Iknife



Onkoknife or intelligent scalpel (English: Jedi knife, onkoknife, iKnife; Hungarian: onkokés, intelligens sebészi kés) is a surgical knife, which immediately gives the tissue tested chemical characteristic about effectiveness and information during the operation, if it contains cancer cells. The information given continuously during surgery the doctor performing the surgery to the affected tissue or cancer can significantly accelerate the healthy nature of biological tissue analysis and assists physicians in performing the surgery to fully remove virtually all cancer cells. The smart knife surgery is not only related to cancer diseases will be used. The iKnife because the tissues with blood can not properly detect and identify the type of bacteria found in tissues as well.

Research and development
Hungarian Zoltan Takats research chemist, PhD invented the intelligent surgeon knife. Semmelweis University, Budapest was currently a researcher at Imperial College staff. The iKnife operation has been tested in three hospitals between 2010 and 2012. Following laboratory analysis of tissue samples in 302 patients were included in a data base, which in 1624 of cancer and non-cancer samples in 1309. The iKnife current pilot version was about £200 thousand (68 million HUF) creating Hungarian scientist undertaking the MediMass Ltd. (Old Buda based company) and colleagues at Imperial College edge, and the Hungarian government can help. However, according to the Takats was worth it, as the device may be marketed.

The Massachusetts Waters Corporation's acquisition under development in MediMass Ltd. "Intelligent late" REIMS called substantive innovative technology - announced by the developer iknife or onkoknife MediMass Ltd on 23 July 2014. The business is under sale includes all MediMass innovation, including patents, software, databases, and human resources related to the technology.

History of direct examination of biological tissue by mass spectrometry (MS)
Direct examination of biological tissue by mass spectrometry (MS) has been raised in the 1970s, but then the next available technical conditions, the method did not provide any useful information on the chemical composition of the samples tested. The first breakthrough in the desorption ionisation methods (secondary ionization mass spectrometry, SIMS, matrix-assisted laser desorption ionization, MALDI) release said. Using these methods, after appropriate sample preparation, chemical biological tissue imaging analysis can be achieved. From the end of the 1990s, it became apparent that mass spectrometry data in the imaging studies show a high degree of tissue specificityie tissue histology determine the mass spectral information and vice versa.

This observation is not Surprising in the case of the detected protein and peptide components, tissue-specific expression of the proteins commonly known as the lower Precisely immunohistochemical methods are based on this phenomenon. However, the mass spectrometer detected, Mainly from cell membranes, similar tissue specificity of complex lipids from the Surprising result. Since the distribution of proteins in good agreement with the distribution patterns Obtained by immunohistochemical methods, the distribution of the lipid components of the direct ionization mass spectrometric Previously Relatively methods for the appearance of a new era in the study of biological specimens. The desorption electrospray ionization (DESI) was the first-MS technique, Which allowed any objects (or organisms) testing without sample preparation, non-invasive, regardless of their shape or mechanical properties.

REIMS (Rapid Evaporative Ionization Mass Spectrometry) technology
The rapid evaporative ionization mass spectrometry (REIMS), in the summer of 2009 was described. This is the second generation method is primarily lipid's components of tissues provides information but different metabolite molecules and certain proteins also allows detection. The most important advantage of the specificity of mass spectrometry data to the histological level, the opportunity to identify biological tissue based on chemical composition. REIMS method is unique in that, while the above-described mass spectrometry techniques specific to the particular method developed ion sources should be used, while in the case of ion source devices used in surgical practice, serve. A variety of tissue-and cutting tools, such as diathermy knife, a surgical laser or ultrasonic tissue atomizer operation of a characteristic of the tissue cut aerosol composition is formed, which also contains ionized cell constructs.

Among them, the REIMS method in terms of the intact membrane forming phospholipids are important, which are easily detectable by mass spectrometry on the one hand, on the other hand, the combination of the characteristics of the particular tissue type. Mass spectrometric analysis is just one implementation of an effective extraction system development was needed to cut the surgical site at the time of running the generated aerosol mass spectrometer. For this purpose, a so-called Venturi-tube serves, as well as the above-mentioned surgical hand pieces had to be modified to the aerosols smoked through them. Analysis of the flue gas in the mass spectrometer instantaneously, within a few tenths of seconds is realized, resulting in a tissue-specific phospholipid mass spectra obtained. The analysis of the collected spectra is made of a special evaluation software, which was developed for this purpose. The software continuously during surgery compares the incoming data, validated mass spectra stored in a database and assigns the appropriate class, and the result is visually displays the surgeon.

The method is therefore suitable for use in a surgical environment for carrying out measurements as well or as part of a complex identification system tissue during surgical tumor removal, can assist the surgeon in the operating surgical site accurate histological mapping. The rapid evaporative ionization mass spectrometry (REIMS) a novel technique that allows electrosurgery cuts in the near real-time characterization of human tissue in vivo analysis through analysis of the vapors released during the process of tissue / aerosols. The REIMS technology and electro-surgical procedure to associate a tissue diagnosis of intelligent knife iKnife operating principle.

The following problems to be able to eliminate iknife

 * Current surgical practice is the best equipped hospitals can take at least 10–30 minutes in case of an intervention related to tumor tissue, organ removal.
 * Doctors are not yet in possession of the result can be sure that every cancer cell, tissue removed to and is often more tissue removed for safety's sake.
 * If cancer cells remain after surgery, the tumor tissue may further surgery, chemotherapy or radiotherapy waiting.

The following are the advantages of applying iknife

 * In view of the results of bacteriological exactly antimicrobial therapy initiated.
 * Highly selective, able to complete the surgical site to provide relevant and objective information, and general surgical protocol is not affected greatly.
 * Safe
 * Organize Friends
 * Fast
 * Provide more information
 * Develop
 * Relatively cheap

More information

 * Sebészeti Műtéttan Egyetemi tankönyv Szerkesztette: Dr. Boros Mihály Szegedi Tudományegyetem Általános Orvostudományi Kar Sebészeti Műtéttani Intézet Szeged 2006
 * Clinical Surgery in General RCS Course Manual CHURCHILL LIVINGSTONE An imprint of Elsevier Science Limited R. M. Kirk, W. J. Ribbans 2004 All rights reserved.
 * Zollinger's Atlas of Surgical Operations, 8th Edition
 * Longmore, Murray; Wilkinson, Ian B; Rajagopalan, Supraj R Title: Oxford Handbook of Clinical Medicine, 6th Edition Copyright Â©2004 Oxford University Press
 * HANDBOOK OF PLASTIC SURGERY Edited by Steven E.Greer, M.D. New York, New York, U.S.A. Copyright © 2004 by Marcel Dekker.
 * http://stm.sciencemag.org/content/5/194/194ra93
 * http://www.healthline.com/health-news/tech-intelligent-knife-detects-cancer-cells-in-seconds-071813
 * http://www.bmj.com/content/345/bmj.e4505
 * http://www.doublexscience.org/iknife-excises-uncertainty-in-tumor-resection/
 * Wells, MP, Bradley, M: Surgical Instruments A Pocket Guide. W.B. Saunders, 1998.