Intelligent knife added to the surgeon's armoury

The iKnife in a demonstration as it sucks in the smoke from the cauterised tissue
MTI/AP/Sang Tan

And you thought that surgery was the biological equivalent of carpentry… Maybe, but it is getting more sophisticated.

When it comes to cancer surgery the goal is to remove the entire tumour, but no more. The difficulty is that at the edges of the tumour it is difficult to distinguish cancerous tissue from normal tissue, so after the operation the surgeon sends the tumour to the pathology lab for inspection under a microscope.

If the edges are not clean the patient often needs repeat surgery or additional radiation therapy. It is estimated additional surgery is needed in one of five cases after partial mastectomy to treat breast cancer.

Imperial College UK has developed an electrosurgical knife – known as the iKnife – that can determine whether the tissue being cut is cancerous.

The technology is a novel combination of two well established techniques. The first, developed in the 1920s and known as electrosurgery, uses a high frequency high voltage electric current to rapidly heat tissue, simultaneously cutting through it and sealing the blood vessels so that there is minimal blood loss. The second, developed in the early 1900s, is mass spectroscopy, an exquisitely sensitive means to identify proteins in samples.

The electrosurgical knife generates a smoke trail as it burns through the tissue. The iKnife rapidly sucks in the protein rich smoke and determines within three seconds whether there are protein traces unique to the cancer cells or not.

With this information, the surgeon can precisely remove just the right amount of tissue at the edges of the tumour to maximise the likelihood of eliminating the cancer without removing any more healthy tissue than is absolutely necessary. Bringing together two well-established technologies, the iKnife is another effective weapon in the war against cancer.

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