Nanoknife

NanoKnife wata na’ura ce ta zamani da aka ƙera domin kashe ƙwayoyin cutar daji (cancer cells) ta hanyar amfani da makamashin lantarki mai ƙarfi (high-voltage electric pulses), ba tare da buƙatar yin tiyata, ƙonawa, ko sanyi mai tsanani ba. Wannan na’ura tana ɗaya daga cikin sabbin dabaru da ke cikin rukuni na non-thermal tissue ablation, wato hanyoyin lalata ƙwayoyin cuta ba tare da amfani da zafi ba.

A aikace, NanoKnife tana aiki ne bisa tushen binciken kimiyyar da ake kira Irreversible Electroporation (IRE). Wannan hanya ce da masana suka gano cewa idan aka shigar da makamashin lantarki mai tsanani cikin ƙwayar halitta (cell), to bango ko tantanin ƙwayar halittar wanda ake kira cell membrane, zai tsage ko ya samar da ƙananan ramuka (nanopores).

Ana iya samun irin wannan tasiri na ɗan lokaci a wasu hanyoyi na gwaji (reversible electroporation), wanda bayan an cire makamashin lantarkin, ƙwayar za ta dawo da yadda take. Amma a wannan fasaha ta IRE, ƙarfin lantarkin da ake amfani da shi yana da tsanani sosai har yana lalata tsarin tantanin ƙwayar gabaɗaya, ta yadda ba zai iya gyaruwa ba. Da zarar tantanin ƙwayar halittar ya tsage:

• Ruwa da sinadaran da ke cikin jiki suna shiga cikin ƙwayar cutar daji, suna lalata tsarin jikinta.
• Hakan na sa ƙwayar ta mutu a hankali cikin awanni ko kwanaki, ba tare da tasirin ƙonewa ba.

Abin mamaki kuma, ƙwayoyin halitta lafiyayyu da ke kusa da yankin ba za su lalace ba, domin ba a yi amfani da zafi ba kuma lantarkin bai daɗe sosai ba. Saboda haka, NanoKnife tana ba da damar lalata ciwon daji cikin tsari mai tsafta, inganci, kuma mai aminci, musamman a wuraren da tiyata ke da haɗari kamar cutar prostate, hanta, pancreas, da koda.

Wannan fasaha ta Irreversible Electroporation ta ƙunshi haɗin gwiwar ilimin lantarki, injiniyanci, da likitanci, wadda ta buɗe sabon babi a fannin minimally invasive oncology treatment. Wato hanyoyin da ke rage rauni ga marasa lafiya yayin da suke samun ingantaccen magani.

Asalin ƙirƙirar Nanoknife

Tarihin ƙirƙirar NanoKnife ya samo asali ne daga haɗin gwiwar masana a fannoni biyu masu alaƙa sosai, wato injiniyancin lantarki da kimiyyar likitanci.

A farkon shekarun 2000s, wani masani mai suna Dr. Boris Rubinsky, malami a Jami’ar California, Berkeley (University of California, Berkeley), ya fara gudanar da bincike kan yadda karfin makamashin lantarki ke iya tasiri ga ƙwayoyin halitta (cells).

Rubinsky ya gano cewa, idan aka tura pulses na lantarki cikin ƙwayar halitta, tantanin ƙwayar halittar yana buɗewa na ɗan lokaci (reversible electroporation), wanda ake amfani da shi wajen shigar da magunguna ko DNA cikin ƙwayoyi halitta. Amma da ya ci gaba da bincike, sai ya lura cewa idan an ƙara ƙarfin lantarkin fiye da iyaka, ƙwayoyin halittar ba sa murmurewa, wato tantanin ƙwayar halittar ya tsage har abada, kuma ƙwayar halittar tana mutuwa gabaɗaya.

Wannan ne ya zama tushen sabuwar hanyar da ake kira Irreversible Electroporation (IRE), wadda daga baya aka yi amfani da ita wajen kashe ƙwayoyin cutar daji (cancer cells) ba tare da amfani da zafi, sanyi, ko tiyata ba.

