Where the knife directs the surgeon.
1. What is it?
An intelligent knife also known as the “sniffing scalpel.” This device is an electrosurgical knife attached to a mass spectrometer which detects the boundary between healthy and cancerous tissue in surgery in real-time.
2. Why is it important?
This is a major breakthrough as it takes seconds for the analytical measurement to be completed. The readings are then matched against a reference library of cancerous and healthy cells. A traffic light signal is used to direct the surgeon whether or not to continue cutting.
Studies have shown that 20% of breast cancer patients required a second operation for complete success. The iKnife shows promising statistics to relieve patients from going under the knife several times, improving the overall patient experience in the long term.
3. How does it work?
The electrosurgical knife burns through tissue, creating smoke (a gaseous sample) which is carried through to a mass spectrometer; an analytical instrument.
This leads to a on screen signal:
- Red – Cancerous cells still present; keep cutting
- Green- Healthy cells present; stop cutting
A recent study with 198 patients and 335 samples showed results with 97.4% sensitivity and 100% specificity.1 This device has cut down surgery time where it took ≤30 mins for lab results to analyse samples and increased efficiency as fewer patients require a second surgery for successful removal of cancerous tissue.
A mass spectrometer provides accurate data on the chemical composition of measured compounds on a graph such as those shown below.
There are numerous types of mass spectrometers which measure different types of samples; solid, liquid, gas. Essentially, the sample is ionised by breaking the compound into fragments which are charged. These fragments are then measured according to their mass:charge ratio, x axis in the graphs above, which can then be identified to prove its chemical composition. The peaks in the graphs, y axis, show the abundance of each fragment.
(This device in particular uses a Rapid Evaporative Ionisation Mass Spectrometer, REIMS)
4. The future
We may see the iKnife being used for a whole range of tests in the future, with the food market proving to be viable market as it can also detects the difference between horse meat and beef which could have prevented some scandals!
5. Who is involved?
1. British Journal of Cancer volume 118, pages1349–1358 (2018)