Irreversible Electroporation (IRE)
The NanoKnife™ System is a localized therapy used for prostate cancer.
What is the NanoKnife System?
How it works
The NanoKnife System uses Irreversible Electroporation or IRE. This is a technology in which electrical pulses are applied to a targeted area of cells. The pulses create small holes in the cells’ membranes.2
After enough pulses are delivered, the cells initiate a process that mimics apaptosis or natural cell death.3 The body responds to the apaptotic-like cell death by initiating the removal of cellular debris.4
Why did my doctor choose the NanoKnife System?
The NanoKnife System is a localized therapy option providing many benefits due to its unique IRE technology. The technology allows the device to be extremely versatile in its use, giving your physician the ability to deliver targeted and effective treatment.5
The NanoKnife System is able to destroy targeted tissue without relying on thermal energy.6 This means the device can be used in areas of the body located near vital structures without causing permanent damage.7 Vital structures can include major blood vessels, nerves and bile ducts.
What to expect during procedure
Step 1
The procedure is performed percutaneously* or open, depending on the preference of your physician. Before the procedure begins, you will be sedated and remain sedated until the procedure is complete.
Step 2
During the procedure, your physician will place the electrodes to bracket the targeted tissue. The number of electrodes used can range from 2 to 6, which is determined by your physician before treatment.
Step 3
Once the electrodes are placed, your physician will initiate a series of electrical pulses. The voltage used and time of the procedure are determined by your physician before treatment.
Step 4
After your physician has delivered a sufficient number of pulses to the targeted area, the procedure is complete, and the electrodes are removed. Post-procedure recovery can be discussed with your physician.
*For a percutaneous procedure, the electrodes are placed throught the skin and the body does not have to be surgically opened.
REFERENCES
[1] National Cancer Institute. Local Therapy. NCI Dictionaries. Accessed April 2021. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/local-therapy
[2] Al-Sakere B, André F, Bernat C, Connault E, Opolon P, Davalos RV, Rubinsky B, Mir LM. Tumor ablation with irreversible electroporation. PLoS One. 2007 Nov 7;2(11):e1135.
doi:10.1371/journal.pone.0001135. PMID: 17989772; PMCID: PMC2065844.
[3] Bower M, Sherwood L, Li Y, Martin R. Irreversible electroporation of the pancreas: definitive local therapy without systemic effects. J Surg Oncol. 2011 Jul 1;104(1):22-8. doi:10.1002/jso.21899. Epub 2011 Feb 28. PMID: 21360714.
[4] Lee EW, Thai S, Kee ST. Irreversible electroporation: a novel image-guided cancer therapy. Gut Liver. 2010 Sep;4 Suppl 1(Suppl 1):S99-S104. doi: 10.5009/gnl.2010.4.S1.S99. Epub 2010 Sep 10. PMID: 21103304; PMCID: PMC2989557.
[5] Scheltema MJ, Chang JI, van den Bos W, Gielchinsky I, Nguyen TV, Reijke TM, Siriwardana AR, Böhm M, de la Rosette JJ, Stricker PD. Impact on genitourinary function and quality of life following focal irreversible electroporation of different prostate segments. Diagn Interv Radiol. 2018 Sep;24(5):268-275. doi: 10.5152/dir.2018.17374. PMID: 30211680; PMCID: PMC6135060.
[6] Maor E. et al., The effect of irreversible electroporation on blood vessels, Technol. Cancer Res. Treat. (2007);6(4):307–312.doi:10.1177/153303460700600407
[7] Li W, Fan Q, Ji Z, Qiu X, Li Z. The effects of irreversible electroporation (IRE) on nerves. PLoS One. 2011 Apr 14;6(4):e18831.doi:10.1371/journal.pone.0018831. PMID:21533143; PMCID: PMC3077412.