Precision laser scalpel
A multidisciplinary team of physical scientists, engineers, laser specialists and clinicians is
investigating a new laser-based solution for minimally invasive cancer surgery.
PreCisE – a precision laser scalpel – uses lasers which deliver energy in a series of ‘ultrashort' pulses only a few picoseconds long. Importantly, because the laser pulses are so short – only one trillionth of a second – there is no time for heat to diffuse into surrounding tissue, which is currently the case with existing surgical tools. Delivering the ultrashort laser pulses through novel hollow core optical fibres, PreCisE facilitates endoscopic approaches which have the potential to open new areas of minimally invasive procedures.
In cancer surgery it is crucial to minimise damage to surrounding healthy tissue to preserve normal function and aid patient recovery, and to ensure that all cancer cells are removed to prevent the cancer reforming. The team have already demonstrated that PreCisE can provide a step change in the precision removal of tumours of the bowel, which could transform endoluminal colorectal cancer surgery.
However, if ultrafast laser ablation is to become a clinically useful technique it also needs to map suspect tissues in three-dimensions. This capability is particularly crucial when it comes to resecting tumours which are close to critical nerves and blood vessels and for neurosurgery. To meet this challenge, the team are leading the development of high-resolution tissue interrogation systems, exploiting techniques such as high-resolution optical coherence tomography, confocal fluorescence imaging and fluorescence lifetime imaging, in order to map out tissue structures in three dimensions with sub-cellular resolution. These systems would then be integrated with the ultrafast laser ablation system.
A combined diagnostic and ablative tool would enable diseased tissue to be detected and removed at the microscopic level, particularly at the margins of a cancer tumour where infiltrative growth can be very difficult to distinguish from normal tissue. Failure to eradicate such microscopic disease is usually the cause of treatment failure and cancer recurrence.
In neurosurgery, a precision tool of this level of accuracy could be transformative, as even a microscopic loss of healthy tissue can result in severe functional consequences that have a huge impact on quality of life. Working with clinicians at the University of Leeds, the team is now looking at how PreCisE could be applied to brain cancers, using its ability to accurately discriminate cancer from normal tissue to greatly enhance the ability of surgeons to completely remove cancers with minimal side-effects for patients.
PreCisE is funded by UKRI-EPSRC. Partners include Coherent Scotland Ltd and Renishaw PLC.
- Total award: £1.2M
- Funder: UKRI-EPSRC
- Lead and co-investigators: Prof. Jonathan Shephard with Prof. Robert Thomson, Prof. Duncan Hand
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