The Tissue Select®
difference!

High intensity ultrasound, such as CUSA®, is highly effective and efficient for fragmenting tissue. Cavitation is the key to this efficiency.

Although ultrasound has some innate selectivity for hydrated, viscous tissues, it is still quite capable of fragmenting blood vessels, ducts, and other critical structures at high amplitude. Tissue Select provides a way to control the fragmentation rate without losing the efficiency of cavitation.

Tissue Select® mode alternates between high and low amplitude vibration, which maintains the efficacy of cavitation, while allowing the surgeon more time to react. This provides greater precision and control around critical structures.

Tissue Select®: Two simultaneous actions enabled by a proprietary sensor inside the CUSA® handpiece, which separates control of amplitude from power.

a/ Pulsed Energy :

In standard mode, the surgical tip vibrates with constant amplitude sinusoidal motion. In Tissue Select® mode, the tip vibration rapidly alternates between high and low amplitudes, above and below cavitation threshold. When amplitude drops below cavitation threshold, cavitation stops, and fragmentation is slower. This high and low amplitude cycle repeats 20 to 50 times per second.

With five settings from 0(off ) to 4(Max), as the Tissue Select setting is increased, the portions of time in high amplitude and cavitation decreases and may allow the surgeons more time to react on elastic tissues, giving improved precision and control around critical structures.

b/ Control of Adaptive Power

It limits the power to the surgical site and enables the tip to stop vibrations when increased pressure is put on resistant tissue.

If, instead of using Tissue Select®, you reduce the amplitude setting, you merely reduce tissue fragmentation without improvement in selectivity.

Activating the Tissue Select® feature has a much different effect than simply reducing the amplitude. For example, when reducing the amplitude setting, there will be a point where cavitation is lost. When cavitation is lost, ultrasonic fragmentation becomes much less efficient, so the time required to remove tissue will increase greatly. More importantly, some moderately tough tissues which the surgeon wants to remove may resist low amplitude ultrasonics, and be impossible to fragment, even with increased dwell time.

When amplitude is reduced below the level where ultrasonics is efficient at fragmenting tissues, and the surgeon persists in long dwell time on target tissue, this will result in increased heating and dessication at the surgical site.

Delivering control without compromise!
When you reduce the Amplitude setting, the efficacy can be lost without any improvement in the ability to discriminate between unwanted tissues and critical structures.

Is Tissue Select® Feature a key element in a surgeon decision to buy a CUSA®?