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Validation of ultrasonic harmonic scalpel for real-time tissue identification using rapid evaporative ionization mass spectrometry

Title: Validation of ultrasonic harmonic scalpel for real-time tissue identification using rapid evaporative ionization mass spectrometry
Authors: Manoli, E
Mason, S
Ford, L
Adebesin, A
Bodai, Z
Darzi, A
Kinross, J
Takats, Z
Item Type: Journal Article
Abstract: In this study, we integrate rapid evaporative ionization mass spectrometry (REIMS) with the Harmonic scalpel, an advanced laparoscopic surgical instrument that utilizes ultrasound energy to dissect and coagulate tissues. It provides unparalleled manipulation capability to surgeons and has superseded traditional electrosurgical tools particularly in abdominal surgery, but is yet to be validated with REIMS. The REIMS platform coupled with the Harmonic device was shown to produce tissue-specific lipid profiles through the analysis of porcine tissues in both negative and positive ionization modes. Comparison with other methods of electrosurgical dissection, such as monopolar electrosurgery and CO2 laser, showed spectral differences in the profile dependent on the energy device used. The Harmonic device demonstrated major spectral differences in the phospholipid region of m/z 600–1000 compared with the monopolar electrosurgical and CO2 laser-generated spectra. Within the Harmonic REIMS spectra, high intensities of diglycerides and triglycerides were observed. In contrast, monopolar electrosurgical and laser spectra demonstrated high abundances of glycerophospholipids. The Harmonic scalpel was able to differentiate between the liver, muscle, colon, and small intestine, demonstrating 100% diagnostic accuracy. The validation of the Harmonic device–mass spectrometry combination will allow the platform to be used safely and robustly for real-time in vivo surgical tissue identification in a variety of clinical applications.
Issue Date: 13-Apr-2021
Date of Acceptance: 16-Mar-2021
URI: http://hdl.handle.net/10044/1/89767
DOI: 10.1021/acs.analchem.1c00270
ISSN: 0003-2700
Publisher: American Chemical Society
Start Page: 5906
End Page: 5916
Journal / Book Title: Analytical Chemistry
Volume: 93
Issue: 14
Copyright Statement: © 2021 American Chemical Society. This work is published under CC BY license.
Sponsor/Funder: National Institute of Health Research
Imperial College Healthcare NHS Trust- BRC Funding
Imperial College Healthcare NHS Trust- BRC Funding
Imperial College Healthcare NHS Trust- BRC Funding
Society of American Gastrointestinal & Endoscopic Surgeons (SAGES)
Society of American Gastrointestinal & Endoscopic Surgeons (SAGES)
Funder's Grant Number: RDB04 79560
RD207
RDB04
n/a
WSSS_P67267
Keywords: Science & Technology
Physical Sciences
Chemistry, Analytical
Chemistry
BIOLOGICAL TISSUES
MONOPOLAR
DIATHERMY
LASER
Science & Technology
Physical Sciences
Chemistry, Analytical
Chemistry
BIOLOGICAL TISSUES
MONOPOLAR
DIATHERMY
LASER
Analytical Chemistry
0301 Analytical Chemistry
0399 Other Chemical Sciences
Publication Status: Published
Online Publication Date: 2021-03-31
Appears in Collections:Department of Metabolism, Digestion and Reproduction
Department of Surgery and Cancer
Institute of Global Health Innovation



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