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Related Experiment Videos

How safe is high-power ultrasonic dissection?

Tarek A Emam1, Alfred Cuschieri

  • 1Department of Surgery and Molecular Oncology & Surgical Skills Unit, Ninewells Hospital & Medical School, University of Dundee, Dundee, Scotland.

Annals of Surgery
|February 1, 2003
PubMed
Summary

High-power ultrasonic dissection generates significant heat, causing collateral damage to nearby tissues, especially at higher settings and longer activation times. Use lower power settings and shorter bursts for safer dissection near critical structures.

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Area of Science:

  • Surgical Technology
  • Medical Device Safety
  • Histopathology

Background:

  • High-power ultrasonic dissection is commonly used in open and laparoscopic surgery.
  • Perceived low risk of collateral damage lacks empirical evidence.
  • Need for objective safety evaluation of ultrasonic dissection devices.

Purpose of the Study:

  • To evaluate the safety and collateral thermal damage of ultrasonic dissection.
  • To compare two ultrasonic dissection systems (Ultracision and Autosonix).
  • To assess the impact of power settings and activation times on tissue injury.

Main Methods:

  • Controlled experimental study in pigs using Ultracision and Autosonix devices.
  • Dissections performed at three power settings (3, 5) on various anatomical structures.

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  • Infrared thermal mapping and quantitative histology used to assess thermal gradients and tissue damage.

    • Main Results:

    • Ultrasonic dissection generated extreme temperature gradients, proportional to power and activation time.
    • Significant histologic injury observed, extending to vessel walls and organ structures.
    • Collateral damage was minimal at power level 3 with short activation times (≤5 seconds).

    Conclusions:

    • High-power ultrasonic dissection (levels 4-5) with prolonged activation (>10 seconds) causes significant collateral thermal damage.
    • Ultrasonic dissections near critical structures should be limited to power level 3.
    • Energy bursts at power levels 4-5 should not exceed 5 seconds to minimize tissue injury.