Laser probe and smart knife 'improve accuracy of removing brain tumors'

Laser probe and smart knife 'improve accuracy of removing brain tumors'

A young man has successfully undergone pioneering brain surgery to remove a tumor. The procedure used two technologies - a laser probe and a smart knife - that appear set to revolutionize the performance of delicate surgery.

The new laser probe and smart knife effectively bring the lab into the operating theater.

Twenty-two-year-old PhD student Reuben Hill is the first patient to take part in a trial being conducted at Imperial College Healthcare NHS Trust in London, UK, to test the use of the two new technologies.

Tumors of the brain result in more life years lost than any other tumor because although they are rare, they often strike the young.

The first step is often brain surgery. This is a delicate and precise operation where one of the major challenges is that the boundary between the tumor and normal brain tissue is hard to see, even through a microscope. Another challenge is leaving enough margin of healthy tissue to ensure all the cancer is removed.

At present, the surgeon has to send samples of removed tissue to the lab for biopsy to find out if it is cancerous or healthy. This can take up to 30 minutes each time. There is also a risk of cutting into healthy tissue, leading to serious side effects such as loss of speech or movement.

The new laser probe and smart knife look set to change this by effectively bringing the lab into the operating theater, providing near instant confirmation for the surgeon of whether the tissue is cancerous or healthy.

Using scattered light, the laser probe distinguishes cancerous from healthy tissue, and helps the surgeon map the tumor and decide precisely where to cut.

The smart knife - called the iKnife - confirms within seconds whether the tissue being cut is cancerous or healthy without the need for a biopsy. It comprises an electric scalpel that burns the tissue, the smoke from which is sucked away and instantly analyzed.

'Considerably improving the accuracy of removing brain tumors'

Mr. Hill says it was a shock to be told he had a brain tumor. But when he was approached to sign up for the trial he "jumped at the chance." Also, it helped that he is studying lasers for his physics doctorate, so he could understand "how the laser probe would work to accurately detect the cancerous tissue."

Neurosurgeon Babar Vaqas, who is leading the trial at Imperial College Healthcare NHS Trust, says:

Being able to use both of these innovative technologies during delicate brain surgeries is considerably improving the accuracy of removing brain tumors. This means that patients are far less likely to suffer from the side effects of cutting away healthy tissue such as loss of speech."

The laser probe, which uses Raman spectroscopy to analyze the light scattered from the tissue, is provided by Verisante Technology, Inc., of Vancouver, Canada.

Vaqas says the trial is the first ever application of Raman spectroscopy during human brain surgery.

The iKnife is the brainchild of Prof. Zoltan Takats of Imperial College London, who realized that the smoke given off by electrosurgery could be a rich source of biological information. The chemical composition of the smoke is analyzed by a mass spectrometer.

The iKnife technology was recently acquired by the Waters Corporation, whose headquarters are in Milford, MA.

In July 2013, reported on research carried out at Imperial College London where the iKnife achieved 100% accuracy in distinguishing between cancerous and healthy tissue in samples from 91 patients.

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Section Issues On Medicine: Medical practice