A new kind of surgical knife can tell cancerous from healthy tissue in seconds and may help improve tumour removal in the operating room, new research shows.
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Known as the iKnife, the tool analyses the vapour given off as surgeons use electrical current to cut away tissue - and it reports in real time whether the tissue is cancerous.
Tests in 91 human patients have shown the tool's diagnoses were extremely accurate and may be reliable enough for widespread use in operating rooms, the study, published in the US journal Science Translational Medicine, revealed.
The iKnife uses mass spectrometry to examine the surgical smoke given off by evaporating tissue, alerting the surgeon in three seconds as to what it contains.
The iKnife ''can augment current tumour diagnostics, and it has the potential to influence 'on-table' decision-making and ultimately to improve oncological outcomes'', the study showed.
It was tested on tissue samples from 302 patients, including those with tumours of the stomach, colon, liver, lung, breast and brain, and later in the operating room during 91 procedures to cut tumour tissue away.
The knife, known as rapid evaporative ionisation mass spectrometry, matched post-operative analysis by histopathology in all 91 cases, the study showed.
It is not commercially available and likely will not be for at least another year, the study's co-author Jeremy Nicholson, of Imperial College London, said. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York, said the study was impressive.
''If perfected, this would help surgeons and patients avoid countless trips back to the operating room to try and obtain clear margins,'' said Dr Bernik, who was not involved with the research.
''A larger study needs to be carried out, but this preliminary data is very exciting.''
For Richard Fogler, chairman emeritus of the department of surgery at Brookdale University Hospital and Medical Centre in Brooklyn, New York, the technique might save some time, and it could be of particular use for plastic surgeons and for removal of head and neck cancers.
However, he said it would take a lot more study to change the standard of care in tumour removal.
Dr Fogler took issue with the paper's claim that the iKnife had the potential ''to improve oncological outcomes''.
''I think it has been pretty well shown over the years you can't make a statement about oncologic outcome without knowing what the stage of the disease is,'' Dr Fogler said.
''It doesn't matter how you take it out. It doesn't matter what you use to biopsy it.''
AFP