Rubinsky da abokan aikinsa sun fara gwaje-gwaje a kan ƙananan dabbobi da tantanin jiki, kuma sakamakon ya nuna cewa IRE na iya lalata ƙwayoyin cutar daji ba tare da taɓa wasu ƙwayoyin halitta lafiyayyu da ke kusa ba, musamman a wuraren da suke da mahimmanci kamar jijiyoyi, tasoshin jini, da gaɓoɓin ciki.

Bayan tabbatar da ingancin wannan fasaha, kamfanin AngioDynamics Inc. wanda ke ƙasar Amurka, ya karɓi haƙƙin ci gaba da ƙirƙira, ya kuma ƙera na’urar farko da ke amfani da wannan tsarin da aka kira NanoKnife System. Manufar kamfanin ita ce samar da wata hanya ta non-thermal ablation, wato lalata ƙwayoyin daji ba tare da amfani da zafi ko sanyi ba, domin rage haɗari ga marasa lafiya.

A cikin shekara ta 2009, hukumar U.S. Food and Drug Administration (FDA) ta amince da NanoKnife don amfani da ita a gwaje-gwajen likitanci. Daga baya kuma, bayan gwaje-gwajen da suka haifar da nasara a kan cututtukan daji na prostate, hanta, da pancreas, FDA ta ƙara amincewa da ita a matsayin na’ura amintacciya da za a iya amfani da ita a wasu asibitoci a Amurka da ƙasashen Turai.

Saboda haka, NanoKnife ba na’ura ba ba ce kawai, wata fasaha ce ta kimiyya da injiniyanci wadda ta samo asali daga nazarin tsarin lantarki na ƙwayoyin halitta. Tana ɗaya daga cikin abubuwan da suka tabbatar da cewa haɗin gwiwar ilimin injiniyanci da likitanci na iya kawo sauyi mai girma a hanyoyin samar da magungunan cututtuka masu haɗari kamar ciwon daji.

Tsarin aiki da Nanoknife

Tsare-tsare aiki da wannan na’ura suna dogara ne da fahimtar tsarin tantanin ƙwayar halitta (cell membrane) wanda ke da alhakin kare ƙwayar halittar daga shiga ko fitar sinadarai a jikinta.

Tantanin ƙwayar halitta yana aiki kamar sanda mai tace ruwa, yana ba da damar wucewar wasu sinadarai kaɗan, amma yana toshe wasu. Idan aka tura pulses na lantarki mai ƙarfi a cikin yankin da ƙwayoyin ke ciki, wannan lantarki yana sa tantanin ƙwayoyin halittar ya buɗe ƙananan ramuka (nanopores).

Idan ƙarfin lantarkin da aka yi amfani da shi ya yi kaɗan, waɗannan ramuka suna rufewa bayan ɗan lokaci, ana kiran wannan da reversible electroporation. Amma idan ƙarfin lantarkin ya kai wani matsayi mai tsanani (yawanci tsakanin 1,500 zuwa 3,000 volts per centimeter), tantanin ƙwayar yana lalacewa gabaɗaya. Wannan shi ake kira irreversible electroporation. A wannan yanayi ne:

• Ƙwayoyin cutar daji suke rasa kuzarin sarrafa sinadarai da ruwa a jikinsu.
• Sinadarai daga wajen ƙwayar cutar suna shiga cikinta, suna rushe tsarin cikin ƙwayar (cytoplasm).
• A ƙarshe, ƙwayar cutar ta mutu a tsarin apoptosis, wato mutuwar ƙwayar cuta ta dabi’a ba tare da fashewa ba.

Abin da ya fi muhimmanci a wannan tsari shi ne cewa ba a amfani da zafi (kamar yadda ake yi a tiyatar ƙonawa da laser ko microwave ablation). Wannan ya sa tantani lafiyayyu da ke kusa da yankin da aka yi aikin ba sa lalacewa. Jijiyoyi, tasoshin jini, da gaɓoɓin kusa da wurin suna ci gaba da aikinsu kamar yadda aka saba.

