Development team demonstrates iKnife on a piece of animal muscle

Development team demonstrates iKnife on a piece of animal muscle

Development team demonstrates iKnife on a piece of animal muscle

When surgeons can’t determine the edges of a tumor, it’s a problem. Cut too much, and they risk hurting the patient. Cut too little, and they may leave stray cancer cells behind. Now, researchers have developed a surgical knife that can sniff the smoke made as it cuts tissue, almost instantly detecting whether cells are cancerous or healthy.


The souped-up scalpel works by analyzing lipids, the fatty molecules that make up much of the cell membrane. Chemists have shown that the ratios of certain lipids can be used to identify various biological tissues, including tumors. But this requires first removing and preparing the tissue for a technique called mass spectrometry, which analyzes the mass and structure of charged molecules.

Hungarian chemist Zoltán Takáts wondered if he could speed things up by directly analyzing the smoke created by the electrosurgical knives that surgeons use to cut and cauterize blood vessels.

Although the smoke is “a very nasty” tarry mixture, Takáts says, he realized that one component is a vapor containing ionized molecules — just what mass spectrometry needs. His team has shown that the lipid profiles identified by piping this vapor from an electrosurgical knife to a mass spectrometer correspond to different tissue types of animals.

Now, his group at Imperial College London, together with Jeremy Nicholson, a biochemist who heads Imperial College’s department of surgery and cancer, have tested what they’ve dubbed the “intelligent knife,” or iknife, in the operating room.
The team collected nearly 3,000 tissue samples from about 300 cancer patients’ surgeries, had pathologists identify if a sample was healthy tissue or a type of cancer, then matched up each result with the lipid profile they got by touching the iKnife to the same sample.