Sonicisions

Question 1

Select all that apply. It is acceptable to utillize which of the following when cleaning the generator, battery insertion guides, and sterilization tray of the Sonicision curved jaw cordless ultrasonic dissection system?

A) An ultrasonic washer
B) A pH Neutral enzymatic or alkaine detergent (at or below a pH of 10.9)
C) Soft nylon-bristle general instrument cleaning brush.

Answer 1

B, C

Question 2

When the active jaw of an ultrasonic dissection device is in contact with tissue, the mechanical vibrating motion causes proteins in the tissue to become denatured as hydrogen bonds are broken; as a result

A) The protein molecules become disorganized and form a sticky coagulum, which has the potential to weld and coagulate the smaller bleeding vessels
B) The collagen and elastin in the vessel walls melt, reforming into a permanent, plastic-like seal
C) The flow of electrical current creates high tissue temperatures, leading to rapid expansion of intracellular fluids and cell explosion or vaporization

Answer 2

A) The protein molecules become disorganized and form a sticky coagulum, which has the potential to weld and coagulate the smaller bleeding vessels

Question 3

True or False. The active jaw of an ultrasonic dissection device moves at a set frequency of 55,500Hz. As the power level changes from max to min, the frequency remains the same, but the distance that the active jaw is displaced, becomes longer, thus increasing the coagulation/hemostatic effect.

Answer 3

False

Question 4

True or False. The surgeon uses the minimum energy setting on an ultrasonic dissection device for less dissection and more coagulation.

Answer 4

True

Question 5

(Select all that apply.) When cleaning the Sonicision curved jaw cordless device’s battery, you should follow which of the following guidelines?

A) Do not immerse, submerge or rinse the battery pack under or in running water
B) Do not use instrument lubricant on the battery pack
C) Do not sterilize the battery pack as it is non-sterile. The battery pack will be damaged if sterilization is attempted.

Answer 5

A, B, C

Question 6

The Sonicision curved jaw cordless battery pack is non-sterile and designed to be used up to how many times?

A) 100
B) 150
C) 200
D) 250

Answer 6

C) 200

Question 7

The Sonicision curved jaw cordless generator is designed to be sterilized and used up to how many times?

A) 100
B) 130
C) 120
D) 150

Answer 7

D) 150

Question 8

Select all that apply. Which of the following sterilization methods is not approved for the Sonicision curved jaw cordless device because they will damage the equipment and compromise sterility?

A) Immediate-use steam sterilization
B) Gamma sterilization
C) Hydrogen peroxide gas plasma
D) Ethylene oxide sterilization

Answer 8

A, B, C, D

Question 9

When cleaning the battery pack, the customer should use a moistened lint-free cloth with a disinfectant solution, or use disinfectant wipe with which of the following disinfectants? (Select 3)

A) Ethyl alcohol
B) Isopropyl alcohol (70%)
C) Steris Valsure alkaline detergent
D) Hydrogen peroxide wipes
E) Metrex CavlWipes disinfecting towelettes

Answer 9

A, B, D

Question 10

True or False. We recommend automatic washing the battery insertion guides and generator in the sterilization tray.

Answer 10

False

Question 11

The Sonicision blade travels ________/seconds during use.

A) 5000
B) 55000
C) 1500000
D) 5000000

Answer 11

B) 55000

Question 12

When using ultrasonic energy, tissue dissection and coagulation ability are impacted by the following:

A) Amount of time the energy is applied
B) Tissue tension
C) Jaw pressure
D) All of the above

Answer 12

D) All of the above

Question 13

True or False. The sonicision device seals vessels up to 7mm.

Answer 13

False

Question 14

True or False. Sonicision and LigaSure are both advanced bipolar devices.

Answer 14

False

Question 15

Which components of Sonicision are reusable?

A) the hand piece
B) the torque wrench
C) the battery and generator

Answer 15

C) the battery and generator

Question 16

Select all that apply: The Sonicision 7 Curved Jaw ultrasonic device is indicated for:

A) dissection and coagulation of vessels up to and including 7mm in min mode
B) Dissection of vessels up to and including 5mm in max mode
C) Dissection and coagulation of vessels up to and including 7mm in max mode

Answer 16

A, B

Question 17

The Sonicision 7 generator uses a three phase algorithm in which mode:

A) min only
B) max only
C) both min and max

Answer 17

A) min only

Question 18

Select all that apply. What are the three phases of the algorithm used by the Sonicision 7 generator?

A) Pre-heat
B) Cut
C) Coagulate
D) Advanced haemostasis

Answer 18

A, B, C

Question 19

When did surgeons star to use ultrasonic dissection devices?

A) 1963
B) 2013
C) 1953
D) 1993

Answer 19

D) 1993

Question 20

What tissue effects can ultrasonic dissection devices perform?

A) coagulation
B) colocation
C) cutting
D) cavitation
E) coaptation

Answer 20

A, C, D, E

Question 21

True or False. The more tension the surgeon applies on the tissue with ultrasonic jaws, the more coagulation it produces.

Answer 21

False

Question 22

What are the three main components of an ultrasonic dissection device?

A) generator
B) handpiece
C) transducer
D) electrode

Answer 22

A, B, C

Question 23

True or False. Surgeons use the minimum energy setting on an ultrasonic dissection device for less dissection and more coagulation.

Answer 23

True

Question 24

True or False. Surgeons can use ultrasonic dissection devices only for laparoscopic procedures.

Answer 24

False

Question 25

Which of the following statements are benefits of ultrasonic dissection?

A) less surgical smoke than monopolar electrosurgery
B) no electric current through patient body
C) potentially less bleeding than monopolar electrosurgery
D) tissue sticking can never occur

Answer 25

A, B, C

Question 26

Which of these statements are disadvantages and risks of ultrasonic dissection?