Manyan sassan Nanoknife

Tsarin NanoKnife na ƙunshe da wasu manyan sassa guda huɗu:

• Generator: Ɓangare ne wanda ke samar da lantarki mai ƙarfi da ke tura makamashi cikin allurai.
• Electrodes (allurai masu tsini): ana soka su cikin yankin ciwon da aka nufa ta ƙarƙashin jagorancin CT scan ko Ultrasound don tabbatar da daidaito.
• Pulse control unit: Yayin da ɓangare wannan ke sarrafa tsawon lokaci, ƙarfi, da adadin makamashin da ake turawa.
• Monitoring system: Sashe ne da ke tabbatar da cewa ana isar da makamashin daidai gwargwado ba tare da lahani ga lafiyayyun sassa ba.

Yayin gudanar da aikin:

• Likitoci suna saka allurai guda biyu zuwa shida, bisa girman yankin da ciwon yake.
• Ana tura makamashin lantarki a lokaci-lokaci cikin millisecond ɗaya zuwa goma.
• Wannan makamashi yana sa tantanin ƙwayoyin cutar daji su tsage, kuma cikin awanni ko kwanaki, jiki da kansa yana rusar da waɗannan ƙwayoyin ta hanyar tsarinsa na garkuwa da rigakafi.
• Wannan tsari yana nuni da cewa NanoKnife na amfani da karfin lantarki a matsayin ‘wukar zamani’, wadda ke yin aikin tiyata ba tare da yanka fata, ƙonewa, ko asarar jini ba.

Yadda ake amfani da NanoKnife

Amfani da na’urar NanoKnife yana buƙatar ƙwarewa ta musamman a fannoni biyu; likitancin tiyata (surgical oncology) da kuma fannin hoto na ciki (medical imaging). Saboda aikin yana dogaro sosai da kwarewar saka allurai da kuma lura da wurin da ciwon ke ciki ta amfani da kayan ɗaukar hoto kamar CT scan ko Ultrasound. Ga cikakken bayani kan yadda ake amfani da NanoKnife:

• Shirya marar lafiya

Kafin fara aikin, ana yi wa marar lafiya binciken jiki da ɗaukar hoton ciki (imaging tests) domin tantance girman ciwon, wurin da yake, da irin tantanin da ke kusa da shi. Wannan mataki yana taimaka wa likitoci su tsara adadin allurai da kuma wurin saka su. Bayan haka, ana ba marar lafiya maganin barci sosai don kada ya motsa yayin aikin.

• Saka allurai a wurin ciwon (electrodes placement)

Likita mai kula da ɗaukar hoto (radiologist) ko likitan tiyata yana amfani da CT scan ko Ultrasound guidance wajen saka allurai masu kaifi guda biyu zuwa shida (ko fiye) a wurin da ciwon ke cikin jiki. Waɗannan allurai su ne ke isar da ƙarfin lantarki mai ƙarfi zuwa yankin ciwon.

• Aika lantarkin (pulsed electric field application)

Bayan an tabbatar da wurin ciwon, likita zai kunna na’urar NanoKnife wadda ke aikawa da makamashin lantarki mai ƙarfin (1,500–3,000 volts) na ɗan lokaci, tsakanin microseconds 70 zuwa 100 a kowace harbawar makamashin lantarki. Wannan lantarki yana haifar da ramuka ƙanana (nanopores) a tantanin ƙwayoyin ciwon daji, wanda ke rushe tsarinsu, har su mutu ba tare da lalata lafiyayyun ƙwayoyin halittar da ke kusa ba.

• Bayan aikin (post-procedure phase)

Bayan kammala aikin, marar lafiya yana zama a asibiti na sa’o’i ko kwana ɗaya domin kulawa. Ba kamar tiyata ta gargajiya ba, babu buƙatar yanke fata, kuma rauni yana warkewa cikin sauri. A cikin kwanaki zuwa makonni, jikin mutum zai fara fitar da ƙwayoyin cutar daji da suka mutu, sannan tantani lafiyayyun su maye gurbinsu a hankali.

Alfanun na’urar NanoKnife

Na’urar NanoKnife ta kawo sauyi mai girma a fannin magance cutar daji saboda fasahar da take amfani da ita tana aiki cikin aminci ba tare da lalata ƙwayoyin halitta lafiyayyu ba. Ga wasu bayanai kan manyan fa’idojinta:

• Ba ta lalata tantani masu lafiya

Babbar fa’idar NanoKnife ita ce ta fi inganci sosai wajen lalata ƙwayoyin cutar daji kawai, ba tare da shafi tantani lafiyayyu da ke kewaye da su ba. Saboda aikin ba ya amfani da zafi ko sanyi, tsarin tantanin lafiyayyu kamar jijiyoyi, hanyoyin jini, da tsoka suna kasancewa cikin aminci. Hakan na da matuƙar muhimmanci musamman a wuraren da ke da haɗarin tiyata, kamar kusa da jijiyoyin hanta ko pancreas.

