Manoli Eftychios, Mason Sam, Ford Lauren, Adebesin Afeez, Bodai Zsolt, Darzi Ara, Kinross James, Takats Zoltan
Department of Surgery and Cancer, Imperial College London, St Marys Hospital, London W2 1NY, United Kingdom.
Department of Metabolism, Digestion and Reproduction, Imperial College London, South Kensington Campus, London SW7 2AZ, United Kingdom.
Anal Chem. 2021 Apr 13;93(14):5906-5916. doi: 10.1021/acs.analchem.1c00270. Epub 2021 Mar 31.
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 It provides unparalleled manipulation capability to surgeons and has superseded traditional electrosurgical tools particularly in abdominal surgery, but is yet to be validated with REIMS.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 CO 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 / 600-1000 compared with the monopolar electrosurgical and CO 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 surgical tissue identification in a variety of clinical applications.
在本研究中，我们将快速蒸发电离质谱（REIMS）与谐波手术刀相结合，谐波手术刀是一种先进的腹腔镜手术器械，利用超声能量来切割和凝固组织。它为外科医生提供了无与伦比的操作能力，尤其在腹部手术中已取代了传统的电外科工具，但尚未通过REIMS进行验证。REIMS平台与谐波设备相结合，通过对猪组织在负离子化和正离子化模式下的分析，显示出能产生组织特异性脂质谱。与其他电外科切割方法（如单极电外科和CO2激光）的比较表明，根据所使用的能量设备不同，其光谱在轮廓上存在差异。与单极电外科和CO2激光产生的光谱相比，谐波设备在600-1000的磷脂区域显示出主要的光谱差异。在谐波REIMS光谱中，观察到甘油二酯和甘油三酯的高强度信号。相比之下，单极电外科和激光光谱显示甘油磷脂的丰度较高。谐波手术刀能够区分肝脏、肌肉、结肠和小肠，诊断准确率达100%。谐波设备与质谱联用的验证将使该平台能够安全、可靠地用于各种临床应用中的实时手术组织识别。
