Does the ultrasonically activated scalpel release viable airborne cancer cells?
GROUND: Viable cancer cells may implant at distant sites and cause tumor recurrence. One possible mechanism is the inadvertent exfoliation of viable tumor cells during dissection. The ultrasonically activated scalpel (UAS) uses ultrasonic energy to disrupt tissues by cavitation and produces a dense cloud of cellular debris that may contain viable cells. This study aimed to investigate the viability of airborne cells released during cancer dissection using the UAS and electrosurgery. METHODS: Flank tumors (n = 8) measuring 1 cm3 were induced in male WAG rats by subcutaneous injection of 2 x 10(6) CC531s colon cancer cells. Dissection was performed in cutting mode using the maximum power output of the respective devices. Electrosurgery was performed using a standard monopolar electrosurgical unit and a needle probe, and ultrasonic dissection was performed with the Harmonic Scalpel utilising the open surgical handset and the hooked spatula tip. The smoke plume was aspirated by a vacuum pu