Intelligent surgical knife detects diseased tissue

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New surgical technique: "iKnife"

With the help of a newly developed electric knife, the "iKnife", surgeons should be able to determine in a matter of seconds whether they are cutting healthy or tumor tissue. The intelligent knife could be extremely helpful for doctors in cancer surgery, but there is still a long way to go before it can be used in practice.

First tests passed During cancer surgery, surgeons are often unable to see where the tumor ends and where the healthy tissue begins. In the future, a newly developed intelligent knife could help doctors recognize within seconds which tissues are affected by the tumor in cancer patients. The technical innovation has already passed initial tests, but there is still a long way to go before it can be put into practice.

Enormous saving of time A quick decision-making aid would make the operations of the surgeons enormously easier. Because if too radical cuts are made, the patient is unnecessarily burdened. However, if too little is removed, cancer cells remain and follow-up operations are necessary. Unfortunately, this is often the case when breast cancer is removed. In case of doubt, tissue samples are analyzed during the operation so that it can be determined what should and should not be removed. It could take more than half an hour to get a result. The new technology would save a lot of time.

"IKnife" Researchers around Hungary's Zoltán Takáts from Imperial College in London have now introduced the new technology, the "iKnife", in the scientific journal "Science Translational Medicine". Within three seconds, a colored display should help the doctor to decide whether Tissue should or should not be cut out using a so-called electrocautery. This wire, through which electrical current flows, has become a standard instrument for surgical interventions. The device is normally used instead of a classic scalpel because of, among other things, the lower blood loss because cuts through the tissue with heat and closes veins at the same time.

Smoke from burned tissue The resulting smoke from the wire burned tissue is analyzed by a mass spectrometer with the "iKnife" and the measured values ​​are compared with the data from a reference database. In a first test, the researchers had saved the smoke signatures of healthy and also malignant tissue. Material from 302 subjects was used for this. There were 1624 cancer-infected samples and 1309 unsuspected samples. The tissue of another 81 patients was then examined by analyzing the electrocautery's smoke from the mobile mass spectrometer and comparing it with the database. The new device was 100 percent correct in the analysis.

German researcher expects a long wait The "iKnife" is still very far from practical use in everyday hospital life. Initially, further studies, this time anonymized, were necessary. The inventor Zoltán Takáts plans to test the knife on 1000 to 1500 patients with various forms of cancer and then market it through his company "Medimass". The Heidelberg cancer researcher Rösli also sees a long way to go before using the technology in the operating room. Among other things, safety aspects such as the sterility of the devices would have to be considered. "It would be good if a red and green light later signaled to the surgeon which tissue he was cutting in," says Rösli. He goes even further in his considerations: "Or even better: If the knife turns itself off when the tissue is healthy."

Approval in two to three years Rösli says: "There are things that a surgeon cannot see with the eyes." And so the knife can be used, for example, in brain tumors, bladder tumors or close to blood vessels, wherever there is a cut in Until then, the new development, financed by the Imperial College and the Hungarian government, has to survive the official approval process, and the researchers assume that it will take another two to three years.

300,000 euros for the prototype Another hurdle to overcome is the financial one. The prototype of the "iKnife" cost the equivalent of around 300,000 euros. According to Takáts and his colleagues, the price of manufacturing larger quantities will drop, but the required mass spectrometer remains an expensive device in any case. (ad)

Photo credit: Thommy Weiss /

Author and source information

Video: iKnife: the surgical device that sniffs out cancer. Cancer Research UK

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