Ultrasonic energy for cutting, coagulating, and dissecting by Wolfgang Feil, Bernhard Dallemagne Feil

By Wolfgang Feil, Bernhard Dallemagne Feil

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Regional application of ultrasound energy to the tissue and concomitant pressure to the tissue seals (coaptates) the vessel walls together before transection. The effect of UltraCision is modified by level (from 1 to 5), shape of the active blade, tissue tension/pressure, and application time of energy. Four Qualities of Action: Cutting, Cavitation, Coaptation, Coagulation 21 Coagulation When the locally applied energy acts for longer periods, there is also a rise in temperature leading to the thermally induced release of water vapor (63 to 100 °C) and later to coagulation at a maximum temperature of 150 °C.

Surg Endosc 1996; 10: 1025−28. Gossot D, Fritsch S, Cälärier M. Laparoscopic splenectomy: optimal vascular control using the lateral approach and ultrasonic dissection. Surg Endosc 1999; 13: 21−25. Gossot D, Buess B, Cuschieri A, et al. Ultrasonic dissection for endoscopic surgery. Surgl Endosc 1999; 13: 412−17. Grosskinsky CM, Hulka JF. Unipolar electrosurgery in operative laparoscopy. Capacitance as a potential source of injury. J Reprod Med 1995; 40: 549−52. Hambley R, Hebda PA, Abell E, Cohen B, Jegasothy BV.

In addition, because of the lower heat generation, ultrasonic energy produces little smoke and minimal tissue charring or desiccation, leaving tissue planes and operative fields better visualized. 25 3 UltraCision Scalpel and Other Energy Modalities W. Feil Principles of High-Frequency Surgery High-frequency electrical coagulation (HF cautery) in monopolar and bipolar form has been used in all branches of surgery for decades to deal with even the smallest sources of bleeding and to divide tissue (Fig.

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