Maltese pioneering safer cancer surgery

A team led by a Maltese surgeon is developing a new technique that could revolutionise cancer surgery.

The novel procedure makes tumours ferromagnetic, allowing them to be removed with magnetic instruments without being touched, thereby reducing the chances that cancer cells are shed when the growth is removed.

The team is being led by Malta-born surgeon Alfred Cuschieri, the knighted professor who holds much of the credit for the development of keyhole surgery.

Speaking to The Times from his office in Scotland, Sir Alfred explained that when tumours were forcibly removed - the norm at the moment - they ran the risk of shedding cancer cells due to trauma in the process. Shed cancer cells could spread to other parts of the body, causing it to metastasise elsewhere.

But if a tumour became responsive to magnets, it could be removed with a special instrument without having to be touched, drastically reducing - if not totally eliminating - the risk of shedding cells.

"These new instruments will just hold the tumour at its tip without actually touching it," he said. The tumour could then be dissected using special instruments with the aim of removing it through a keyhole incision.

Tissue can be made ferromagnetic either by injected the growth with a ferro-fluid solution or by having ferromagnetic plastic films stick to it.

Sir Alfred, the director of the Dundee-based Institute of Medical Science and Technology, said he was "fairly confident" about the procedure's success, although there was still a long way to go before the technology was fully developed.

"It usually takes around 10 years for something to be used on patients and I doubt whether this will be an exception. You have to be sure not only that technology does what it is supposed to do but also that it does not harm the patient. And you cannot achieve that in a short time," he said.

Research into the technique has been under way for the past three years and the institute, which forms part of the Dundee and St Andrew's universities, has just secured a £1.2 million grant from the Engineering and Physical Sciences Research Council to further the research.

Sir Alfred said initial studies have had very positive results and the team would now be focusing on the details. This stage was expected to take around four years, after which clinical trials could kick off.

The eminent surgeon, who studied at the University of Malta, left the island in the 1960s and moved to the UK. He was at the forefront of research into minimally invasive surgery despite initial opposition, even from his superiors, who felt keyhole surgery should be left for gynaecologists while surgeons performed big cuts and got inside the body.

But after years of research, the first minimally invasive surgery was carried out in Britain in May 1987 and helped change the face of surgical medicine. Today some 60 per cent of surgeries in the UK are carried out through a minimal access approach.

Sir Alfred was knighted in 1987 for his services to surgery.