Using the Harmonic Scalpel in Cardiac Surgery: How to do it

The Harmonic scalpel (HS), (Ethicon Inc.), was initially introduced in clinical practice with the aim of reducing tissue trauma, facilitating dissection, and improving surgical trauma. The HS uses ultrasonic energy (vibration range of 55,500 Hz) to achieve simultaneous cutting and coagulation and to minimize lateral thermal damage.

The Video shows the easy use of the HS in cardiac surgery. This is a simple and effective technique for harvesting the scelonized mammarian artery (IMA) and the radial artery (RA) for Coronary Artery Bypass Grafting (CABG). The IMA and the RA are safely harvested by using the HS and the use of arterial conduits in CABG seems to be easily achieved. Also we describe the use of the HS for redo cardiac surgery and for pericardectomy

In summary, the use of HS for harvesting conduits, as well as for redo operations, is a technique with limited collateral damage and easy to learn. In fact optimal tissue dissection can be achieved with little blood loss.