Scientists have created an “intelligent” surgical knife that can detect in seconds whether tissue being cut is cancerous, promising more effective and accurate surgery in future.
The device, built by researchers at London’s Imperial College, could allow doctors to reduce the number of additional operations needed to remove further pieces of cancerous tumours.
The technology merges an electrosurgical knife that cuts through tissue using heat with a mass spectrometer for chemical analysis.
It has also been shown to be able to distinguish beef from horsemeat.
Surgeons often find it impossible to tell by sight where tumours end and healthy tissue begins, so some cancer cells are often left behind. A fifth of breast cancer patients who have lumpectomy surgery need a second operation.
The new ‘iKnife’ is designed to get round the problem by instantly sampling the smoke given off as tissue is cut through using an electric current to see if it is cancerous.
In the first study to test the device in patients, the iKnife diagnosed tissue samples from 91 patients with 100 percent accuracy, researchers at Imperial College reported in Science Translational Medicine.
Currently, tissue that is removed can be sent for laboratory analysis while the patient remains under general anaesthetic – but each test takes around half an hour, while the iKnife provides feedback in less than three seconds. It analyses biological information given off from the burning tissue and compares the findings to a database of biological fingerprints from tumours and healthy tissue.
“It’s a really exciting innovation and a very promising technique for all types of surgery,” said Emma King, a head and neck surgeon at Southampton Hospital, England, who was not involved in the research. She said she is keen to see how the iKnife performs in a randomised clinical trial.
Zoltan Takats of Imperial College, who invented the device, said he aimed to test it in such a study, involving between 1,000 and 1,500 patients with various types of cancers.
That trial process is likely to take two or three years and only then will the iKnife be submitted for regulatory approval, paving the way for its commercialisation. Takats has founded a Budapest-based company called MediMass to develop the product and he expects to strike a partnership deal with a major medical technology company to bring it to market in North America and Europe.
Hi-tech surgical equipment is being used increasingly in modern hospitals to help surgeons do a better job, most notably with the da Vinci surgical robot from Intuitive Surgical
The current experimental version of the iKnife cost Takats and colleagues at Imperial around 200,000 pounds (232,000 euros) to build. Takats said the price would come down once it entered commercial production.
The research was welcomed by British Health Minister Lord Howe, who said it could benefit both patients and the health service by reducing the number of people needing secondary operations for cancer.
The iKnife may also have a place beyond cancer, according to Takats, since it can identify tissue with an inadequate blood supply, as well as types of bacteria present in tissue.