Surgeons Predict the Future Practice of Nanomedicine

A new review explores how nanotechnology may provide powerful new tools that could have a marked impact on the therapeutic and diagnostic measures available to surgeons.

While at first glance it might appear that nanomedicine is irrelevant to surgery as it is practiced today, surgery as a discipline is not limited to clinical procedures, but dovetails with parallel medical therapeutics. Consequently, the manipulation of macroscopic devices, as surgery as viewed today, can benefit from methodologies that enhance overall perioperative care. An alternative view is that nanomedicine is perhaps destined to put surgeons out of certain kinds of business, much as minimally invasive techniques (including invasive radiology) have progressively infringed on clinical areas that were once the purview of more conventional surgical approaches.

However, as is often the case, the truth is somewhere in the middle, as the review authors demonstrate. Nanodevices travel relatively freely throughout the body and can enter cells, making them useful for drug delivery, or mimic the features of the environment outside cells, making them useful for tissue engineering. Their very properties can change as they become very small, allowing them to be triggered by external energy sources. Incorporation of nanoparticles into other materials can also change the latter's properties, making them stronger, or more flexible. All of these properties can potentially be usefully harnessed by surgical practitioners to move their field forward.

For example, review coauthor Christopher Weldon MD, PhD, of Children's Hospital Boston (CHB; MA, USA), is developing everyday surgical implements enhanced by nanoscale features for improved performance and drug delivery. Coauthor Bozhi Tian, PhD, of Harvard Medical School (Boston, MA, USA) and the Massachusetts Institute of Technology (MIT; Cambridge, USA) is developing an approach for integrating nanoscale digital electronics with engineered tissues, with the goal of combining prosthetic devices and conventional engineered tissues at the cellular level, so that parallel diagnostics and tissue repair can be achieved. The review was published online on February 25, 2011, in the Wiley Interdisciplinary Reviews: Nanomedicine and Nanobiotechnology.

"Surgeons are effective gatekeepers in controlling access of technology to their patients. It is therefore important for surgeons to know what nanotechnology is and is not,” said review author Daniel Kohane, MD, PhD, of CHB, who is developing a wide range of nanotechnology-based drug delivery devices that could be triggered by a patient or physician on demand. "The ability to assess the merits of nano-based approaches is crucial for the protection of the best interests of patients and for the assessment of the cost-effectiveness of new therapies.”

Nanomedicine is the medical application of nanotechnology, and ranges from the use of nanomaterials, to nanoelectronic biosensors, and even possible future applications of molecular nanotechnology. Current problems for nanomedicine involve understanding the issues related to toxicity and environmental impact of nanoscale materials.

Related Links:
Children's Hospital Boston
Harvard Medical School
Massachusetts Institute of Technology