Irreversible Electroporation (NanoKnife)

Irreversible electroporation (IRE) places needle electrodes around a tumour and delivers brief high-voltage electrical pulses. These pulses create permanent pores in cell membranes, leading to cell death. NanoKnife is a trade name for one IRE system; it is not a surgical knife and it is not nanotechnology.

IRE is a local procedure, not a general treatment for every cancer. Published clinical use has focused on selected difficult-to-treat soft-tissue tumours, including some pancreatic, liver, prostate and kidney settings. Evidence, standard of care and regulatory indications differ by organ and country.

Risks include bleeding, infection, injury to nearby structures, thrombosis, arrhythmia and anaesthesia-related complications. Electrical pulses require cardiac synchronization and specialist safety planning. Risks vary by tumour site.

Specialist review usually considers contrast imaging, pathology, tumour size and location, vessel or duct involvement, previous treatment, heart rhythm, implanted cardiac devices, clotting status and anaesthetic fitness.

IRE may be discussed when a multidisciplinary team believes local ablation is appropriate and thermal ablation or surgery is unsuitable or carries specific concerns. It may be combined with systemic treatment. It is not proven superior for every indication.

This technology does not prevent cancer and is not a screening test. The goal may be local control or palliation, depending on the confirmed disease and care plan.

Why is IRE being considered instead of surgery, radiation or thermal ablation? Is this use standard, guideline-supported or investigational? What outcome is intended? What nearby structures and heart-related risks apply?

• FDA 510(k): NanoKnife System K183385
• NCI Dictionary: Electroporation therapy