MP10-03 SUPER TRANSURETHRAL BLADDER TUMOR RESECTION

Abstract

You have accessJournal of UrologySurgical Technology & Simulation: Instrumentation & Technology I (MP10)1 Sep 2021MP10-03 SUPER TRANSURETHRAL BLADDER TUMOR RESECTION Shengkun Sun, Yong Xu, Weijun Fu, Guangfu Chen, and Xu Zhang Shengkun SunShengkun Sun More articles by this author , Yong XuYong Xu More articles by this author , Weijun FuWeijun Fu More articles by this author , Guangfu ChenGuangfu Chen More articles by this author , and Xu ZhangXu Zhang More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001983.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The existing TURBT technology has a history of more than 80 years. The fragmented resection of tumors are inherent defects of traditional TURBT. The objective of this study was to explore a safe and effective method of TURBT. We performed a novel transurethral bladder tumor resection under air cystoscope. Since the depth of resection is limitless under pneumocystoscope, and there is no previous report, we named this novel operation as “Super Transurethral Resection of Bladder Tumor” (STURBT). METHODS: The operation was performed under general or epidural anesthesia. The Super Scope (S-Scope) was inserted through the urethra, and the bladder was filled with carbon dioxide, and the pressure was set as 12 mmHg. The novel S-Scope has a channel to accommodate conventional laparoscopic surgical instruments, such as supersonic scalpel, bipolar scissors, forceps, and suctions. First the normal bladder mucosa 1 cm from the tumor was marked with a supersonic scalpel. Blunt separation and sharp resection were performed from periphery to the central base of the tumor to achieve en bloc resection. The β basket, a bladder tumor retrieving device, was inserted through the channel, and the tumor was removed in whole or by dividing into 2 to 3 parts. The urethral stent was placed, and the bladder was flushed with normal saline. RESULTS: 5 patients underwent STURBT, and 6 tumors were resected with the largest diameter of 3∼5cm. The average resection time was 28±16.4 minutes, and the tumor was retrieved en bloc or sub-en bloc. There was no obturator nerve reflex or bleeding during operation. Pathological diagnosis showed 1 case of pheochromocytoma and 4 cases of high grade urothelial carcinoma with stage T1∼T2a. Bladder muscle layer was visible in all cases. 3 cases of bladder cancer with muscle invasion received adjuvant intravenous chemotherapy. 4 cases with high grade urothelial carcinoma also received intravesical irragation of BCG periodically. Cystoscopy 3 months post-operation showed well healing of the bladder. There was no tumor recurrence during a mean follow-up of 11.8 (3-18) months. CONCLUSIONS: STURBT is a novel surgical method to treat bladder tumor, which has several advantages over traditional TURBT. No fluid irrigation was needed, and no urine extravasation developed. The supersonic scalpel will not stimulate the obturator nerve. The en bloc tumor resection decreased tumor dissemination and an accurate pathological TNM stage could be obtained. S-Scope assisted STURBT could make full use of the current laparoscopic surgical instruments, which had obvious advantages in transurethral treatment of bladder tumors. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e169-e169 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Shengkun Sun More articles by this author Yong Xu More articles by this author Weijun Fu More articles by this author Guangfu Chen More articles by this author Xu Zhang More articles by this author Expand All Advertisement Loading ...