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Irreversible electroporation (Nanoknife®)

What is Nanoknife?

Nanoknife® is a technique of tumour ablation which uses very high voltage electricity to destroy cancer cells.  The electrical current is passed through electrodes inserted directly into the tumour.  The most important feature of Nanoknife® is that it does not destroy blood vessels and bile ducts.

When is Nanoknife used for pancreatic, liver or bile duct cancer?

Nanoknife can be used when a tumour has not spread (localised) but it cannot be removed with surgery, because of the proximity of vital blood vessels (which if removed would cause injury).

The most common indication in upper GI cancer is pancreatic adenocarcinoma which locally invades other structures, but has not spread to the liver or lining of the abdomen (peritoneum).  The system can also be used for liver or biliary tumours which involve the hilum of the liver.

How is Nanoknife different from other tumour ablations – microwave or radiofrequency (RFA)?

Microwave and radiofrequency ablation use high frequency radio waves to destroy tissue by creating heat (burning tumours).  The Nanoknife® system does not burn the tumour but causes damage to tumour cells due to an electrical shock.

How is Nanoknife performed?

Pancreas and biliary tumours – Nanoknife of pancreatic tumours is performed by an open surgical approach under ultrasound guidance.  A laparoscopy may be performed to exclude spread of cancer cells, followed by an open surgical incision.  An intra-operative high definition ultrasound is performed to precisely locate the tumour.  With the tumour held in the surgeons hand the Nanoknife® probes are placed into the tumour and then electrical pulses are delivered to destroy the tumour.

Liver tumours - Liver tumours may be ablated using the Nano knife system by placing electrodes directly through the skin, into the tumour, under ultrasound or CT guidance.

Is Nanoknife suitable for me?

Nanoknife surgical ablation is still in an experimental phase for HPB tumours. People who may benefit most, are those who have pancreatic or biliary tumours that cannot be removed with surgery, but have not spread. Nanoknife does not replace medical and standard surgical treatment. Patients will often have undergone a course of chemotherapy, or radiotherapy, prior to being considered, to assess the response of a tumour. Nanoknife is also not considered to be a curative procedure, but part of a range of treatments to prolong life.

Where is the Nanoknife® procedure available?

Nanoknife is available to public and private patients at the Prince of Wales Hospitals in Sydney.

Who performs Nanoknife® procedures?

Nanoknife ablations are performed by trained HPB surgeons at the Prince of Wales hospitals. For surgical consultations contact Dr Robert Gandy or Dr Koroush Haghighi.