The CUSA is a unique modality for precise removal of tissue. This ultrasonic scalpel represents a major technical advance in surgery by providing a small handpiece device that can selectively remove tissue in a controlled manner. The usefulness of this modality in removing parenchymal tissue while sparing vascular or ductal structures is outstanding. Laboratory and clinical experience have demonstrated that utilization of this scalpel, particularly in vascular organs and lesions, provides the surgeon with increased visibility, reduced bleeding, and shorter operating time. Our application of this instrument in the performance of renal surgery in dogs as well as in the clinical setting has been well documented. Its future application as a surgical tool in the armamentarium of the urologist is uncertain and awaits the outcome of future studies.
