I totally agree with Dr Gossot’s remarks that the working temperature of the Harmonic Scalpel (Ethicon Endo-Surgery, Cincinnati, OH) increases if activated for more than 5 seconds. Of course, the Harmonic Scalpel is, as is every cutting or coagulating surgical device, dangerous if applied in the wrong place or used beyond visual control (eg, for tumors of the superior sulcus using the videothoracoscopic approach). The operation should always be converted into a thoracotomy should visual control be suboptimal. These rules are not quaint but common sense. If the rules are respected, ultrasonic dissection is safe and the device is convenient for the removal of neurogenic tumors.
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