Background <p>This study aims to investigate the performance degradation and morphological changes of ultrasonic scalpels following gastric cancer surgery, and to evaluate their potential interactions with medical-grade titanium alloys (such as titanium clips and staplers).</p> Methods <p>Three experimental groups were established: Group C (control group), Group OP (post-gastric cancer surgery group), and Group OP+Ti (post-gastric cancer surgery group exposed to titanium alloys). Cutting rates were measured for each group and analyzed using one-sided t-tests and linear mixed-effects models. Surface morphology was observed using scanning electron microscopy (SEM).</p> Results <p>Compared with Group C, all blades in Group OP exhibited varying degrees of tissue carbonization, adhesion, and microcracks, with a significant decrease in cutting rate (<i>P</i> &lt; 0.05). Group OP+Ti not only displayed the aforementioned phenomena observed in Group OP but also exhibited severe morphological damage at the blade tip, with a similarly significant reduction in cutting rate. Interaction with titanium alloys accelerated blade wear, further compromising their performance.</p> Conclusions <p>During gastric cancer surgery, the cutting performance and characteristics of ultrasonic scalpels undergo significant degradation. Their interaction with titanium alloy implants is a critical factor that cannot be overlooked, as it may cause additional damage to the blade tip, leading to a decline or even loss of performance. It is recommended that surgeons use the instruments properly, avoid contact with metal during ultrasonic scalpel operation, and regularly assess the wear status and safety of the instruments to ensure patient safety during surgery and optimal postoperative recovery.</p> Graphical abstract <p></p>