Intelligent electronic knife on its way to speed up cancer operations


Britain’s parliamentary undersecretary of state at the Department of Health, Lord Howe, offered a statement yesterday praising the intelligent electronic knife (iKnife) developed by Zoltán Takáts, formerly of Budapest’s Semmelweis University, who is currently working in London.

The new scalpel is a real breakthrough in cancer treatment. Semmelweis University congratulated Takáts on his success, which is proving to be an international sensation, adding that it wished it had had sufficient resources to keep the intelligent knife in Hungary.

Hungarian Zoltán Takáts’s invention, the iKnife, is able to consistently identify cancerous and non-cancerous human cells while surgery is underway. It needs just a few seconds to let surgeons know whether the tissue they cut into is cancerous or healthy, the journal Science Translational Medicine reported on July 17. When research is completed and the scalpel goes on the market it will be able to effect a huge cut in operation time, and accompanying blood loss and risk of infection. It might also make surgery possible in cases otherwise deemed too risky. Takáts, who began working on the iKnife in Budapest, is currently on the staff of Imperial College London.

Lord Howe acknowledged the achievements of the Hungarian doctor and his team. He said that the iKnife once again proved how government support was helping to reinforce the United Kingdom’s leading position in international medical research.  Semmelweis University voiced its disappointment at not having the money to fund the research.

A major problem in oncological surgery is that tumorous tissue is hard to distinguish from surrounding healthy tissue, at least with the naked eye or by touch. Since doctors do not know where to cut to get rid of the cancerous tissue while leaving healthy tissue alone, they routinely send questioned samples to pathologists while the surgery is underway, often more than once. This means taking the samples and waiting for laboratory analysis which can take up to 30 or 40 minutes before surgery can be continued. Takáts’s iKnife, when acting as an electronic scalpel, transmits the smoke generated by the scalpel itself to an analytical unit which analyzes it in seconds with 97 percent accuracy, immediately letting the surgeons know what the questioned tissue it.

The iKnife itself, shown to the media on the 17th, is white and looks like a thick pen. It underwent testing in three British hospitals between 2010 and 2012. Laboratory analyses of tissues excised from three hundred patients were used to set up a database that included 1,624 cancerous and 1,309 non-cancerous samples.  According to the study, the iKnife and its analytical unit – a refrigerator-sized mass spectrometer which analyzes the smoke created by the electronic scalpel as it cuts and cauterizes the tissue – has been used during 91 operations since the database was set up, consistently identifying the tissues.

According to MTI, both Imperial College London and the Hungarian government contributed to financing the research. During the public presentation of the iKnife Takáts said that more research was still necessary. The team is about to start on a project that will test between 1,000 and 1,500 oncology patients suffering from different types of cancer. The project, he said, would require two to three years and only after that would they apply for a permit to market the tool.

“The goal of the study so far has been to verify that technology is at least as reliable as intra-operative pathological analysis when it comes to giving feedback to surgeons, and it is a whole lot faster to boot. We will need additional permits but it is likely that as of early next year surgeons will be able to take the iKnife into operating rooms and put it to use,” Takáts told Magyar Nemzet in a telephone interview. Speaking from London he explained that he had moved there a year ago, but that development of the tool is in the hands of a Hungarian company.  The team at Imperial College has been collecting the biochemical data needed to operate the iKnife, he said.

Semmelweis University’s statement noted that it had run tests of the iKnife on dogs with tumors in 2011, and this research had also contributed to the outcome. The technology was also tested by Semmelweis University at its No. 1 Surgery Clinic as well as at the Surgery Institute of Debrecen University. They too had participated in “teaching” the tool, in other words, in compiling the database with the information it needed to identify the various tissues, by collecting data from their own patients.