From Which Medical Device

This is a new non thermal tumour ablation technique that works by applying a short burst of high voltage DC current across the tumour. This causes irreversible disruption of the cell membrane and consequently cell death. The NanoKnife system consists of a generator and electrical probes which are 19g in diameter. Energy (3000V) is delivered by a single bipolar probe or 2 or more monopolar probes. The voltage is adjusted for the distance between the probes and treatment time is approximately 2 minutes for one ablation.

The technique appears to give a sharp demarcation zone on microscopy and has the major benefit of leaving other structures such as bronchi, vessels and ducts intact. There is the absence of the ‘heat sink’ effect seen with thermal ablation techniques such as RF and cryo abalation. The ablation zones appear to be large and tissues heal after treatment.

814 cases have been reported to date, the majority being liver, then pancreas. Other treated tissues include prostate, kidney and lung. The equipment is currently very expensive but has the potential to provide treatment options for patients who are unsuitable for resection or other ablation techniques.

Further large scale trials are awaited.

Lencioni R. Loco-regional treatment of hepatocellular carcinoma. Hepatology 2010; 52: 762-773.


Which Medical Device of the Year 2011

Special Commendation: Interventional Radiology

"This device promises to provide tumour kill whilst maintaining the integrity of blood vessels and other structures close to the tumour, allowing ablation in previously untreatable situations." - Dr Phil Haslam, Editor-in-Chief. Read more 




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