A German/ Hungarian research team has recently developed a new tool for use by oncologic surgeons that will allow them to actually analyze tissues as they perform surgery.

The procedure is based around mass-spectrometry, and represents yet another advance in cancer surgery.

In the past the analysis of excised tissue has been performed after a patient’s surgery is over, with it often taking days for conclusive results to be sent back to the surgeon treating the patient. Only then can it be determined if the patient will need to undergo a second surgery to ensure that all malignancies have been excised. The idea behind the new technique is that by giving doctors the ability to analyze tissues in real time, while they are still operating, patients may be spared the distress and trauma of a second surgery.

The procedure is intended to be used in electro surgery, a technique already in use that replaces the traditional scalpel with a an electrical one, which offers significant benefits to both patient and surgeon as blood vessels can be immediately closed off, averting hemorrhaging or excessive bleeding.

During an electrosurgical procedure the scalpel exposes the tissue to a high-frequency electrical current, which is used to cut through it, as well as cauterize the blood vessels to immediately halt bleeding. Much heat is generated during this process, and part of the tissue vaporizes as a reaction to the high temperatures. The current itself also generates electrically charged molecules during the vaporization.

The research team, led by Zoltan Takats of the University of Giessen, makes uses of these vaporized gases for their new technique, which they have termed called rapid evaporation ionization mass spectrometry, or REIMS. The team equipped a standard electrosurgical instrument with a special pump that sucked up the vaporized cell components and then introduce the charged components into a mass spectrometer.

They discovered that the largest components of a cell membrane, lipids, register on the mass spectrometer. Because tumor tissue varies in its lipid contents from that of healthy tissue surgeons are seeing immediately which is which.

According to Takatas the whole analysis process takes just a fraction of a second. This lets a surgeon see in real time, as they continue to operate exactly what they are dealing with.

This innovation should open up a whole new level of accuracy in cancer surgery. Not only can the technique help a surgeon delineate between tumor tissue and healthy cells, avoiding needless excision of useful tissue, it can also tell the doctor instantly whether the carcinoma is an early stage, or if the cancer is advanced.