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The Nanoknife System is a nonthermal and novel minimally-invasive technology for tumor ablation. It is also known as Irreversible Electroporation (IRE). Its rationale goes like as follows: during the procedure, high electric-field and ultrashort pulses are given to destroy lipid bilayer structure of cancer cell membrane and form numerous irreversible nano-sized pores in the cell membrane. Cell membrane permeability will be changed to allow molecules of different sizes free access to cells, which will lead to cell death.
Nanoknife Therapy can be applied to treat tumors in solid organs such as pancreas, liver, lung, kidney and prostate, and is especially suitable for tumors adjacent to pancreas, hepatic hilar region, gallbladder, bile duct and ureters. Nanoknife Therapy has been approved by America FDA and European Union for clinical application respectively in April and December 2012. In June, 2015, it has been approved by China for clinical application. Guangzhou Fuda Cancer Hospital become the first in Mainland of China to introduce Nanoknife Therapy and successfully completed the first case of Nanoknife treatment on July 1.
Nanoknife system for tumor ablation
Nanoknife Therapy can more precisely induce tumor cell apoptosis, which has made thorough tumor ablation possible. It inflicts no irreversible damage to other important tissues in ablation area, such as vessels, bile duct and nerves; therefore, complications caused by other traditional ablation methods will be reduced.
The Rationale of Nanoknife Therapy
Based on numerous clinical studies, Nanoknife Therapy is a safe and effective technology for tumor treatment. It boasts the following advantages:
1. Short ablation duration
For solid tumors about 3 cm in diameter, it requires just 90x100milisecond ultrashort pulses. One group of treatment takes less than one minute. Even if there are 3 to 4 overlapped ablation areas, the whole ablation duration will be less than 5 minutes.
2. Preserving important tissues such as vessels and nerves in ablated areas
Nanoknife Therapy can protect important tissue structures in ablated areas. Important liver structures, such as hepatic artery, hepatic vein, portal vein and intrahepatic bile ducts can be well protected after being treated with Nanoknife Therapy.
3. No heat island effect
Nanoknife System for tumor ablation uses electrical pulses to breakdown cell membrane. The procedure will neither generate energy nor be influenced by external temperature. While during traditional thermal ablation or cryoablation, energy will be taken away by blood flow if there are big vessels in ablated areas, which will lead to incomplete ablation in surrounding area.
4. Thorough ablation with clear dividing line
IRE will perform thorough ablation to tumor whether it’s close to vessels or irregular and big in size. Moreover, there is a clear dividing line between ablated area and non-ablated area that is only about 1 to 2 cell units in thickness. Therefore, more precise judgment and evaluation can be made for the follow-up, effectiveness and treatment performance of Nanoknife Therapy.
5. Ablated area will remain functional
Nanoknife will cause irreversible damages to tumor cells and induce cell apoptosis. Cell apoptosis is able to stimulate immunity to promote cell death. Human body will identify cell apoptosis as normal cell death and then clean apoptotic tissue through cytophagy so as to promote the regeneration and repair of normal tissue.
No heat island effect with good postoperative recovery
6. Real time monitoring during treatment
Nanoknife Therapy can be navigated and monitored by ultrasound, CT or MR. There is only few millimeters of difference in size between ablated areas monitored by ultrasound or CT and that measured in pathological analysis. The imaging can also clearly display unablated residual cancer cells, to which doctors can perform ablation again. Moreover, real time monitoring allows doctors to observe the changes in the surrounding tissues of ablated area and predict the possibility of complications so as to guarantee patient’s safety and quick postoperative recovery.
7. Nanoknife Therapy can be applied to more complicated conditions
Traditional ablation cannot be adopted when tumor is close to such areas as big vessels, bile duct, pancreatic duct and hepatic portal vein. Ablation would also cause nerve damage that will lead to paralysis and loss of sexual ability if cancer happens to prostate or close to spine. As Nanoknife Therapy inflicts no damage to canals and nerves and delivers secure and effective treatment for the above-mentioned cases, it plays an irreplaceable role for these patients.
Nanoknife Therapy can be applied to cases that other types of ablations can’t manage.