The harmonic scalpel is a surgical instrument that utilizes ultrasonic vibrations to simultaneously cut and cauterize tissue, providing advantages such as reduced bleeding, quicker recovery time, and minimal thermal damage. It is versatile for various procedures, including endoscopic and open surgeries, but has disadvantages like reduced maneuverability and slower coagulation compared to traditional electrosurgical units. Overall, it represents a significant advancement in surgical technology offering precise dissection and reliable hemostasis.

1. HARMONIC SCALPEL
Jamilah saad Alqahtani
CNS,MSN,NS,RGN,BSN, OR Specialist

2. Outlines
Introduction
Definition
Uses
Advantage & disadvantage
Procedures involved
video demo

3. Before starting quick
review of previous lecture
2 minutes only

4. What is ESU stand for ?
Electrosurgical unit

7. HARMONIC SYNERGY® Blades
• HARMONIC SYNERGY® Blades use high-frequency mechanical
vibration to simultaneously cut and coagulate at the same time,
sealing vessels at lower temperatures than electrosurgery:
• Precise: Minimal lateral thermal tissue damage for safer dissection
near vital structures
• Reliable: Seals and divides vessels <= 2mm, as well as lymphatics
• Versatile: Cuts, coagulates and dissects, reducing instrument
exchanges

8. What is the use of
harmonic scalpel?

9. Uses
• 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

11. What are the
advantages of the
Harmonic Scalpel?

12. Benefits of the Harmonic Scalpel
• The Harmonic Scalpel's biggest advantage is the reduced bleeding
and recovery time for the patient. Other advantages include the
ability for a surgeon to make more precise cuts, and an overall
reduction of lateral thermal tissue damage in comparison to other
operating devices.
• Operates as much lower temperature than other instruments –
electrosurgical units(ESU).Produces very little if any smoke charring of
tissue clearer surgical field

13. What Procedures Can the
Harmonic Scalpel
Accomplish?

14. What Procedures Can the Harmonic Scalpel
Accomplish?
• The Harmonic scalpel is used for endoscopic and open surgical
procedures, and uses ultrasound.
• The Harmonic Scalpel is used in dental and ophthalmic surgeries. Some
specific procedures in which the device is used include: lung biopsies,
gynecologic cancer, hemorrhoidectomy, thyroidectomy, and
cholecystectomies.

15. What are the
Disadvantages of the
Harmonic Scalpel?

16. Disadvantages of the Harmonic Scalpel
• The Harmonic Scalpel’s primary competitor is the Bovie. The
Harmonic Scalpel is able to cut through thicker tissue.
However, it is not as maneuverable and takes more time to
coagulate and cut tissue. Additionally, the Harmonic Scalpel
can only coagulate tissue when it cuts.

17. HARMONIC FOCUS + Shears with Adaptive Tissue Technology, manufactured and submitted by Ethicon USA
1- https://www.youtube.com/watch?v=hVvtie7c_eI
2- https://www.youtube.com/watch?v=dR0H9no9yME
Demo video

18. Conclusion
• The harmonic scalpel is a surgical instrument used to simultaneously
cut and cauterize tissue. It is the latest device to have been
introduced in last decade or so.
• Ultrasonic energy is famously used in Harmonic scalpel where
ultrasonic energy is converted to mechanical energy at the active
blade [1].
• The main mechanism is the active blade which delivers high-grade
frictional force while the inactive upper arm holds tissue in
apposition.

19. Conclusion
• Its main advantages include precise dissection, reliable hemostasis,
less lateral thermal spread and charring mainly works by applying
pressure and then sealing with a denatured protein coagulum while
applying ultrasonic vibration to denature hydrogen bonds perform
vessel coagulation [2]. Ultrasicon is the name given to the dissection
method by harmonic.

20. References
• Dutta, D. K., & Dutta, I. (2016). The Harmonic Scalpel. Journal of
Obstetrics and Gynaecology of India, 66(3), 209–210.
http://doi.org/10.1007/s13224-016-0850-x
• http://www.tech-faq.com/harmonic-scalpel.html
• https://www.ethicon.com/na/products/energy-sealing-and-
dissecting/ultrasonic-shears/harmonic-synergy-blades
• http://medical.tpub.com/14275/css/Handpiece-And-Bur-Exchange-
118.htm

21. Research base
• Burn accidents due to the use of electrosurgical instruments
(electrotomy, electrocoagulation) are uncommon but generally
serious: explosion of inflammable anaesthetics or antiseptics, local
tissue necrosis by an uncontrollable current or coagulation necrosis
by a high current. An appropriate use of electrosurgical instruments
based on the correct range of indications is the basis for the
prevention of accidents.

22. Burn under patient plate is
always
Negligence