• Tana aiki da sauri

Tsarin NanoKnife yana ɗaukar ƙanƙanin lokaci idan aka kwatanta da tiyata ta gargajiya. A mafi yawan lokuta, gabaɗaya aikin yana ƙarewa cikin mintuna 30 zuwa 60, gwargwadon girman yankin da ake aikin a kai. Wannan na ba wa likitoci damar yin aiki cikin inganci tare da rage haɗarin jini ko tsawon lokacin maganin barci.

• Ba a buƙatar tiyata

NanoKnife ba ya buƙatar yanke fata ko fitar da ciwon da hannu, saboda haka marar lafiya ba ya fuskantar rauni mai tsanani. Ana saka allurai ne kaɗan cikin jiki ta hanyar ƙananan ramuka, sai na’urar ta riƙa aikawa da lantarki don kashe ƙwayoyin cutar dajin. Saboda haka, babu jini mai yawa, babu buƙatar dinki, kuma jiki yana murmurewa cikin gajeren lokaci.

• Ta dace da wuraren da ke da haɗari

A wasu wurare na jiki kamar hanta, pancreas, prostate, da zuciya, ana samun matsala wajen yin tiyata saboda haɗarin lalacewar ƙwayoyin halitta masu lafiya ko hanyoyin jini. Amma NanoKnife tana iya aiki cikin aminci sosai a irin waɗannan wurare saboda tana lalata ƙwayoyin cutar dajin ne kawai ba tare da lalata sassan jiki lafiyayyu da ke kusa ba. Wannan ya sa likitoci ke amfani da ita wajen magance ciwon daji da ke wurare masu haɗari sosai.

• Ƙarancin illa da saurin murmurewa

Bayan an yi amfani da NanoKnife, marar lafiya baya jin zafi sosai ko samun kumburi mai tsanani. Haka nan, ba a buƙatar zaman asibiti mai tsawo, wasu marasa lafiya ma suna iya komawa gida a kwana guda bayan aiki. Wani lokaci ana iya samun ɗan kumburi ko jin raɗaɗi, amma hakan yana gushewa cikin ‘yan kwanaki.

Ƙalubalen amfani da NanoKnife

Kodayake NanoKnife ta zama ɗaya daga cikin sabbin fasahohin da suka kawo sauyi wajen magance cutar daji, tana da wasu ƙalubale da iyakoki da ke rage yawan amfani da ita a fannoni daban-daban na likitanci. Ga wasu daga ciki:

• Tana da tsada sosai

Ɗaya daga cikin manyan matsalolin NanoKnife shi ne tsadarta da kudin gudanar da aiki da ita. Na’urar kanta tana da tsada sosai, haka ma sauran kayayyakin haɗi kamar electrodes da ake amfani da su sau ɗaya kacal. Saboda haka, asibitoci da dama, musamman a ƙasashe masu ƙarancin tattalin arziki, ba sa iya saye ko kula da wannan na’ura cikin sauƙi. Har ila yau, kuɗin aikin ga marar lafiya ma yana da tsada idan aka kwatanta da sauran hanyoyin magani kamar tiyata ko chemotherapy.

• Tana buƙatar ƙwararrun likitoci masu horo na musamman

NanoKnife tana buƙatar likitocin da suka samu horo na musamman a fasahar Irreversible Electroporation (IRE) da kuma sanin yadda ake amfani da CT scan ko Ultrasound wajen jagorantar aikin. Ba duk asibitoci ke da irin waɗannan ƙwararru ba, saboda haka yawan cibiyoyin da ke iya gudanar da aikin yana da iyaka. Idan ba ƙwararre ne ya yi aikin ba, akwai yiwuwar a samu kuskure wajen saka allura ko tura makamashin lantarkin, wanda hakan zai iya shafar sakamakon aikin.

