Portal de Periódicos da CAPES

A Novel Resectoscope for Transurethral Resection of Bladder Tumors and the Prostate

2007; Lippincott Williams & Wilkins; Volume: 178; Issue: 6 Linguagem: Inglês

10.1016/j.juro.2007.08.042

1527-3792

Allan J. Pantuck, Jack Baniel, Ziya Kırkalı, Tobias Klatte, Nazy Zomorodian, Ofer Yossepowitch, Arie S. Belldegrun,

Urological Disorders and Treatments

No AccessJournal of UrologyAdult urology1 Dec 2007A Novel Resectoscope for Transurethral Resection of Bladder Tumors and the Prostate Allan J. Pantuck, Jack Baniel, Ziya Kirkali, Tobias Klatte, Nazy Zomorodian, Ofer Yossepowitch, and Arie S. Belldegrun Allan J. PantuckAllan J. Pantuck David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California , Jack BanielJack Baniel Tel Aviv University, Tel Aviv, Israel , Ziya KirkaliZiya Kirkali Dokuz Eylul University School of Medicine, Izmir, Turkey , Tobias KlatteTobias Klatte David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California , Nazy ZomorodianNazy Zomorodian David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California , Ofer YossepowitchOfer Yossepowitch Tel Aviv University, Tel Aviv, Israel , and Arie S. BelldegrunArie S. Belldegrun David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California View All Author Informationhttps://doi.org/10.1016/j.juro.2007.08.042AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Transurethral bladder tumor resection is associated with imperfect clinical staging and incomplete tumor removal. Transurethral prostate resection may be complicated by inadvertent damage to the urinary sphincter, bladder neck and trigone. We performed a multicenter pilot and feasibility study of a novel working element for resectoscopes designed to improve the efficacy and safety of transurethral endoscopic surgery. Materials and Methods: An innovative working element for resectoscopes was developed to convert the standard in/out linear/axial movement at the handgrip into a side-to-side, bidirectional, lateral rotating motion. The device is compatible with current optical technology and conventional electrocautery generators, and it has been granted marketing approval. It consists of variably sized cutting loops designed for transurethral resection of bladder tumors and the prostate. To date 80 patients with bladder cancer (38) or benign prostatic hyperplasia (42) have undergone surgery with this instrument at our 3 clinical sites. Results: No safety concerns were evident. When used during transurethral bladder tumor resection, lateral resection at the base of the tumor enabled accurate depth of penetration into the bladder wall, which may decrease the risk of bladder perforation and improve pathological assessment of tumor invasion. During transurethral prostate resection this novel tool facilitated dissection of adenoma adjacent to the verumontanum and prostatovesical junction, which may decrease the risk of sphincteric damage and bladder neck injury. Conclusions: A novel resectoscope is currently under prospective clinical investigation to establish its surgical and pathological efficacy, ease of use and side effect profile. Current data suggest that the learning curve is mild, its use is safe and it provides distinct advantages when used for transurethral resection of bladder tumors and the prostate. References 1 : Cancer statistics, 2007. CA Cancer J Clin2007; 57: 43. Google Scholar 2 : The value of a second transurethral resection in evaluating patients with bladder tumors. J Urol1999; 162: 74. Link, Google Scholar 3 : Technique and complications of transurethral surgery for bladder tumours. BJU Int2004; 94: 492. Google Scholar 4 : Risk factors for clinical benign prostatic hyperplasia in a community-based population of healthy aging men. J Clin Epidemiol2001; 54: 935. Google Scholar 5 : Complications of transurethral resection of the prostate (TURP)—incidence, management, and prevention. Eur Urol2006; 50: 969. Google Scholar 6 : New Iglesias resectoscope with continuous irrigation, simultaneous suction and low intravesical pressure. J Urol1975; 114: 929. Link, Google Scholar 7 : An innovative resectoscope for transurethral resection of bladder tumors and the prostate. J Urol2004; 171: 183. abstract V691. Link, Google Scholar 8 : Early history of endoscopic treatment of bladder tumors from Grunfeld's polypenkneipe to the Stern-McCarthy resectoscope. J Endourol2006; 20: 85. Google Scholar 9 : A new cystoscope for retrograde fulguration. J Urol1931; 26: 491. Abstract, Google Scholar 10 : Prostate operation: Prospects of the patient with prostatic disease in prostatectomy vs. resection. JAMA1931; 2: 1674. Google Scholar 11 : The management of prostatic obstructions by endoscopic revision. N Engl J Med1932; 207: 305. Google Scholar 12 : Transurethral Prostatectomy. Springfield, Illinois: Charles C. Thomas1943. Google Scholar 13 : A history of transurethral prostatectomy. Rev Mex Urol1975; 35: 349. Google Scholar 14 : The influence of the type of current upon the post-operative complications in transurethral surgery. J Urol1933; 30: 537. Abstract, Google Scholar 15 : High power potassium-titanyl-phosphate laser vaporization prostatectomy. J Urol2000; 163: 1730. Link, Google Scholar 16 : Expanding the role of photoselective vaporization of the prostate. Rev Urol2006; 3: S3. Google Scholar 17 : Early complications of endoscopic treatment for superficial bladder tumors. J Urol2000; 164: 1529. Link, Google Scholar 18 : Transurethral resection of 1250 bladder tumours. Int Urol Nephrol1992; 24: 35. Google Scholar 19 : Transurethral bladder tumor resection: intraoperative and postoperative complications in a residency setting. J Urol2005; 174: 2307. Link, Google Scholar © 2007 by American Urological AssociationFiguresReferencesRelatedDetails Volume 178Issue 6December 2007Page: 2331-2336 Advertisement Copyright & Permissions© 2007 by American Urological AssociationKeywordsendoscopyprostatebladder neoplasmsprostatic hyperplasiatransurethral resection of prostateAcknowledgmentsThe novel resectoscope working element was developed at Roei Medical Technologies, Israel.MetricsAuthor Information Allan J. Pantuck David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California More articles by this author Jack Baniel Tel Aviv University, Tel Aviv, Israel More articles by this author Ziya Kirkali Dokuz Eylul University School of Medicine, Izmir, Turkey More articles by this author Tobias Klatte David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California More articles by this author Nazy Zomorodian David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California More articles by this author Ofer Yossepowitch Tel Aviv University, Tel Aviv, Israel Financial interest and/or other relationship with Roei Medical Technologies Ltd. More articles by this author Arie S. Belldegrun David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California More articles by this author Expand All Advertisement PDF downloadLoading ...