Depth of Tissue Injury During Culdotomy Using the Ultrasonically Activated Scalpel

The ultrasonically activated scalpel is an energy source which relies on mechanical, vibrational energy rather than thermal energy to incise tissue and achieve hemostasis. To determine the zone of tissue necrosis, microscopic sections were taken from the midpoint of culdotomy incisions performed during laparoscopic hysterectomy. Photomicrographs using trichrome staining technique indicate an approximately 1 mm zone of denaturation of collagen. Minimal coagulation necrosis or thermal artifact occurred. We conclude the ultrasonically activated scalpel may be used with safety in proximity to pelvic structures at risk for injury.