Instead of the classic scalpel, surgeons can also operate with an electroscalpel.
A significant advantage to this technique is that while a cut is being made,
blood vessels are closed off and hemorrhaging eliminated. Now another advantage
may be added as well: a German-Hungarian research team has developed a mass-spectrometry-based
technique by which tissues can be analyzed during a surgical procedure. As the
team led by Zoltán Takáts reports in the journal Angewandte
Chemie, it may be possible to distinguish between malignant tumor cells
and the surrounding healthy tissue in real time during cancer surgery. Until
now, precise histological examination of the removed tissue has followed after
tumor surgery, and has required several days. If it reveals that the tumor has
not been completely removed, a second operation is needed. The new method may
spare patients this second surgery in the future.
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In electrosurgery, tissue is locally exposed to high-frequency electrical
current in order to guide a cut, remove tissue, or halt bleeding. The tissue
being treated becomes very hot and is partially vaporized. The electrical current
also generates electrically charged molecules during the vaporization. The team
of scientists from the University of Giessen, the Budapest firm Massprom, Semmelweis
University, and the National Research Institute for Radiobiology and Radiohygiene,
also in Budapest, made use of this process for their new method called rapid
evaporation ionization mass spectrometry, or REIMS. They equipped an electrosurgical
instrument with a special pump that sucks the vaporized cell components up through
a tube and introduces the charged molecules into a mass spectrometer.
It turns out that mainly lipids, the components of cell membranes, are registered
by the mass spectrometer. “Different tissue types demonstrate characteristic
differences in their lipid composition,” explains Takáts. “Tumor
tissue also differs from healthy tissue.” The scientists were able to
develop a special algorithm to unambiguously identify and differentiate between
types of tissue.
“Tissue analysis with REIMS, including data analysis, requires only fractions
of a second,” according to Takáts. “During an operation,
the surgeon thus received virtually real-time information about the nature of
the tissue as he was cutting it.” This opens new vistas for cancer surgery
in particular: the method helps to precisely localize the tumor during surgery
and to delimit it from the surrounding healthy tissue. REIMS also provides information
about whether the carcinoma is in an early or advanced stage.
Posted September 29th, 2009
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