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LETTER TO THE EDITOR |
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Year : 2016 | Volume
: 9
| Issue : 5 | Page : 666 |
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The “intelligent knife”: The knife that tells surgeons whether the tissue they are cutting is cancerous or not
Dhaval Thakkar, Rajesh Kuber, Mansi Jantre, Amarjit Singh
Department of Radiology, Dr. D.Y. Patil Medical College, Pimpri, Pune, Maharashtra, India
Date of Web Publication | 13-Oct-2016 |
Correspondence Address: Dhaval Thakkar 403, Alaknanda, Neelkanth Valley, Ghatkopar (East), Mumbai - 400 077, Maharashtra India
Source of Support: None, Conflict of Interest: None | Check |
DOI: 10.4103/0975-2870.192166
How to cite this article: Thakkar D, Kuber R, Jantre M, Singh A. The “intelligent knife”: The knife that tells surgeons whether the tissue they are cutting is cancerous or not. Med J DY Patil Univ 2016;9:666 |
Sir,
Surgical excision of solid tumors (along with a reasonable margin of healthy tissue) is often the treatment of choice in cases of cancer. However, this is done based on macroscopic sight alone, and it is often impossible to tell by sight whether tissue is cancerous or not. In cases where the surgeons are uncertain, the excised tissue is sent for laboratory examination. The patient meanwhile remains under general anesthetic, a condition itself associated with numerous possible complications. Hits and misses by the surgeons in identifying healthy tissue margins translate into recurrences, repeat surgeries and increased mortality.
In 2013, Balog et al. described their use of an electrosurgical knife called the intelligent knife or 'iKnife' to identify cancerous tissue in the operating theatre itself. Electrosurgical knives use an electrical current to rapidly heat tissue, cutting through it while minimizing blood loss.[1] As the knives vaporize tissue, they create smoke that is usually withdrawn by extraction systems. The authors connected an electrosurgical knife to a mass spectrometer, an instrument used to identify the chemicals present in a sample. Different cell types produce metabolites in concentrations unique to their type, so the chemical profile of a tissue sample can reveal important information about the metabolic state of that tissue. The researchers first used the knife to analyze cancerous and noncancerous tissue samples to create a reference library, and then in the operating theatre to perform real-time analysis during surgery. Here, the iKnife matched profiles to those from the reference library to identify cancerous and noncancerous tissues within a time-span span of three seconds. The tissue type identified by the iKnife was found to match the traditional laboratory diagnosis.[1]
This technology can be extended beyond cancer to identify infection and hypoxia as well. We believe that the invention of the iKnife heralds the translation of the basic science into devices of invaluable clinical value.
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1. | Balog J, Sasi-Szabó L, Kinross J, Lewis MR, Muirhead LJ, Veselkov K, et al. Intraoperative tissue identification using rapid evaporative ionization mass spectrometry. Sci Transl Med 2013;5:194ra93. |
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