The Harmonic scalpel is a surgical instrument used to simultaneously cut and cauterize tissue. Unlike Electrosurgery, the harmonic uses ultrasonic vibrations instead of electric current to cut and cauterize tissue.
The harmonic scalpel may be superior to electrosurgery in that it can cut through thicker tissue, creates less toxic surgical smoke, and may offer greater precision. The harmonic scalpel is not as easily maneuverable as an electrosurgical instrument, and takes longer to cut and coagulate tissue. Additionally, while electrocautery can be used to coagulate bleeding tissue at any time, the harmonic scalpel only coagulates as it cuts.
A 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. However, incidents have been reported where the active jaw has caused bowel perforation.
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