The Origin and Evolution of the HARMONIC® Scalpel

AdventHealth gynecologic surgeon Steven D. McCarus, MD, FACOG, published an article in Surgery Technology International that reviewed the evolution of the HARMONIC® scalpel, a surgical instrument first released in 1988 that uses ultrasonic vibrations to simultaneously cut and cauterize tissue.

The use of ultrasonic energy in surgery originated from surgeons’ desires to continually improve outcomes through more effective methods and instrumentation. Instead of using electricity to achieve hemostasis, ultrasonic energy uses the mechanical energies of coaptation and cavitation to achieve precise tissue cutting and sealing. Gynecological surgeons were among the first to use this technology for a number of procedures, including coagulating or excising endometriosis, removal of uterine fibroids, tubal surgery, ovarian surgery, colpotomy, and total and subtotal hysterectomies. However, surgeons from a variety of specialties now use it, including general surgery, breast, colorectal, thoracic and bariatric.

Over the years, the HARMONIC® scalpel technology has continued to evolve, providing surgeons with increased precision and versatility, and allowing for use in minimally invasive procedures that are performed with smaller incisions. Surgeons have reported that using HARMONIC® devices resulted in shorter surgical times because tissue is quickly cut, coagulated and sealed with one instrument. Hospitals have also noted reductions in total reported costs and operation-only costs.

Numerous clinical trials and meta-analysis studies over the years have compared the use of ultrasonic energy to conventional methods for a variety of surgical procedures. Documented clinical benefits for patients have included less collateral tissue damage, fewer complications, a reduction in postoperative pain and/or postoperative medications, less drainage and postoperative bleeding, reduced length of stay and quicker return to work.

In his article, Dr. McCarus reports that the ability of ultrasonic energy to be used near vital organs with precision by adjusting for tissue tension, power settings and activation time has accounted for its safety and clinical outcomes. He concludes that as the HARMONIC technology and ultrasonic energy platforms continue to advance, the focus should remain on achieving less tissue trauma and faster recovery.

View the full document here.