Smart Surgical Instruments: the NaviKnife
This new technology will offer for the first time, real‐time definition and pathological analysis of the tumour margins during surgery. It will allow surgeons to remove cancerous tissue with precision, decrease the incidence of positive margins, and thus avoid repeat surgeries and systemic therapies.
Removing a tumor from a person’s body is hard work. When a surgeon performs cancer removal procedures, their goal is to remove the tumor in its entirety with a rim of healthy tissue surrounding it, which allows them to determine that all the cancer has been removed. Still, surgeons must also be cautious to minimize the amount of healthy tissue they extract, a process that is complicated by the irregular shape of most tumors and their tendency to shift during surgery. Because of this, cancer removal procedures tend to be unpredictable – doctors may not be able to confirm they’ve removed a person’s cancer until tests are done on the tissue post-operation.
Collaborating with researchers at the Imperial College in England, the Queen’s University Laboratory for Percutaneous Surgery (Perk Lab) has created a tool they call the “NaviKnife” to make tumor-removal procedures more effective. The tool is essentially a fusion of the British iKnife, a “smart” surgical instrument, and real-time electro-magnetic mapping capacity developed at Queen’s. The iKnife without this modification could only alert surgeons if they had cut into cancerous tissue, whereas the NaviKnife allows them to be proactive in avoiding cancerous tissue altogether. The Queen’s School of Computing, specifically Dr. Gabor Fichtinger and colleagues, has also been instrumental in the NaviKnife’s development, troubleshooting issues of electro-magnetic mapping. So far, a NaviKnife pilot study has been conducted on several women seeking breast-conserving surgery with positive outcomes. When the NaviKnife is used, fewer women had to get repeat surgeries—20% of the time additional surgeries were needed, in comparison to a current rate of 40-50%. The NaviKnife team looks forward to further developing this technology, and hopes to continue to reduce tumor removal procedures’ “positive margins”—instances wherein patients require additional procedures.