The Tissue Effects of Ultrasound-Assisted Lipoplasty

Abstract

The objective of our study was to investigate the effects of ultrasonic energy on tissues, using a porcine model, performed under various instrumental and procedural parameters. Domestic pigs were anesthetized and prepared for surgery. An incision was made on the side of the hip randomly assigned to the right or left side. Tumescence solution was infiltrated via a blunt tip, small diameter cannula, followed by performance of standard liposuction. On the contralateral side, a similar incision was made. For ultrasonic liposuction experiments without the sheath, a percutaneous introducer was inserted into the incision, which was protected at the entry site from contact with the cannula. Tumescence solution was infiltrated via a blunt tip, small diameter cannula, and then the site was treated with ultrasonic energy at maximum output from the machine with liposuction concurrent through the hollow cannula. The experiments with the sheath did not require a pretreatment with tumescence solution but consisted of tumescence solution pumped through the sheath at a low infusion rate, with concurrent treatment utilizing ultrasonically assisted liposuction through the central lumen of the cannula. In all cases, the lipoaspirate was preserved for biochemical analysis. After treatment, the pigs were euthanized, and samples for histopathology were taken. The pigs were then perfused with a radio-opaque solution through the left ventricle following preperfusion with saline. The groups were ultrasound-assisted liposuction with sheath (n = 3), ultrasound-assisted without sheath (n = 4), and tumescence alone (n = 1), with standard liposuction performed on the contralateral side for all ultrasound-assisted liposuction animals. The lipoaspirates from the ultrasonically assisted liposuction with the sheath showed significantly less blood loss (measured as hemoglobin in the aspirate) than standard liposuction (p = 0.012) at comparable levels of fat (measured as triglycerides in the aspirate). The lipoaspirates from ultrasound-assisted liposuction without the sheath showed blood loss comparable to that experienced with standard liposuction. The ratio of hemoglobin to triglyceride was lowest in the ultrasound-assisted group with (p = 0.01) and without (p = 0.06) the sheath when compared to traditional liposuction. In both of these treated groups, the radiograms of the perfused areas showed significantly less vascular disruption when compared with suction-assisted liposuction. Histopathologic examination of specimens taken from various treated areas showed substantial tissue damage comparable in ultrasound- and suction-assisted liposuction treated groups. This preliminary experimental study showed that ultrasound-assisted lipoplasty is comparable to traditional suction-assisted lipoplasty. Treatment with ultrasound provided more significant hemoglobin/triglyceride ratios, indicative of more lipid aspirated per hemoglobin lost, and better preservation of vascular tissues as demonstrated by our perfusion studies. Treatment with the sheath show...

Tissue Harvest by Means of Suction-Assisted or Third-Generation Ultrasound-Assisted Lipoaspiration Has No Effect on Osteogenic Potential of Human Adipose-Derived Stromal Cells

“…16,17 At the same time, investigations by Karmo et al and Kenkel et al have demonstrated that comparable, if not reduced, levels of blood loss result from ultrasound-assisted lipoaspiration relative to suction-assisted lipoaspiration. 18,19 In addition to these patient benefits, progress in the conduct of lipoaspiration arising from technical refinements in ultrasound-assisted lipoaspiration equipment have been reported by operating surgeons. 14,16 However, the technique is not without its drawbacks.…”

“…The panel's findings, and those of other investigators, established that concern over long-term tissue effects arising from the above factors is unfounded. 19,21,23 The true benefits appreciated by patients treated with ultrasound-assisted lipoaspiration compared with alternative lipoplasty techniques remain to be elucidated. However, the adaptation of ultrasoundassisted lipoaspiration in the clinical arena is expanding at an exponential rate.…”

Laparoscopic ultrasound-assisted liposuction for lymph node dissection: a pilot study

“…Tissue coagulation with necrosis is a usual finding after electrosurgical or ultrasonic tissue dissection. Ultrasoundassisted liposuction induces fat liquefaction and in the remaining adipose tissue margin, fat necrosis [17]. Although the use of water irrigation for UAL helps to reduce tissue heat, an increase in tissue temperature is expected.…”

Sonochemistry and Sonoluminescence in Simulated Ultrasound-assisted Lipoplasty Environment☆, ☆☆, ★

“…1,3 The possibility of SL and FR production resulting from UAL has been Sonochemistry and Sonoluminescence in Simulated Ultrasound-assisted Lipoplasty Environment S c i e n t i f i c F o r u m rejected by others. 14,15 Low-intensity SL emission was detected in our laboratory by a sensitive photon-detecting system in the process of sonication of wetting solution and varying ratios of FFP, at conditions simulating intercellular environment and UAL operating conditions in the frequency and intensity range used in current instrumentation. SL emission is multifactorially dependent.…”