Lasers used during brain surgery reduce side effects

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Surgeons in London have used lasers to detect and help remove abnormal tissue during an operation to remove a brain tumour.

The non-invasive technique measures the spectral signature of tissue to distinguish between healthy and cancerous material in real time, significantly reducing the risk of side effects caused by the removal of healthy tissue.

Removing a brain tumour can often be challenging for surgeons, as the boundary between healthy brain tissue and the tumour can be hard to observe, even when using an operating microscope. Currently, numerous biopsies must be taken during surgery to guide tumour excision, which sometimes leads to healthy tissue being removed, causing serious side effects such as loss of speech or movement.

During the recent operation which took place at Charing Cross hospital in London, by using a laser surgeons were able detect the subtle differences between cancerous and healthy brain tissue and accurately map the tumour site within a couple of seconds.

The surgeons first used a laser probe to fire beams of near-infrared light onto the exposed brain, which caused the molecules in the cells to vibrate. Fibre optics in the laser probe collected the scattered light, which was then analysed using Raman spectroscopy. Healthy and abnormal tissue could then be determined by looking at their spectral signatures.

The tumour was then removed using another specialist surgical tool, known as iKnife, which sucks in the smoke created by the electric scalpel used during surgery and instantly analyses it, confirming to surgeons that they are cutting away cancerous tissue, leaving only healthy tissue behind.

The iKnife is based on electrosurgery, a technology invented in the 1920s that is commonly used today. Electrosurgical knives use an electrical current to rapidly heat tissue, cutting through it while minimising blood loss. In doing so, they vaporise the tissue, creating smoke that is normally sucked away by extraction systems.

The iKnife consists of an electrosurgical knife connected to a mass spectrometer, which is used to analyse the thousands of metabolites of the biological sample – in this case brain tissues – to reveal whether it is healthy or cancerous.

‘Being able to use both of these innovative technologies during delicate brain surgeries is considerably improving the accuracy of removing brain tumours,’ said Mr Babar Vaqas, neurosurgeon at the Imperial College Healthcare NHS Trust. ‘This means that patients are far less likely to suffer from the side effects of cutting away healthy tissue such as loss of speech.’

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Further information 

iKnife technology