iKnife Combines Electrosurgery and Mass Spectrometry to Distinguish Cancerous Tissue

Electrosurgical knives, aka Bovies, are common surgical tools that use an electrical current to rapidly heat and cut tissue, as well as cauterize blood vessels to minimize blood loss. These are useful tools for excising diseased tissue such as tumors, however, it is nearly impossible to distinguish cancerous tissue that needs to be removed from vital, healthy tissue. Oftentimes, this difficulty prolongs surgical procedures as excised tissue is sent to a lab to be analyzed while the patient is still on the operating table and unconscious, or in worse cases, the patient has to completely undergo a second operation to remove cancerous tissue that was left over.

Dr. Zoltan Takats, a researcher at Imperial College London has developed a modified surgical tool that he calls the “intelligent knife”, or iKnife, that allows surgeons to distinguish cancerous tissue from the healthy variety. The iKnife is a standard electrosurgical knife connected to a mass spectrometer, an analytical instrument used to identify chemicals in a compound based on the mass of the underlying molecules. As a surgeon cuts tissue with the iKnife, smoke is produced, which is typically sucked away via exhaust vents. However, smoke produced by healthy vaporized tissue differs in chemical composition from cancerous tissue of the same type, so the smoke instead is redirected into the mass spectrometer to help the surgeon determine what kind of tissue he or she is cutting. In the first study of the iKnife, it was able to diagnose tissue samples from 91 patients with an amazing 100 percent accuracy.

The iKnife isn’t yet able to instantly provide a diagnosis as a surgeon is simultaneously cutting into tissue, but the results are much faster than traditional methods. Moreover, the technology isn’t limited to oncology; Takats suggests that the iKnife could be used for identifying bacteria present in tissue, or even letting you know if the meatballs you’re eating actually come from a Romanian horse, just as you ordered.

Journal abstract from Science Translational Medicine: Intraoperative Tissue Identification Using Rapid Evaporative Ionization Mass Spectrometry

Imperial College London: “Intelligent knife” tells surgeon if tissue is cancerous…