dissection techniques using UCS (Harmonic ACE) for colorectal cancer with regard to the retroperitoneum dissection, dissection technique, dissection technique around the feeding artery, and various other dissection techniques. We therefore review the outcomes of using various energy sources for laparoscopic colorectal surgery and describe our laparoscopic dissection techniques with UCS (Harmonic ACE) for colorectal cancer.

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Section: Dissection By Ultrasonic Coagulating Shearsmentioning

confidence: 99%

Literature review of the energy sources for performing laparoscopic colorectal surgery

Hotta¹,

Takifuji²,

Yokoyama³

et al. 2012

WJGS

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“…They recommended that power level be reduced when dissecting near important structures. In a comparable study performed in a perfusion model, using the Harmonic Scalpel (Ultracision, Ethicon, Norderstedt, Germany), Koch et al (2003) recorded temperature elevation in excess of 40 •C at 1mm distance from the blades, where as at distances of greater than 5mm, perfusion removed the heat efficiently, confirming the importance of perfusion in minimizing adverse effects. They concluded that chances of tissue damage are remote providing a safety margin of 3mm is maintained from sensitive tissue structures.…”

Section: Protein Denaturation/necrosismentioning

confidence: 70%

“…In simplest terms, it is thought that the vibrating ultrasonic tip is used to cut or shatter hard tissue or to cut and emulsify soft tissues Cimino and Bond, 1996;Wells, 1984). Parameters affecting cutting (Khambay and Walmsley, 2000a,b) and removal rate (Chan et al, 1986;Cimino and Bond, 1996;Stumpff et al, 1975), effect of dissipated ultrasonic energy and extent of residual tissue damage (Emam and Cuschieri, 2003;Koch et al, 2003) in individual tissues have been investigated experimentally.…”

Section: Overviewmentioning

confidence: 99%

High-power low-frequency ultrasound: A review of tissue dissection and ablation in medicine and surgery

OʼDaly

Morris

Gavin³

et al. 2008

Journal of Materials Processing Technology

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Ab s t r a c t High-power low-frequency ultrasound in the range 20-60 kHz has wide ranging clinical applications in surgical and medical instruments for biological tissue cutting, ablation or fragmentation, and removal. Despite widespread clinical application and common device operating characteristics, there is an incomplete understanding of the mechanism of tissue failure, removal and damage. The relative contribution of cavitation, direct mechanical impact and thermal effects to each process for specific tissue types remains unclear. Different and distinct mechanisms and rates of tissue removal are observed for interaction with soft and hard tissue types. Device operating parameters known to affect the interaction include frequency, peak-peak tip amplitude, suction and application time. To date, there has been little analysis of the effect of variations in, and interactions of, these parameters on tissue removal and damage for individual biological tissue types. Potential controllable damage mechanisms occurring in tissues include alteration in global biomechanical properties, histomorphological changes, protein denaturation and tissue necrosis. This paper presents a critical review of the literature on the clinical application, mechanism of tissue interaction, removal and residual tissue damage. It describes known mechanisms for distinct tissue types.

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“…In vivo tissue have di erent characteristics from in vitro tissue, most importantly, blood perfusion can modify thermal spread [119]. Many studies use an in vitro setup [14,16,120,121].…”

Section: Animal Modelmentioning

confidence: 99%

Energy based surgical instruments : With particular focus on collateral thermal injury

Carlander¹

2015

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Determination of temperature elevation in tissue during the application of the harmonic scalpel

Cited by 96 publications

References 24 publications

Literature review of the energy sources for performing laparoscopic colorectal surgery

Literature review of the energy sources for performing laparoscopic colorectal surgery

High-power low-frequency ultrasound: A review of tissue dissection and ablation in medicine and surgery

Energy based surgical instruments : With particular focus on collateral thermal injury

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