The Nanoknife (Irreversible Electroporation - IRE) procedure begins under general anesthesia. The surgical team performs an exploratory laparotomy, involving a midline incision to access and thoroughly examine the abdominal organs. The pancreas and the tumor are exposed and prepared for IRE application. Subsequently, the Interventional Radiology team joins the procedure. Under ultrasonographic guidance, the tumor's boundaries and its relationships with surrounding vessels and ducts are precisely determined. Several specialized needles are then carefully placed into the pancreatic tumor. It is critical that these needles are positioned along the tumor's periphery, maintain a parallel alignment, and are no more than 2 cm apart. After confirming the precise placement of the needles with ultrasound, high-voltage electrical pulses (up to 3000 Volts / 50 Amperes) are delivered to the needles in pairs, effectively destroying tumor cells without causing thermal or mechanical damage. This process, known as apoptosis (programmed cell death), differs from the necrosis induced by other ablation methods. In apoptosis, tumor cells lose viability but their structural integrity is preserved. This preservation of cellular structure is crucial as it prevents permanent damage to adjacent vital tissues such as blood vessels, nerves, and bowel.