Intelligent surgical knife detects diseased tissue

New surgical technique: „iKnife“

07/20/2013

With the help of a newly developed electric knife, the „iKnife“, In future, surgeons should be able to determine within seconds whether they are cutting in healthy or tumor tissue. In cancer surgery, the smart knife could be enormously helpful to physicians, but it may still be a long way to a surgery.

First tests passed
For cancer surgery, it is often not possible for surgeons to see where the tumor ends and where healthy tissue begins. In the future, a newly developed intelligent knife could help physicians recognize within seconds which tissues in cancer patients are affected by the tumor. The first tests have already passed the technical innovation, but it is still a long way to a practical application.

Enormous time savings
Quick decision-making would greatly facilitate surgeons' operations. Because if too radical cuts are made, the patient is unnecessarily burdened. However, if not enough is removed, cancer cells will be left behind and follow up operations will be necessary. This is unfortunately often the case with the removal of breast cancer. In order to determine what is to be removed and what is not, tissue samples are analyzed in doubt during surgery. But it could take more than half an hour to reach a result. The new technology would bring a huge amount of time.

„iKnife“
Researchers around the Hungarian Zoltán Takáts from Imperial College in London have the new technique, the „iKnife“, now in the trade magazine „Science Translational Medicine. "Within three seconds, a colored display should help the doctor decide whether or not to cut out tissue using a so-called electrocautery device, a wire that is traversed by electric current Standard instrument for surgical interventions The device is usually used instead of a traditional scalpel because of the lower blood loss, among other things, because it cuts through the tissue with heat and at the same time closes veins.

Smoke from burned tissue
The resulting smoke from the tissue burned by the wire is released during the process „iKnife“ analyzed by a mass spectrometer and the measured values ​​are compared with the data of a reference database. In a first test, the researchers had stored the smoke signatures of healthy and also of malignant proliferating tissue. For this material of 302 subjects was used. These were 1624 cancerous samples and 1309 unsuspected ones. Subsequently, the tissue of another 81 patients was examined by analyzing the smoke of the electrocautery from the mobile mass spectrometer and comparing it with the database. The new device was 100 percent correct in the analysis.

German researcher assumes a long wait
The „iKnife“ but is still very far from a practical use in everyday hospital life. First, further, anonymized studies are needed. The inventor Zoltán Takáts plans to test the knife on 1,000 to 1,500 patients with various cancers and then on his company „Medi Mass“ market. The Heidelberg cancer researcher Rösli also sees a long way to go before using the technology in the operating theater. Among other things, safety aspects such as the sterility of the devices would have to be considered. „It would be good if later a red and green light signals to the surgeon in which tissue he cuts ", says Rösli, who goes even further in his thoughts: „Or even better: when the knife turns off on healthy tissue by itself. "

Admission in two to three years
Rösli says: „There are things that a surgeon can not see with his eyes. "And so the knife could be used, for example, in brain tumors, bladder tumors or close to blood vessels, ie wherever a cut into healthy tissue could be particularly consequential The new development funded by Imperial College and the Hungarian government must pass the official approval process, with researchers expecting another two to three years.

300,000 euros for the prototype
Another hurdle to master is financial. The prototype of „iKnife“ cost around 300,000 euros. According to Takáts and his colleagues, the price will decrease in the production of larger quantities, but the necessary mass spectrometer remains a costly device in any case. (Ad)