One of the most significant challenges in cancer surgery is completely removing a tumor without harming surrounding healthy tissue. Current techniques, such as intraoperative tissue sampling, only provide insight into the success of the surgery after the fact. To improve cancer treatment, more accurate diagnostic tools and precise surgical methods that preserve function are needed. This is particularly critical for cancers located near important functional structures, such as the brain or vocal folds in head and neck cancers. Now, an innovative endoscope could make cancer surgery safer by precisely identifying and selectively removing tumor tissue in real time during surgery. By integrating cutting-edge laser and imaging technologies with artificial intelligence (AI), this approach presents new opportunities for improving patients' recovery outcomes.

The endoscope, developed by an interdisciplinary research team that included researchers from the Leibniz Institute of Photonic Technology (Leibniz IPHT, Jena, Germany), is powered by light and AI and precisely detects tumor boundaries – without using of dyes. The technology combines various optical imaging methods in a multimodal imaging approach to analyze both the chemical and structural properties of tissue in real time, enabling precise identification of tumor borders. The system’s AI processes the data swiftly, providing surgeons with actionable information and allowing them to make informed decisions during the procedure.

What sets this technology apart is its dual functionality: it integrates both diagnostic and therapeutic capabilities into a single device. The endoscope features an embedded femtosecond laser that can precisely remove diseased tissue while preserving healthy tissue around it. This method has been successfully tested in preclinical studies using tissue samples from 15 patients. Research results published in Science Advances demonstrate that the technology achieved a 96% accuracy rate in identifying tumor tissue and removed it with an exceptional level of precision. Currently, the technology is in preclinical testing, with the next step being a clinical trial involving a larger group of patients. The researchers aim to make this light-based technique a standard tool in cancer surgery within the next few years. In the long term, this technology could also be adapted for use in other medical fields, such as dermatology and neurosurgery.

“The ‘see and treat’ principle is a significant advancement, as it makes surgery safer and improves patients’ chances of recovery,” said Prof. Dr. Orlando Guntinas-Lichius, co-author of the study. “For us as surgeons, this means that we can remove tumors more effectively while preserving healthy tissue. This could significantly reduce the need for follow-up surgery and reduce the burden on patients.”

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