Less angled loop allowed the resectoscope tip to sweep up and down, making it possible to sweep in a shallow arc below the tumor. During resection, the custom-designed spatula prevented tumor accumulation in the image area, and the 45° angle provided resecting the wall layers smoother within the resection margins circumferentially in different bladder locations. Using a bipolar current provided a significant advantage, as switching to resection in fragments is attainable whenever necessary during resection without equipment change.Ĭonclusions: Bipolar black runner spatula loop seems to be safe and effective for the ERBTs from our initial experience. Furthermore, the angled loop allowed for the use of en bloc resection in different anatomical regions of the bladder. The loop's 45° angle allowed for circumferential resection of the wall layers, making them smoother with the bladder tumor bed within the resection margins. Thus, tumor base and detrusor fibers could be seen more clearly. The spatula apparatus of the loop prevented the tumor from accumulating on the resectoscope. The detrusor muscle was present in all samples, and T1 substaging and lateral margin assessments were provided in all cases. Mean resection time was 15 minutes (3–30). Results: The patients were 44–77 years with a mean of 62.33. The tumors were circumferentially confined to the normal urothelium, and resection was started at the base of the tumor under narrow band imaging guidance (Olympus Visera Video System).
Methods: Bipolar black runner spatula loop, which was custom designed for transurethral prostate enucleation (Olympus ® WA22558C), was used in this study in addition to standard TUR equipment (Olympus, The TURis bipolar system). In this study, we report our favorable experience using a bipolar black runner spatula loop, which enabled us to perform precise ERBT. This angle may be suitable for the trigon and bladder neck, but depth control is more difficult in posterior and lateral wall tumors.
6, 7 The commonly used resecting loop for bipolar transurethral resection is set at a 90° angle and is designed for prostatic resection. 5 Specifically, due to mass tissue accumulation in large tumors, it is not always possible to perform ERBT. The evidence is scarce in terms of how ERBT can be applied technically in the most practical way, and it seems that ERBT is still not sufficiently generalized in the clinical practice of urologists. 1–4 However, there is still a need to enhance versatile instrumentation for the safe and precise resection of bladder tumors, those shapeless, different-sized, and distorted in challenging locations of the bladder. Introduction: En bloc resection of bladder tumor (ERBT) aims to preserve the basic oncologic principles in bladder cancer resection, improve histopathologic evaluation, and provide high-quality samples.
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