• Ba dukkan nau’in ciwon daji ba ne take magancewa ba

NanoKnife tana aiki ne a ciwon dajin da ke cikin gaɓoɓin da ba su da yawa sosai kamar hanta, prostate, da pancreas. Ba ta da tasiri sosai a kan manyan cututtuka ko waɗanda suka bazu zuwa wasu sassan jiki. Saboda haka, amfani da ita yana da takamaiman iyaka, kuma ba za ta iya maye gurbin sauran hanyoyin magani gabaɗaya ba.

• Yiwuwar sake bayyanar ciwon bayan lokaci

Kodayake NanoKnife tana kashe ƙwayoyin cutar daji cikin inganci, a wasu lokuta ƙwayoyi kaɗan na iya tsira idan ba a rufe yankin gabaɗaya da makamashin lantarkin ba. Wannan na iya sa ciwon ya sake bayyana bayan wasu watanni ko shekaru. Saboda haka, marasa lafiya suna buƙatar ci gaba da sauran kulawa don tabbatar da cewa babu sabuwar alamar ciwon.

Rashin wadatattun bincike na dogon lokaci

Saboda sabuwar fasaha ce, binciken da aka yi game da tasirinta na dogon lokaci bai wadatar ba. Masana har yanzu suna nazarin yadda NanoKnife ke shafar jiki bayan shekaru da yadda tasirinta yake idan aka haɗa da wasu magunguna. Saboda haka, ana buƙatar ƙarin gwaje-gwaje da sakamakon likitoci daga sassa daban-daban kafin a tabbatar da ingancinta gabaɗaya.

Ƙasashen da ke amfani da NanoKnife

A cikin shekarun baya-bayan nan, fasahar NanoKnife ta samu karɓuwa a sassan duniya da dama saboda ingancinta wajen kashe ƙwayoyin cutar daji ba tare da lalata sauran tantanin jiki ba. Haka kuma, sakamakon bincike da ake ta gudanarwa ya tabbatar da cewa tana daga cikin hanyoyin da ke taimakawa wajen ƙara tsawon rayuwar marasa lafiya da rage wahalar jinya.

A halin yanzu, akwai ƙasashe da dama da suka amince da amfani da NanoKnife a cikin asibitoci na musamman (specialized cancer centers), musamman waɗanda ke da damar samun na’urorin zamani da ƙwararrun likitoci. Waɗannan ƙasashe sun haɗa da:

1. Amurka: Ita ce ƙasar farko da ta amince da amfani da NanoKnife ta hannun hukumar U.S. Food and Drug Administration (FDA). Ana amfani da ita a cibiyoyi kamar Johns Hopkins Hospital da Mayo Clinic don maganin prostate cancer da pancreatic tumors.
2. Birtaniya: Gwamnatin Ingila ta amince da amfani da NanoKnife a wasu manyan asibitocin gwamnati da masu zaman kansu kamar The Royal Marsden Hospital. Ana amfani da ita wajen magance cancer ta prostate da hanta.
3. Jamus: Asibitocin Jamus sun kasance cikin sahun gaba wajen amfani da wannan fasaha, musamman a fannin interventional oncology, don magance ciwon hanta da koda.
4. Kanada: Likitocin Kanada suna amfani da NanoKnife wajen magance kansar hanta da pancreatic, tare da gudanar da bincike kan tasirin fasahar idan aka haɗa da chemotherapy.
5. Japan: Masana a Japan suna amfani da NanoKnife wajen magance ciwon kansar hanta da hanji, musamman ga marasa lafiya da ba su dace da tiyata saboda haɗarin lafiya.
6. China: A cikin shekaru goma da suka gabata, kasar China ta zuba jari sosai wajen shigo da fasahar NanoKnife a manyan cibiyoyin kimiyya da asibitoci na biranen Beijing da Shanghai.

Tasirin NanoKnife ga cigaban likitanci

Fasahar NanoKnife ta taka muhimmiyar rawa wajen haifar da sauyi a fannin likitanci na zamani, musamman a ɓangaren minimally invasive surgery, wato tiyata mai sauƙi wadda ke rage rauni, fitar da jini, da tsawon lokacin jinya. Wannan cigaba ya tabbatar da cewa haɗin gwiwar kimiyyar lantarki, injiniyanci, likitanci, da fasahar zamani na iya haifar da sabbin hanyoyin da ke sauƙaƙa magance cututtuka masu tsanani kamar cancer.