A) Ultrasonic active blade retains heat longer than jaws of advanced bipolar devices
B) Vessel sealing and dissecting depend on surgeon skills
C) Blade fatigue can occur

Answer 26

A, B, C

Question 27

True or False. Contact between the active blade on other metal objects may result in product damage, such as broken active blade.

Answer 27

True

Question 28

(Select all that Apply) Surgeons use ultrasonic dissection:

A) to control bleeding
B) to minimize thermal injury
C) in laparoscopic and open procedures
D) for soft tissue dissection

Answer 28

A, B, C, D

Question 29

What Color does the LED Indicator Display when the Sonicision 5 Generator is connected to A Sonicision 7 Dissector?

Answer 29

Red

Question 30

(Select All that Apply): What are the Three Phases of the Algorithm used by the Sonicision 7 Generator?

Answer 30

Cut, Pre-heat, Coagulate

Question 31

(Select All that Apply) Which of the following claims are true for the Sonicion vs Harmonic Ace +7?
- 21% Faster Activation Time
- 14% Higher Burst pressure
- 20% Lower Max Jaw Temperature
- 29% faster Cool down after activation

Answer 31

21% Faster Activation Time

Question 32

Pick one: The Sonicision™ 7 generator uses a three phase algorithm in which mode:
Min only
Both Min and Max
Max only

Answer 32

Min Mode Only

Question 33

Pick one: What is our current Market Share in Ultrasonic Dissection Market?

Answer 33

Approximately 10%

Question 34

True or False: The active jaw of an ultrasonic dissection device moves at a set frequency of 55,500Hz. As the power level changes from max to min, the frequency remains the same, but the distance that the active jaw is displaced, becomes longer, thus increasing the coagulation/hemostatic effect?

Answer 34

False

Question 35

True or False: The SonicisionTM 7 and Sonicision™ 5 generators can be used interchangeably with any Sonicision™ dissector?

Answer 35

False

Question 36

Select all that apply: Which of the following claims are true for the Sonicision™ vs HarmonicTM* HD1000i?
21% faster activation time
20% lower max jaw temp
29% faster cool down time after activation
14% higher burst pressure

Answer 36

• 20% Lower Max Jaw Temp
• 29% Faster Cool down time after Activation
• 14% higher Burst Pressure

Question 37

True or False: The Surgeon uses the minimum energy setting on an ultrasonic dissection device for less dissection and more coagulation.

Answer 37

True

Question 38

What are the components of an ultrasonic dissection system?

Answer 38

Generator (power source), Transducer (transforms electrical energy into mechanical movement), Dissector or Handpiece.

Question 39

How does ultrasonic dissection technology work? What are the principles behind the technology?

Answer 39

The transducer converts the electrical energy into mechanical motion, through the contraction and expansion of the ceramic elements. A longitudinal vibratory response is produced that moves the distal end of the blade up to 55,500 Hz, depending on the manufacturer of the device. As the power increases, the frequency remains the same, but the longitudinal excursion of the tip becomes longer. When the tip of the ultrasonic scalpel is in contact with tissue, the mechanical motion causes tissue proteins to become denatured as hydrogen bonds are broken; as a result, the protein molecules become disorganized and form a sticky coagulum, which welds and coagulates the smaller bleeding vessels.

Question 40

Ultrasonic devices have four mechanisms of action, depending on the manufacturer of the device

Answer 40

1. Cutting – The ultrasonic scalpel uses a combination of tension and pressure to rapidly stretch tissue; when the tissue reaches its elastic limit, the blade cuts through it easily ,
2. Coaptation – The vibration of the ultrasonic device disrupts the hydrogen bonds in tissue, causing collagen molecules to collapse and adhere to one another at a low temperature. In this process, the tissue is subsequently transformed into a sticky coaptate.
3. Coagulation – When ultrasonic energy is applied to tissue for a few seconds longer than it takes to achieve coaptation, a rise in temperature will lead to the release of water and vapor and then to coagulation.
4. Cavitation – A side effect of the ultrasonic energy that is used to cut, coaptate or coagulate occurs when the vibration of the device is transmitted to the surrounding tissue, causing rapid volume changes of the tissue and cellular fluid. Cavitation facilitates tissue plane dissection and improves visibility of the operative field.

Question 41

What are the four factors a surgeon controls when using the device and how do each or a combination of the four affect tissue?

Answer 41

Factors that impact the delivery and effect of ultrasonic energy include tissue tension, the power setting (blade excursion min./max.), blade pressure / angle, and activation time.

First of all, ultrasonic shears can be used like a scalpel by opening the jaw allowing the oscillating blade to be applied directly to the tissue. More often, the compressive jaw function is employed by applying press to jaw closure lever in the handle. This pressure adds tension to the tissue that facilitates the mechanical shearing effect increasing the cutting efficiency of the device. Lifting the tissue being cut can create additional tension. The more tension or pressure applied, the more rapid the cutting effect. However, with more efficient cutting, there is progressively less tissue coagulation and a greater risk of bleeding if dissecting through vascular tissue. Consequently, the surgeon must operate varying the blade excursion by selecting MIN or MAX and appropriately adjusting the tension on the tissue by varying the pressure of the articulated jaw, and/or the amount of tension applied by lifting the target tissue.

Question 42

What consideration does a surgeon make when selecting ultrasonic dissection vs. other technologies such as monopolar or advanced bipolar?

Answer 42

Surgeons typically select ultrasonic when the surgical procedure requires a great amount of tissue dissection with hemostasis, and a monopolar pencil will not achieve the desired hemostasis. Furthermore, some surgeons are opposed to using monopolar in laparoscopic scenarios due to concerns with perception of the risk of stray current or lack of control over the energy.