NanoKnife – Irreversible Electroporation (IRE)

The NanoKnife system utilizes irreversible electroporation (IRE). This is a novel technology implying a series of rapid electrical pulses. Those pulses trigger opening of cell membranes in cancer. The application of an electric field accross a cell alters the transmembrane potential. Thus, the lipid bilayer structure is disrupted and small nanopores are created in the cell membrane allowing uncontrolled transport of micro- and macromolecules.

These pores become permanent with the high voltage and contribute to cell death by interfering with cell homeostasis. By using the NanoKnife system, our multidisciplinary team insert two or more needle like probes into the cancerous tumor area by image-guided. Then probes rapidly deliver very short electrical pulses that target the tumor. An ideal candidate for IRE treatment should have a tumor located within a specic organ without systemic metastases. In terms of contraindications, it should not be applied to patients with pacemakers or patients who have a history of cardiac arrhythmias.

The great advantage of such a system is the greatly enhanced protection of tissue, particularly nerves, vessels, bile ducts, which was not possible with all previous ablation systems such radiofrequency (RFA) or microwave ablation. Additionally, the Soft Tissue Ablation Registry has been created among the centers that are currently using this technology in the United States, The University of Louisville in Kentucky is the primary investigator for the registry. Our Swiss HPB and Transplantation Center Zurich is collaborating for scientific evaluation of the Nanoknife system in the treatment of liver, bile and pancreatic cancers.

Figure NanoKnife: These three images show around the application of nanoknife technology in lymph node metastases around the aorta, which are aufgund their position difficult to resect completely. The electricity flows between the electrodes in a dumbbell-shaped box.