For a brain surgeon, telling tumorous tissue from healthy tissue can be tricky business in the middle of a procedure, with potentially disastrous repercussions if mistakes are made. Looking to give these doctors a helping hand, scientists have designed a smart scalpel that provides real-time guidance on whether the tissue it is tending to is cancerous or otherwise.
The new tool is the same size of a regular scalpel, but features a spherical tip on the end. Inside are sensors that gauge the mechanical properties of the tissue and, within around 400 milliseconds, present the surgeon with visual or audio cues to indicate its health.
"The technology of the device is based on self-sensing actuators using piezoelectric transducers," David Oliva, who developed the device at the Belgium's Free University of Brussels, explains to Gizmag. "The self-sensing actuator generates vibration on the tip of the instrument. When the device is touching brain tissue, the vibration is induced into the brain tissue and the device realizes the estimation of the mechanical properties, then this measurement is compared to a reference value previously taken on a well known healthy area to determine if there are changes in the consistency of the tissue. The process is, therefore, a tissue differentiation evaluation."
While MRI and ultrasounds can pinpoint the whereabouts of a brain tumor prior to an operation, various factors can lead doctors to lose its position once the surgery commences, especially when dealing with early stage tumors which can look much like healthy tissue. In this scenario, doctors are left to use microscopic observations or go poking around with tissue manipulation tools.
In 2013, researchers at the Imperial College London developed a similar knife that uses mass spectrometry to assess clouds of biological smoke emitted from surgical incisions and sniff out signs of cancer. And way back in 2000, researchers developed a scalpel that can detect cancer by searching cell populations for abnormal protein content.
So a tool that offers neurosurgeons a higher level of precision when carrying out these procedures has been in the works for some time. About six years in the making, this latest take on the smart scalpel has been used on artificial tumors and pig brain tissue with what the researchers claim to be "excellent results."
According to Oliva, who developed the scalpel in collaboration with German neurosurgeon Dr Ralf Stroop, it is designed specifically to tackle early stage brain tumors that are visible through an MRI but not in the operating room. He says that the technology could also be adapted to detect tumors in other parts of the body, and that the early testing has demonstrated its suitability for human trials.