Tiresias - Real time pathology

"I wish you pathologists could tell us, if a tissue is cancer or not, while the patient is still on the table.” declared William Mayo to MD Wilson in 1905. The quote appeared in JAMA.

My Friends

Will Mayo, with his brother Charlie were surgeons and the founders of the Mayo Clinic.

A long time ago, Tiresias spent several years in Rochester Minnesota, at the Mayo Clinic, and breathed the air and imbued the spirit of the Mayo Bros. Mayo Clinic has been at the forefront of medicine ever since, because Will and Charlie did not accept the things as they were. They looked but looked to the future and did not just make do and demanded that it be better than the present. Will and Charlie Mayo understood the surgeons needed fast reliable diagnostic histopathology and cytology whilst the patient was undergoing surgery. It would then, and only then, be useful to the surgeon, modify the operation appropriate. Histopathology results, after surgery are just too late to be useful to the surgeon. Therefore, in 1905, frozen section biopsy was introduced into cancer surgery.

Tiresias has previously talked about the shortcomings, the technical difficulties, the inaccuracy, and the excessive and unnecessary prolongation of operation time by frozen section biopsy, and the expense of frozen section biopsy. For all its shortcomings however, it has been the standard for intra operative histopathology for the last 115 years. The development of Optiscan confocal laser endomicroscopy is the biggest development in cancer surgery pathology. The development of real-time in vivo continuous histopathology and cytology, with the patient on the operating table changes everything. Will Mayo and Charlie Mayo would be delighted. It is the biggest development in intraoperative cancer histopathology in 115 years. It is the next big thing in the field.