Cavitron ultrasonic surgical aspirator (cusa)

what is CUSA?
CUSA in ent

1. CAVITRON ULTRASONIC SURGICAL ASPIRATOR (CUSA) DR ASHLY ALEXANDER ENT PG GMC BHOPAL

2. ULTRASOUND Ultrasonic waves: Sound waves with frequencies >20,000 Hz. Audible Range: 20 Hz - 20,000 Hz. Infrasonic waves: Sound waves with frequencies <20 Hz.

3. What is CUSA ? The Cavitron Ultrasonic Surgical Aspirator (CUSA) device generates ultrasonic waves in the range of 23 kHz to produce tissue cavitations . Tissue fragmentation is accomplished by a hollow titanium tip that vibrates up to 23,000 times per second. An irrigating fluid is delivered through the handpiece to create an emulsion while suction is provided through another portal to aspirate tissue and provide a clean operative site.

4. Principle High speed mechanical waves can be used in non-elastic media, such as water, to create a cavitation effect. Cavitation is the process of boiling in a liquid ( vapour formation) as a result of pressure reduction rather than heat addition. Tissues with weak intracellular bonds and high water content, such as tumors and lipomas, are easy to fragment, whereas tissues with strong intracellular bonds, such as nerves and vessel walls, resist fragmentation.

5. EFFECTS The ultrasonic aspirator has two rupturing effects at the tissue interface: The first is caused by a SUCTION EFFECT that couples tissue to the tip and forces impacted tissue to vibrate, accelerate, and decelerate with the tip, eventually fragmenting away from nonaffected tissues. The second important effect is that of CAVITATION. The rapidly oscillating tip produces localized pressure waves, which cause vapor pockets around cells in tissues with high water contents; the collapse of these pockets causes the tissue cells to rupture.

6. Mechanism

7. Uses CUSA can “cut out” brain tumors without adversely affecting the surrounding healthy tissue. Eg : Acoustic neuroma, meningioma, pituitary tumours Other uses : gynecological tumor debulking and liver, spleen, and renal resections, mucosal proctectomy for patients with ulcerative colitis, isolation of the coronary arteries for bypass grafting, and vessel dissection

8. 1. Rapid removal of tumor- less time needed 2. Controlled removal of tumor- safe 3. Minimal manipulation of structures surrounding tumor 4. Removal of firm tumors in obscure locations 5. No bleeding 6. Better visibility Advantages Disadvantages 1. Apparatus hard for nursing to set up 2. Some studies show nerve injury in relation to the intensity and the duration of application of probe There are no known contraindications. There are only limitations (financial, personal, etc.)