Ultrasonic Surgical Aspiration in the Treatment of Vulvar and Vaginal Disease

Ultrasonic surgical aspiration (USA) is a surgical technique for precise tissue removal by the application of rapid mechanical movement. A cavitational effect occurs as a result of rapid mechanical movement causing selective tissue removal. Cavitation is defined as the rapid formation and collapse of vapor pockets in a flowing liquid media. This results in cellular fragmentation preferentially in tissues with a high water content. The process of cavitation is the major force that creates cellular disruption. USA has been used in a number of clinical situations. In gynecology, it has been primarily advocated for cytoreduction in patients with ovarian cancer. USA has been applied to vulvar and vaginal disease because of its ability for precise tissue removal with minimal damage to the surrounding tissue. The selectivity of USA results from differences in the water content of tissues as cavitational effect is greater in water-rich tissues. Diseases of the lower genital tract have this differential and thus permit selective and precise tissue removal.