One can turn to the blunt mode to complete transection. The flat mode will transect tissues following coagulation. For improved performance, coagulate with the flat mode, then rotate to the blunt mode to transect. In the shear cutting mode, the LCS can rapidly cut unsupported tissues. The ultrasonically activated blade edge pushes the target tissue against the tissue pad and shears the tissue between the blade edge and the flat surface of the pad.
Lateral coagulation is minimal.
The shear mode is best used in relatively avascular tissues and is useful for cutting the peritoneum, areolar tissue, fibrous ligaments, and smooth muscle. It has also been used successfully to morcellate large myomas and transect avascular adhesions. The LCS in blunt mode. The knife-like cutting mode of the LCS blade may be used as an ultrasonic scalpel with the tissue pad in the open position. If increased hemostasis is desired, cutting speed should be reduced.