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What is CUSA Machine
cavitron ultrasonic Surgical aspirator CUSA
An ultrasonic cavitation device is a surgical device using low-frequency ultrasound energy to dissect or fragment tissues with low fiber content. It is an ultrasound probe (acoustic vibrator) combine with an aspirator device.
The tip of the device, placed in contact with the target tissues, destroys and emulsifies the cell membranes, which irrigate and remove through a built-in suction tube. The vibration occurs with a frequency of 23 kHz and with an adjustable stroke of 0-300 microns.
How to use CUSA machine
1. Innovative tool for dissecting through the liver parenchyma, which can potentially reduce intraoperative blood loss and perioperative morbidity.
2. Powerful ultrasonic aspirator and dissector with a wide application not only in liver surgery but also in other surgical specialties as well.
3. Used in multiple surgical subspecialties, including neurosurgery, gastrointestinal, hepatobiliary surgery, gynecology, and urology.
4. Ultrasonic surgical aspirator there is happens, where fragmentation, suction, and irrigation occur simultaneously, allowing the surgeon to remove tissue with accurate control.
5. In liver surgery, it is an invaluable tool, particularly in a situation where the tumor is closely adjacent to a vital structure that needs to be saved.
6. CUSA will enable dissection around any structure that needs to be preserved.
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What is the Basic components of CUSA machine
1. Transducer
a. A device that converts electromagnetic energy into mechanical vibration.
b. The transducer composes of a stack of nickel alloy plates.
c. A magnetic field produces by a coil placed around the plates and causes mechanical motion of approximately 300 microns.
2. Connecting body
a. Mechanically conveys the motions of the transducer to the surgical tip.
b. It amplifies the vibration motion of the transducer.
3. Surgical tip
a. Completes the amplifications of the motion and contacts the tissue.
b. This is long compare to its diameter hence providing adequate motion amplification.
What is the Basic principle of CUSA machine
(1) Cavitation
a. Cavitation is defined as the process of formation of the vapor phase of a liquid when it is subjected to reduced pressures at constant ambient temperature.
b. Thus, it is the process of boiling in a liquid as a result of pressure reduction rather than heat addition.
c. Cavitation occurs when, on the negative side of a pressure cycle, such as when the probe-tip is retracting with sufficient amplitude and frequency, suspended gas bubbles either within a fluid, tissue, or trapped at solid interfaces expand and collapse resulting in the generation of shockwaves.
(2) Aspiration
a. Aspiration means to draw in or out using a sucking motion. This term has two meanings depending on how it use.
b. Aspiration can mean breathing in a foreign object.
c. Aspiration can refer to a medical procedure that removes harmful or misplaced substances from of an area the body.
d. Suction is the aspiration of a gas or fluid by reducing air pressure over its surface, usually by mechanical means or negative pressure device.
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(3) Ultrasound
a. Audible Range:-20Hz…..20,000Hz.
b. Infrasonic waves:-Sound waves with frequencies
<20Hz
c. Ultrasonic waves:-Sound waves with frequencies
>20,000Hz
- The cavitron ultrasonic Surgical aspirator (CUSA) device generates ultrasonic
waves in the range of 23kHz to produce tissue cavitation’s. - The entire device ebbed with an irrigator and aspirator to dispose of the tissue debris.
What is Piezoelectric transducer of CUSA
- Used to produce and detect Ultrasonic Waves.
- It is a quartz crystal that converts electrical oscillations into mechanical vibrations(sound) and vice versa.
What is the use of CUSA’s mechanics
- The CUSA console provides alternating current (24 or 35 kHz) to the handpiece.
- In the handpiece, the current passes through a coil, which induces a magnetic field.
- The magnetic field in turn excites a transducer of nickel alloy laminations, resulting in oscillating motion in the transducer laminated structure-vibration-along its long axis.
- The transducer transmits vibrations through a metal connecting the body to an attached surgical tip
- the vibrating tip contacts tissue, it breaks cells apart (fragmentation).
- The CUSA system supports different Magnetostrictive handpieces based.
- The CUSA has a self-contained suction capability to remove fragmented tissue and irrigation fluid.
- The Suction and Irrigate performers three function in CUSA operation.
- It draws tissue toward the vibrating tip and creates a tip/tissue coupling effect.
- It keeps the surgical site clear of irrigation and fragmentation debris.
- Irrigation fluid flows axillary around the outside of the vibrating tip to keep the tip cool.
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