Ultrasonic energy was first used in the medical field for the
treatment of Meniere’s disease in 1960. Use of ultrasonic energy
for simultaneous cutting and cauterizing (sealing) of tissues was
reported in 1980, wherein the technique was employed for laparoscopic
cholecystectomy in over 200 patients successfully. Harmonic scalpel
is an ultrasonic surgical equipment used as an alternative for other
surgical scalpels or electro-surgical diathermy to cut and cauterize
tissues during surgeries. Harmonic ultrasound technology and its
dissection capability was first demonstrated in 1998, when ‘harmonic
scalpel shears’ were introduced by Ethicon (Johnson &
Johnson).
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A harmonic scalpel typically consists of a hand-held transducer, hand
switch, foot pedal, scalpel or blade (cutting instrument), and
generator. The basic working principle of harmonic scalpel is
conversion of ultrasonic energy into mechanical energy. Energy
conversion takes place at the active blade delivering high-grade
frictional force, while the tissue is held in apposition by the
inactive upper arm. The active scalpel cuts through the tissue using
low-frequency ultrasonic vibrations in the range of 20–60 kHz. The
vessel sealing is enabled by de-natured protein coagulum achieved due
to tamponade and co-aptation
Introduction of technologically advanced harmonic scalpel equipment
through research and development is expected to drive the harmonic
scalpel market during the forecast period. For instance, ARMONIC ACE
+7 Shears is the latest harmonic scalpel offered by Ethicon. It is
the first ultrasonic energy device with an indication of 7 mm vessel
sealing capacity. It is popular for its advanced hemostasis and
adaptive tissue technology enabling high vessel sealing capacity and
providing multfunctionality with fine precision, respectively.
Increasing adoption of harmonic scalpels over conventional steel
scalpels and electrosurgical devices is likely to boost the harmonic
scalpel market during the forecast period. Harmonic scalpel is
considered a better alternative to surgical diathermy, as it causes
less thermal damage.
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The harmonic scalpel market can be categorized on the basis of
procedure, end-user, and geography. Based on procedure, the market
has been categorized into gynecological procedure, thyroidectomy,
lung biopsy, bowel resection, tonsillectomy, plastic surgery, and
other procedures. Plastic surgeries include procedures such as breast
augmentation, breast reduction, and tummy tuck; while other
procedures include cholecystectomy and adhesiolysis. In terms of
end-user, the harmonic scalpel market can be segmented into
hospitals, ambulatory surgical centers, academic & research
institutes, and others. The increasing use of harmonic scalpels in
medical procedures for ENT (ear, nose, and throat) and rising demand
for these scalpels in medical aesthetics procedures are likely to
propel the harmonic scalpel market during the forecast period.
For instance, tonsillectomy cold surgical dissection was gold
standard until the late 1960s, followed by introduction of hot
electrocauter in the 1970s. Even though monopolar electrocautery
dissection is still being carried out as a common procedure for
tonsillectomy, harmonic scalpels introduced by Ethicon in 1993 are
becoming increasingly popular as tonsillectomy devices. Increasing
popularity of harmonic scalpels is attributable to their efficiency,
safety, reduced post-operative pain, and earlier return of patients
to regular activities such as oral intake.
Based on region, the global harmonic scalpel market has been
classified into Asia Pacific (APAC), Europe, Middle East & Africa
(MEA), North America (NA), and Latin America (LA). The increasing
number of surgical procedures in the U.S is projected to boost the
harmonic scalpel market in North America. In addition, high economic
contribution of health care, well-established health care
infrastructure, and patient compliance in North America have driven
the demand for harmonic scalpel devices in the region. Growing
opportunities for the harmonic scalpel market in developing economies
such as India and China is anticipated to register higher growth rate
compared to North America and Europe.
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Key players partaking in the global harmonic scalpel market include
Johnson & Johnson Services Inc., Olympus Medical Systems Corp.,
BOWA-electronic GmbH & Co. KG, and VDW GmbH.
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