Variable aspiration control in surgical procedures. At least one example is a method of performing a surgical procedure, the method comprising: driving, by a surgical controller, a motor within a handpiece coupled to a resection instrument, the driving causes mechanical resection of tissue by the resection instrument; aspirating, by a peristaltic pump associated with the surgical controller, fluid and tissue fragments through a suction lumen of the resection instrument during the resection of tissue; and modulating, by the surgical controller, speed of the peristaltic pump during the driving and aspirating, the modulating responsive to an interface device defined on an exterior surface of the handpiece.