Precision Surgery and Surgical Spectroscopy

Surgical practice is largely based on 20th century principles, and little, if any, biological data is provided to the clinician either preoperatively or intraoperatively to assist in decision making. Therefore novel technologies are urgently required to deliver the vision of personalized health care in surgery. Metabolic phenotyping has distinct advantages over other “-omics” based technologies in surgery, as the analysis of thousands of metabolites is possible in near real time, and it is able to provide critical data on tissue phenotypes and on the functional biochemistry of surgical pathology during surgery. The inference is that surgeons, pathologists, oncologists, and physicians will be able to augment current clinical strategies with chemical analysis at the patient bedside or in the operating theater. This chapter explores emerging technologies in this field and provides practical applications of their use in several areas of surgery and perioperative care. Particular attention is paid to oncology and the application of ambient mass spectrometry technologies in this field.