Ultrasonic dissection.

Following its development for cataract surgery, and gaining widespread use in neurosurgery and liver resection, ultrasonic dissection has been adapted for laparoscopic use. The turbulence, heat, and pressure generated by imploding bubbles disrupts tissues high in water content. This phenomenon is called cavitation and is the principal means by which ultrasonic dissection is accomplished. A randomized, prospective trial demonstrated the utility of the device for laparoscopic cholecystectomy. It was particularly effective in the presence of acute periportal inflammation or fat. Additional experience with a wide range of laparoscopic procedures is being accumulated by several investigators around the world. The laparoscopic use of ultrasonic dissection will be most valuable whenever selective, precise, and, therefore, safe dissection is desired.