En bloc transurethral resection of bladder tumor with Olimpus button: a novel tecnique
Abstract
The quality of transurethral resection of bladder tumor is able to determine patients prognosis, main limitation of standard transurethral resection (TUR) of bladder cancer is fragmentation of the specimen, en bloc TURBT overcomes this problem. We describe our “en bloc “ tecnique with button.
Tecnique
The bladder is filled to a medium capacity and the wall is incised using a Bottun loop (with a cutting current), starting from apparently ‘normal’ mucosa surrounding the base and then extending throughout detrusor muscle. The muscular fibres are sectioned cautiously from the periphery to the centre of the lesion base. After the lesion has been detached from the bladder, the tumour is grasped by the loop and taken away from the bladder under direct vision. Each specimen is macroscopically orientated and examined to assess its greatest dimension and the lateral circumferential margins. Staging is done in accordance with TNM classification (2002 International Union Against Cancer/UICC) and grading by the WHO 2004 classification.
Circumferential lateral margins and bottom are resected with a classic loop.
Conclusion
In our preliminary experience en bloc bipolar button TURBT is a feasible and safe tecnique.