Electrosurgical and ultrasonic scalpels are the main tools for surgery, especially gastrointestinal tumor surgery. Both have their own advantages and disadvantages, and they are generally used in the same operation.
The high-frequency electrosurgical knife is an electrosurgical instrument that replaces the traditional scalpel for tissue cutting and separation. It heats the tissue when it comes into contact with the body through the high-frequency current generated by the electrode tip of the electrosurgical knife. It separates and solidifies the tissue, thereby cutting and stopping bleeding. The electrosurgical mode during surgery is divided into electric cutting and electrocoagulation modes. Electric cutting is mainly used to cut the skin. It is usually cut by electrocoagulation after traditional surgery to cut the epidermis and dermis. When the electrocoagulation mode is working, it can play a hemostasis while cutting the tissue. Generally, when the skin is cut, the electrocoagulation mode is not used, which may cause skin burns to form coke, causing poor wound healing in the later stage.
When the high-frequency high-voltage current generated by the high-frequency electric knife passes through the high-impedance structure, heat is generated in the tissue, causing the tissue to vaporize or solidify. The advantage of the electrosurgical knife is that it can stop bleeding well when the tissue is cut, the tissue is cut faster, and the separation of the tissue is easy to perform. The disadvantage is that when the subcutaneous fat is thick, it is prone to fat liquefaction and affect the healing of the wound. There is also an electric knife that does not stop bleeding when the blood vessel is cut off. This is obviously not as good as an ultrasonic knife.
Ultrasonic knives, the application principle of ultrasonic knives is to convert electrical energy into mechanical energy through a special conversion device. The high-frequency ultrasonic vibration of the ultrasonic cutter head causes water vaporization in the contacted tissue cells, and the protein hydrogen bonds are broken, and the tissue is solidified and then cut. Ultrasonic knives are divided into fast and slow gears, fast gears are mainly used for tissue cutting, and slow gears are mainly used for hemostasis. The use of ultrasonic scalpel in laparoscopic surgery has significant advantages. It can be said that the main surgical instruments for laparoscopic surgery, especially in laparoscopic surgery for gastric cancer and colorectal cancer, can reach more than 95%.
The study found that the ultrasonic knife has much less damage to the surrounding tissue than the electrosurgical knife, and its precise cutting action, as well as the ultrasonic cutter head is divided into the working end and the non-working end. When used, the non-working side cutter head is close to the blood vessel or important organ, so that It can safely separate and cut along important organs and large blood vessels without losing blood vessels and organs, and less smoke and less irritability, making the laparoscopic surgery clearer and smoother. In addition, the ultrasonic scalpel is not like an electrosurgical knife. The work is no electric current through the human body to make the operation safer and reduce the occurrence of complications. In the separation of adhesions, especially when the tumor adheres to nearby tissues, separation with an electric knife can sometimes lead to bleeding or organ damage, but it becomes easier to handle after using an ultrasonic scalpel, which reduces the difficulty of surgery and reduces the amount of intraoperative blood loss. More in line with the principle of tumor-free surgery.