Sabuwar hanyar tiyata mai sauƙi (Minimally Invasive Surgery)

A da can, tiyata ce kawai ke ba da damar cire ciwon cutar daji daga jiki. Wannan hanya tana buƙatar yanke fata, jini mai yawa, da tsawon lokacin murmurewa. Amma NanoKnife ta buɗe sabon babi ta hanyar kawo hanya mai aminci wadda ba ta buƙatar yanke fata, domin ana amfani da ƙananan allurai ne kawai wajen shigar da makamashin lantarki cikin yankin ciwon daji. Sakamakon haka, jiki yana murmurewa cikin sauri, kuma marar lafiya na iya komawa gida cikin kwana ɗaya bayan aikin.

Haɗin kai tsakanin kimiyya da fasaha

Na’urar NanoKnife ta nuna irin tasirin haɗin gwiwa tsakanin fannoni uku: kimiyyar lantarki, injiniyanci, da likitanci. Masu bincike a fannin injiniyanci sun yi amfani da ka’idojin electroporation, likitoci kuma suka daidaita su da buƙatun tsarin jiki da aikin gaɓoɓin, yayin da masana’antun ƙirƙire-ƙirƙiren fasaha suka ƙirƙiri na’urar da za ta iya gudanar da aikin cikin aminci. Wannan haɗin kai ya nuna cewa makomar kiwon lafiya tana da alaka kai tsaye da cigaban fasahar kere-kere.

Ƙirƙirar sabbin hanyoyin magani masu aminci

NanoKnife ta tabbatar da cewa ana iya kashe ƙwayoyin cutar daji ba tare da zafi ko lalacewar tantanin jiki masu lafiya ba. Hakan ya haifar da ƙarfafa bincike wajen ƙirƙirar sabbin na’urori masu amfani da wutar lantarki, haske, ko maganaɗiso wajen lalata ciwon daji da sauran cututtuka. Saboda haka, masana suna ganin wannan fasaha ta buɗe hanya ga sabon salo na “bioelectrical medicine”, wato amfani da sinadaran lantarki wajen magance cututtukan jiki.

Tasiri ga cigaban magungunan kansa

NanoKnife tana taimakawa wajen rage buƙatar chemotherapy da radiotherapy, waɗanda ke da illa mai tsanani ga jiki. Ta haka, marasa lafiya suna samun magani mai sauƙi, mara illa sosai, kuma mai tasiri kai tsaye ga yankin da ciwon ke ciki. Hakan ya jawo hankalin masana a duniya wajen binciken yadda za a haɗa NanoKnife da sauran hanyoyin magani don ƙara tasiri da kariya ga lafiyar marasa lafiya.

Makomar fasahar NanoKnife

Masana da dama na ganin cewa NanoKnife da makamantanta za su zama ginshiƙan manyan hanyoyin magance ciwon daji a nan gaba. Ana fatan cewa da ci gaban bincike, za a rage tsadar na’urar, a sauƙaƙa amfani da ita, kuma a faɗaɗa damar samun ta a ƙasashe masu ƙarancin tattalin arziki. Hakan zai sa fasahar ta zama daga cikin manyan nasarorin likitanci na ƙarni na 21, wadda ta haɗa fasaha da kulawar ɗan Adam domin ceto rayuka da sauƙaƙa jinya.

Manazarta

AngioDynamics. (2024). NanoKnife System: Irreversible electroporation for soft tissue ablation. AngioDynamics, Inc.

FDA. (2023, September 18). FDA clears AngioDynamics NanoKnife System for prostate ablation. U.S. Food and Drug Administration.

Rubinsky, B. (2007). Irreversible electroporation in medicine. Technology in Cancer Research & Treatment, 6(4), 255–260.

Scheffer, H. J., Nielsen, K., van Tilborg, A. A., Vieveen, J. M., Bouwman, R. A., Kazemier, G., … & Meijerink, M. R. (2014). Ablation of locally advanced pancreatic cancer with irreversible electroporation: Safety, feasibility, and clinical outcomes. Annals of Surgery, 260(5), 754–761.

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