How The Tissueselect Feature Works - Integra Cusa Excel Service Manual

How the TissueSelect Feature Works

How the TissueSelect Feature Works
6-4
TissueSelect is a feature that allows the surgeon to maintain a high fragmentation
rate while increasing selectivity and control at the surgical site.
Fragmentation occurs when the vibrating tip interacts with tissue. As the tip
begins to move toward tissue, it accelerates, then impacts and penetrates the
tissue. The acceleration, impact, and penetration produce a combination of direct
mechanical forces and hydrodynamic pressures that burst cells.
Several variables affect the fragmentation rate. Most are functions of the
CUSA EXcel system:
• Stroke (tip excursion—the total distance the tip travels)—greater stroke
results in greater fragmentation rate.
• Suction
Suction has two functions:
It draws tissue toward the vibrating tip and creates a tip/tissue
(1)
coupling effect.
It removes irrigation and fragmentation debris from the surgical site.
(2)
If there is no suction or low suction, coupling does not occur, resulting in
minimal tissue fragmentation and increased tissue temperature.
• Tip acceleration—produces the peak forces and pressures that fragment
tissue.
• Tip cross-sectional area at the tip-tissue contact site.
These variables also affect tactile feedback—what the surgeon's hand feels when
using the handpiece.
CUSA EXcel Ultrasonic Surgical Aspirator System Service Manual