Ultrasonic Shears

Ultrasonic energy devices, first introduced in the 1980s, have become integral to modern laparoscopic surgery. Compared to conventional electrosurgical modalities, ultrasonic shears offer several advantages, including faster tissue cutting and coagulation, reduced lateral thermal spread, improved haemostasis with decreased blood loss, and reduced surgical plume production. These devices function through the conversion of electrical energy into high-frequency mechanical vibrations via piezoelectric transducers, enabling tissue dissection and vessel sealing through mechanisms of coaptation and cavitation. Over the past decade, significant technological advancements have enhanced device performance, including improved energy delivery systems and thermal control. Contemporary ultrasonic platforms, such as Harmonic, Sonicision, and Thunderbeat, incorporate refined ergonomics, enhanced safety features, and hybrid energy capabilities. This chapter provides an overview of the principles, mechanisms, and current technologies of ultrasonic shears, with a focus on their clinical applications and evolving role in minimally invasive surgery.