Harmonic scalpel
The Harmonic scalpel is a surgical instrument used to simultaneously cut and cauterize tissue. Unlike a Bovie, the harmonic uses ultrasonic vibrations instead of electric current to cut and cauterize tissue.
Medical use
The harmonic is superior to a bovie in that it can cut through thicker tissue, creates less toxic surgical smoke,[1] and may offer greater precision. The harmonic scalpel is not as easily maneuverable as the Bovie, and takes longer to cut and coagulate tissue. Additionally, while a Bovie can be used to coagulate bleeding tissue at any time, the Harmonic scalpel only coagulates as it cuts.
Mechanism
Whereas a Bovie performs its action via an electrical current (and production of heat), the 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] However, incidents have been reported where the active jaw has caused bowel perforation.
Manufacture
The Harmonic brand is manufactured in Mexico and distributed by Ethicon Endo-Surgery a subsidiary of Johnson & Johnson.
See also
References
- ↑ Fitzgerald JEF, Malik M, Ahmed I. A single blind controlled study of electrocautery and ultrasonic scalpel smoke plumes in laparoscopic surgery. Surgical Endoscopy 2012;26(2):337-342. PMID 21898022. DOI: 10.1007/s00464-011-1872-1
- ↑ Sabiston Textbook of Surgery. 2012. p. 236. ISBN 978-1-4377-1560-6.
- Msika S, Deroide G, Kianmanesh R, et al. (March 2001). "Harmonic scalpel in laparoscopic colorectal surgery". Dis. Colon Rectum 44 (3): 432–6. doi:10.1007/bf02234745. PMID 11289292.
- Awwad JT, Isaacson K (October 1996). "The harmonic scalpel: an intraoperative complication". Obstet Gynecol 88 (4 Pt 2): 718–20. doi:10.1016/0029-7844(96)00075-0. PMID 8841266.
- Siperstein AE, Berber E, Morkoyun E (February 2002). "The use of the harmonic scalpel vs conventional knot tying for vessel ligation in thyroid surgery". Arch Surg 137 (2): 137–42. doi:10.1001/archsurg.137.2.137. PMID 11822946.
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