En-bloc Excision of Papillary Bladder Tumours

URO 42-1 03/2014-E
En-bloc Excision of Papillary Bladder Tumours
with the new KARL STORZ Needle-Electrode
Needle-Electrode for En-Bloc Excision
of Papillary Bladder Tumours
Transurethral resection of bladder tumours using a wire loop
and diathermy is considered the gold standard treatment
for tumour removal but in truth may be seriously flawed.
Recurrence rates following TURBT are astronomically high and
in any other tumour type this level of local occurrence would
be considered unacceptable. The goal of TURBT appears
straightforward: to remove all visible tumor and obtain tissue
for histological diagnosis with minimal morbidity to the patient.
The goal of all urologists should be to be continually driving
down the recurrence rates in their population of patients.
This recurrence, in theory, could be due to unresected residual
tumour either adjacent to or distant from the dominant tumour;
implantation of cells shed during surgery or to tumour cells
arising in visibly apparently normal areas of the bladder due to
a ‘field effect’.
The basic principle of all oncological surgery is to remove the
tumour en-bloc by dissecting through normal tissue to prevent
scatter of malignant cells. The principle is completely ignored
during conventional TURBT when the technique is essentially
one of ‘incise and scatter’, showering tumour cells around the
bladder.
The Sand Wedge Electrode offers the chance to perform
en-bloc excision of some papillary bladder tumours. This, we
think, could lead to a lower risk from seeding but this remains
to be proven. The shape and length of the electrode, and the
availability of loops individually shaped for resecting on the left
and right sides of the bladder, optimises the chance of achieving safe en bloc transurethral excision of bladder tumours.
It‘s not appropriate for all tumours but works well for many,
particularly those on a narrower base.
Use of the Sand Wedge Electrode with meticulous attention to
good quality initial resection, early re-resection where appropriate and technologies such as Photo Dynamic Diagnosis
could lead to improved surgical clearance and higher quality
surgery.
Mr. Tim O’Brien
Consultant Urological Surgeon
Guy’s & St Thomas’ Hospital
London, UK
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Needle-Electrode for En-Bloc Excision of Papillary
Bladder Tumours – Sand Wedge Electrode
This needle-electrode can be used for the treatment of tumors
in the bladder, especially papillary tumors. The geometrical
form of the cutting wire allows thereby to recite the tumor
en-bloc of the bladder wall. The special resection-technique
opens up the possibility to avoid the bursting of tumor cells
and reduce the recurrence rate.
The needle-electrode can be used with the consisting unipolar
working elements 27050 E/D/C and the corresponding resectoscope sheath in conjunction with a 12° or 30° telescope.
Special Features:
• En-bloc excision of papillary tumors leads to a lower
risk of seeding
• The acicular design and the specific wire geometry
assures a maximal variety to treat papillary bladder
tumors
• Exact positioning of the needle-electrode within the
visual field
• Two designs: left and right curved, so that all bladder
walls can be reached
27050 TL
Cutting Loop for Bladder Tumors, left curved, 24/26 Fr.,
colour code: yellow
27050 TR
Cutting Loop for Bladder Tumors, right curved, 24/26 Fr.,
colour code: yellow
Notes
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Notes
Notes
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Notes
It is recommended to check the suitability of the product for the intended procedure prior to use.
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