Nanotechnologies in Surgery: The New Paradigm

Abstract

Nanotechnology requires surgeons to rethink their concept of surgery. Rather than “cutting out the bad tissue, and repairing the good tissue” (with ever-increasing precision and minimal tissue disruption), the surgeon using nanotechnologies must think in terms of the cellular (or subcellular) characteristics of tissues and how the surgeon can interact at the cellular/micron/nano level. The nanorealm—from the micron (10⁻⁶ m) to the nanometer (10⁻⁹ m)—lies below the detection of the human eye. Nanoparticles and nanomaterials accomplish surgical goals by interacting with tissues at the cellular or subcellular level. The surgeon must substitute “visual flight rules” and “hands-on surgery” with “instrument flight rules” and “vicarious surgery.” Nanoparticles such as quantum dots, liposomes, and paramagnetic nanoparticles and nanomaterials such as carbon nanotubes, nanoscaffolds, and nanofilms have already shown broad applications in surgery and related disciplines. Paramagnetic nanoparticles and quantum dots can be used to image tumors and enhance MRI scans. Nanoendoscopes can be used to investigate the interior of cells—with quantum dots labeling various intracellular organelles—without injury to the cell. Nanoscaffolds can be used for both hemostasis and improved tissue repair and regeneration. Nanotechniques are enabling point-of-care handheld lab-on-a-chip devices; nanotechniques are essential for tissue-machine and brain-machine interfaces that can restore or replace lost tissues and functions. The era of “surgical nanorobots” utilizing the body’s “metabolic highways”—the vascular system from aorta and vena cava to capillary and venule—to atraumatically operate on any bodily tissue (down to a single errant cell, if need be!) is close at hand.