MarginGuide – 3 simple steps to adequate tumor resection

Globally, over 350.000 patients are diagnosed with oral cavity cancer each year. For these patients, the primary treatment is surgery. The surgeon then tries to accomplish a  complete resection of the tumor including a margin of healthy tissue, so-called adequate tumor resection. This gives the best prognosis and it reduces the necessity of post-operative treatment such as radiotherapy. This has a huge impact on the patient’s prognosis and quality of life.  The current problem in oral cavity cancer surgery is that this goal is achieved in  less than 20%.

SurGuide aims to improve adequate tumor resections with the development of MarginGuide. It is an easy-to-use device to intraoperatively assess in 3 simple steps the resection specimen – MarginGuide.

Together with its development partners and the Erasmus-University Medical Center, SurGuide has put a functional prototype of MarginGuide in working. MarginGuide is developed to rapidly assess the resection margins, thereby aiming to minimize the number of inadequate resection margins and reducing the need for additional treatment. MarginGuide can easily be integrated into the surgico-pathological workflow, and can be used by every trained team member in only 3 simple steps to obtain results.

Step 1 – Tumor resection, activate MarginGuide & set up anatomical orientation

MarginGuide is transported to the operating room and started. The advantage of MarginGuide is that its tumor assessment does not require any contrast agents or additional tissue preparation for its measurement. So during cancer surgery the surgeon tries to remove the tumor as complete as possible but to spare critical structures and as much healthy tissue as well. Directly after tumor resection, the resection specimen is brought to MarginGuide and its anatomical orientation and other critical information from the surgeon are recorded. Now the user is ready to assess the resection margins of the specimen.

cancer surgery

Step 2 – Easy measurement with MarginGuide

The assessment of the specimen takes approx. 10-15 minutes. The user assesses the complete resection specimen by measuring the margin at multiple points. To measure the margin, the user places the measuring arm with a detection needle on the specimen.

The arm is freely movable and is held like a pen, thus ensuring that positioning is easy and that the specimen can be measured from different angles. Once positioned, on the surface of the specimen the user simply indicates the location and the measurement starts. During the measurement the detection needle penetrates the surface of the specimen and records the distance of tumor tissue from the surface, the so-called tumor margin, in millimeters. The result is obtained and presented to the user in just a few seconds.

This process of positioning and measurement can be repeated until the specimen is completely assessed.

Intraoperative assessment

Step 3 – Clear reporting & communication

After the assessment, a report is generated that summarizes critical information on the anatomical orientation of the specimen and an overview of all measurements. MarginGuide indicates whether the margin at that point was adequate (green), inadequate (red) or invalid (grey). The user therefore does not require any specific expertise to interpret the measurement data, meaning every member of the surgico-pathological team after a short training will be able to perform the assessment.

The report information provides then feedback to the surgeon whilst the patient is still on the table. On this base next steps such as additional tumor resection to improve the outcome can be undertaken.

Margin report

With these 3 easy steps and a total measurement time between 15 to 20 minutes, SurGuide aims to increase certainty and quality of care in complex cancer surgeries, which often take many hours. It is our ambition to reach a threefold improvement of the percentage of adequate tumor resections compared to the situation today, and thereby contribute to a better prognosis, decreased need for adjuvant treatment and better quality of life for oral cancer patients.

About SurGuide B.V.

Global healthcare systems are under strain and more than ever there is a need for delivering care  first time right’. SurGuide is on a mission to ensure with its first development, the MarginGuide to impact the intraoperative assessment.

With initial funding SurGuide has developed – in close cooperation with scientific partners such as the Erasmus Medical Centre and River D – the MarginGuide. A highly innovative device using an extremely precise optical technology known as Raman spectroscopy to asses tumour margins. SurGuide and her technology platform are not limited to oral cancer and starts exploration for new areas in 2021

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