Physics of ultrasonic surgery using tissue fragmentation

The ultrasonic surgical aspirator employs a vibrating metal tip to fragment tissue and then aspirates the debris through the hollow center of the tip. The mechanism of interaction has been stated to be poorly understood, most likely related to cavitation, possibly acting in concert with other mechanical actions. The role of stroke, suction, frequency, tissue type, and tip area have been examined with regard to tissue fragmentation rate. Suction is shown to make a significant contribution to the interaction. Photographic and acoustic data from experiments in water and on a range of fresh pig tissues are used to investigate the fragmentation effect. A model for the primary mechanism for tissue fragmentation is presented. This involves the horn-tip impact and other mechanical forces, operating in combination with hydrodynamic forces applied to the tissue on the forward stroke in each cycle. No evidence of cavitation in tissue was observed.