• Journal of Chest Surgery
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• v.36 no.8
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• pp.610-613
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• 2003

A 68-year-old man with constrictive pericarditis underwent pericardiectorny. The pericardium was dissected with a Harmonic Scalpel (Ethicon Endo-Surgery, Cincinnati, OH). The harmonic scalpel differs from electrocautery in that there is only a minimal transfer of energy and no transfer of electrical energy to the tissues. A significant decrease in intraoperative and possibly even postoperative heart rhythm disorders is to be expected, as there is no conduction of electricity. This new device has many advantages including no muscular stimulation, low heat, a smokeless fold and easy hemostasis. We exprienced a patient who underwent pericardiectomy using the Harmonic scalpel, so we report this case with a brief literature.

• Korean Journal of Head & Neck Oncology
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• v.24 no.2
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• pp.179-183
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• 2008

Objective：To evaluate efficacy and postoperative morbidity in tonsillectomy using the harmonic scalpel vs conventional electrocautery. Materials and Methods：1) We compared intra-operative bleeding and operation time and analyzed the degree of pain, oral feeding and the ability to return to normal activities from the questionnaire. 2) Animal study：Using rats, we made each linear wound with harmonic scalpel or electrocautery, then compare the width of thermal injury area with trichrome stain. Result：Harmonic scalpel tonsillectomy had significant advantages over electrocautery tonsillectomy in terms of post operative pain, oral diet tolerance and the time of return to normal life. In addition, it increased patients’ overall satisfaction with the surgery. In animal study, it was found that the thermal injury was less severe in the wound caused by harmonic scalpel than by electrocautery. Conclusion：Harmonic scalpel tonsillectomy decreases the thermal injury of the adjacent tissue, thus it has advantages over electrocautery in post tonsillectomy morbidity.

• Journal of Chest Surgery
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• v.36 no.8
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• pp.595-601
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• 2003

Background: It has been known that the most effective treatment method of hyperhidrosis is video-assisted thoracoscopic sympathetic nerve block. Postoperative compensatory hyperhidrosis and anhidrosis are major factors that decrease the postoperative satisfaction. Although sympathetic rami have been selectively blocked to decrease the complications, technical difficulties and excessive bleeding have prevented the universal application. Material and Method: Three pre-fixative cadavers were dissected before clinical application. Bilateral sympathetic chains were exposed in supine position after the whole anterior chest wall was removed. Second and third sympathetic rami were blocked using clips. After the sympathetic chains including ganglia were removed, we evaluated the extents of rami block. Twenty-five patients were subjected to the clinical application. Surgeries were performed in semi-fowlers position under general anesthesia and bilateral ventilation. 2 mm thoracoscopy and 5 mm trocar were intro-duced through third and fourth intercostal space, respectively. Second and third sympathetic rami were blocked using thoracoscopic clips. The postoperative complications, satisfaction, and compensatory hyperhidrosis rate were evaluated retrospectively. Result: Sympathetic rami were completely blocked in cadaver dissection study Hyper-hidrosis symptom was improved in all patients without operative complication. Operative time was shorter than that of traditional ramicotomy. All patients, except four, were satisfied with postoperative palmar hyperhidrosis. Com-pensatory hyperhidrosis was more severely happened in fifteen patients (60%). The remaining six patients had no complaint. Two patients had a minimal degree of gustatory hyperhidrosis. Conclusion: This operative method had shorter operative time and less complication rate, compared with traditional ramicotomy Operative success rate was similar to the traditional syrnpathicotorny; lower extent and occurrence rate of compensatory hyperhidrosis. The thoracic sympathetic rami clipping was suggested as an alternative method for treatment of palmar hyperhidrosis.