NanoKnife (Irreversible Electroporation)

NanoKnife is a targeted, minimally invasive treatment that uses electrical energy rather than a scalpel or thermal energy to destroy a tumour. Fine needle-like probes are placed around and into the tumour, and the system delivers rapid pulses of high-voltage current between them. These pulses create permanent micro-pores in the membranes of the cancer cells, which triggers cell death in a precisely shaped zone. Crucially, the supporting structures within and around the tumour, such as the walls of blood vessels and ducts, are far more resistant to this effect, so they can be largely preserved even when the tumour is wrapped around them.

The procedure is carried out under general anaesthesia, with imaging used to guide the probes precisely into position. Once the probes are placed at planned points, the system delivers a series of very short, strong electrical pulses across the tumour. The treated cells are damaged beyond repair and are gradually cleared by the body over the following weeks. Because the effect is electrical rather than thermal, the treatment zone has sharp borders and nearby vessels, ducts and nerves are spared. The probes are then removed; only small puncture sites remain, with no large incision.

NanoKnife is used mainly for tumours that sit in difficult locations close to vital structures, where surgery or heat-based ablation would be too risky. Its best-known use is in locally advanced pancreatic cancer that cannot be removed surgically, where the tumour often surrounds major blood vessels. It is also used for selected tumours in the liver and other soft-tissue sites near critical structures. It is not suitable for every tumour or every patient, and a specialist team decides whether it is appropriate based on the type, size and exact position of the tumour and the patient's overall condition.

The main advantage is the ability to treat tumours in places that are otherwise hard or impossible to reach safely, while protecting the surrounding blood vessels, ducts and nerves. As a minimally invasive technique using only small probe sites, it can mean less impact than open surgery and is often part of a wider treatment plan that may include other therapies. As with any procedure, results and recovery depend on the individual situation, and the care team provides a tailored plan for monitoring, follow-up imaging and further treatment as needed.