Perko Z, Pogorelić Z, Bilan K, Tomić S, Vilović K, Krnić D, Druzijanić N, Kraljević D, Juricić J
University Department of Surgery, Clinical Hospital and Medical School Split, Spinciceva 1, Split, 21000, Croatia.
Surg Endosc. 2006 Feb;20(2):322-4. doi: 10.1007/s00464-005-0089-6. Epub 2005 Dec 5.
Use of the Harmonic Scalpel transduces a lower amount of energy to tissues, thereby limiting the potential for lateral thermal damage and deep penetration because only low temperatures are reached. The working principle of the Harmonic Scalpel is the transformation of electric power into the longitudinal mechanical movement of the instrument tip. This study aimed to determine the effects from varying durations of Harmonic Scalpel application on the experimental model of rat abdominal wall without skin.
After the rats had been anesthetized, and a laparotomy was performed. The Harmonic Scalpel shears were used on the muscular part of the abdominal wall without skin. Different durations of output power 3 were applied: a single 5-s application, a single 10-s application, and a regimen of two sequential 5-s applications. Each animal in each group of 10 received five individual activations, after which the animals were killed. Tissue samples were fixed and embedded in paraffin before sections were taken and stained. Using light microscopy and morphometric imaging analysis, the width of tissue lateral thermal damage was measured from the point of Harmonic Scalpel incision.
The rat abdominal wall showed lateral thermal damage over a mean width of 0.0522 +/- 0.0097 mm after a 5-s Harmonic Scalpel application, a damage width of 0.1544 +/- 0.0419 mm after a 10-s application, and a damage width of 0.1020 +/- 0.0430 mm after a 5-s application followed by 5 s of inactivity and another 5 s of activity. These differences in thermal damage width between all the groups are statistically significant.
The findings lead to the conclusion that tissue lateral thermal damage after Harmonic Scalpel application at standard output power is greater when a longer sustained period of application is used. Lateral thermal damage also is greater if the Harmonic Scalpel application time is continuous rather than of the same total duration with a brief midpoint interruption.
超声刀向组织传导的能量较少，因此由于仅达到低温，横向热损伤和深层穿透的可能性有限。超声刀的工作原理是将电能转化为器械尖端的纵向机械运动。本研究旨在确定在大鼠无皮肤腹壁实验模型中，不同超声刀应用持续时间的影响。
大鼠麻醉后行剖腹术。在无皮肤的腹壁肌肉部分使用超声刀剪。应用不同持续时间的输出功率3：单次5秒应用、单次10秒应用以及两个连续5秒应用的方案。每组10只动物中的每只接受五次单独激活，之后处死动物。组织样本固定并包埋在石蜡中，然后切片并染色。使用光学显微镜和形态计量成像分析，从超声刀切口点测量组织横向热损伤的宽度。
超声刀应用5秒后，大鼠腹壁的横向热损伤平均宽度为0.0522±0.0097毫米；应用10秒后，损伤宽度为0.1544±0.0419毫米；应用5秒后静止5秒再应用5秒，损伤宽度为0.1020±0.0430毫米。所有组之间热损伤宽度的这些差异具有统计学意义。
研究结果得出结论，在标准输出功率下应用超声刀后，如果应用持续时间更长，则组织横向热损伤更大。如果超声刀应用时间是连续的，而不是在总持续时间相同但中间有短暂中断的情况下，横向热损伤也更大。
