We are supporting a translational research programme to create real-time diagnostics to improve surgical decision making. As part of this programme, scientists are developing an ‘intelligent knife’ which gives surgeons instant feedback about the tissue they are cutting.
In modern surgery, the simple blade has been largely supplanted by electrocautery, a technique which uses an electric current to heat soft tissue rapidly so surgeons can cut through it with minimal blood loss. This procedure produces smoke which carries the molecular signature of the tissue being burnt. The smoke is usually sucked up into an evacuation system to avoid potentially harmful substances being released.
An Imperial team has developed a modified electrocautery knife which sends the smoke into a mass spectrometer to give a rapid readout of the smoke’s chemical composition. Preliminary research has found strong evidence that different tissue types and disease states produce a different molecular signature in the smoke.
The research team hopes to translate the mass spectrometer analysis into a simple readout which tells surgeons in real time what sort of tissue they are cutting. This is significant because when a surgeon is removing a tumour, it is not always possible to tell by sight which areas of tissue are cancerous and which are healthy. Consequently, excess healthy tissue is removed unnecessarily or the cancer is not completely excised.
Professor the Lord Ara Darzi, who is leading the research team, said: “We hope to transform the way surgeons make sure they’re cutting in exactly the right place. This will make surgery safer and improve our success rates at removing cancers.
“Ultimately, we hope to apply this approach to less invasive types of surgery, such as endoscopy and keyhole surgery. We think metabolic tissue profiling could really improve the way in which we carry out all sorts of operations.”
