Bipolar Transurethral Resection in Saline (TURis<sup>®</sup>): Outcome and Complication Rates After the First 1000 Cases

Puppó, P.; Bertolotto, Franco; Introini, Carlo; Germinale, F.; Timossi, Luca; Naselli, Angelo

doi:10.1089/end.2009.0011

Cited by 66 publications

(34 citation statements)

References 15 publications

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“…Other potential complications include perforation of the bladder wall, which may result from aggressive, deep resection or as a result of accidental stimulation of the obturator nerve, triggering a reflex that results in violent adduction of the leg during the resection. A few centers have reported on the utilization of bipolar equipment for resection of BTs [5–8, 10, 11]. The largest series reports on 480 BT and 376 prostate resection or incisions.…”

Section: Discussionmentioning

confidence: 99%

Prospective evaluation of plasma kinetic bipolar resection of bladder cancer: comparison to monopolar resection and pathologic findings

et al. 2014

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Objective To determine whether the Gyrus ACMI plasma kinetic bipolar device (Gyrus ACMI, Southborough, MA) improves pathologic specimen preservation and clinical outcomes compared to standard monopolar electrocautery. Patients and methods In our prospective study, 83 patients underwent monopolar or bipolar transurethral resection of bladder tumors between April 2006 and February 2007 at Memorial Sloan-Kettering Cancer Center. Dedicated genitourinary oncology pathologists blinded to resection type and assessed pathologic features including stage and grade, presence of muscularis propria, fragment size, presence and thickness of thermal artifacts within the specimen, layer of tissue most affected, severity of tissue distortion, and diagnostic impact of thermal artifacts. Clinical outcomes including, perforation, obturator reflex, need for muscle paralysis, a catheter, or admission, were recorded. Clinical and pathologic outcomes between resection modality were compared. Results There were no significant thermal artifacts in 9/38 (23.7 %) and 11/45 (24.4 %) monopolar and bipolar specimens, respectively. The layer of bladder tissue most affected by thermal artifacts was readable in 18/38 (47.4 %) monopolar and 27/45 (60.0 %) bipolar specimens. Tissue distortion from thermal artifacts led to areas within 11/38 (28.9 %) monopolar and 7/45 (15.6 %) bipolar specimens being unreadable. Ultimately, thermal artifacts caused moderate diagnostic difficulty in 2/38 (5.3 %) specimens of the monopolar group and severe diagnostic difficulty in 1/45 (2.2 %) bipolar specimens. Clinically, there was no major difference between resection methods. Conclusion Plasma kinetic bipolar equipment appears to cause less tissue distortion and has the potential to facilitate staging and grading of bladder tumors. No differences in clinical outcomes were appreciated between resection methods. If these results can be repeated in larger studies, the bipolar device represents a small advancement in transurethral resection.

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Section: Discussionmentioning

confidence: 99%

Prospective evaluation of plasma kinetic bipolar resection of bladder cancer: comparison to monopolar resection and pathologic findings

et al. 2014

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“…With the development of bipolar and laser resection techniques， new methods were introduced in the management of TURB as alternatives of conventional mTURB. Different from monopolar electrocautery resecting loop, plasmakinetic bipolar resection is performed with isotonic saline for irrigation instead of the hypotonic glycine, sorbitol or mannitol, which helps to avoid TUR syndrome 22,23 . Furthermore, in mTURB, electrical energy is directed into the tissues, where its electrical resistance creates a temperature higher than 300℃.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, in mTURB, electrical energy is directed into the tissues, where its electrical resistance creates a temperature higher than 300℃. In bipolar systems, however, the radiofrequency energy converts the conductive medium into a plasma field of highly ionized particles disrupting the organic molecular bonds between the tissues at a much lower temperature as 40℃ to 70℃, which may reduce the thermal damage to the surrounding tissues 7,8,15,22,24,25 . Additionally, bTURB is much safer for high-risk patients with bladder tumor, such as those with implanted pacemakers or pregnant women 26 .…”

Section: Discussionmentioning

confidence: 99%

Bipolar Versus Monopolar Transurethral Resection of Nonmuscle-Invasive Bladder Cancer: A Meta-Analysis

Zhao

Tang

Yang

et al. 2016

Journal of Endourology

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“…Recently, the bipolar system used for TURP was introduced for the treatment of bladder cancer. The main advantage of bipolar electrocautery is the ability to resect in saline, which helps to avoid TUR syndrome [10]. Because hypotonic/hypo-osmolar fluid irrigation is necessary when performing monopolar electrocautery, massive fluid absorption can result in TUR syndrome.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Monopolar and Bipolar Transurethral Resection of Non-Muscle Invasive Bladder Cancer

Balcı¹,

Tuncel²,

Keten³

et al. 2017

Urol Int

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Objective: We aimed to compare the safety and efficacy of monopolar and bipolar transurethral resection (TUR) of bladder tumors (TURBTs). Material and Methods: A total of 240 patients who underwent TURBT were prospectively included in the study from May 2011 to May 2014. All patients with suspected bladder tumors were eligible for study inclusion. Those who refused consent and those undergoing routine restaging TURBT were excluded from analysis. Patients were divided on the basis of the monopolar arm and the bipolar arm. Study outcomes included the incidence of bladder perforation and obturator jerk, decrease in hemoglobin and sodium levels, rates of re-coagulation and blood transfusion, TUR syndrome, and operation time. Results: The mean age of the patients was 62 ± 13.7 years. The incidence of obturator jerk and bladder perforation was greater in the bipolar arm. However, with a decrease in the hemoglobin and sodium levels, rates of re-coagulation and blood transfusion were greater in the monopolar arm. Statistical analysis did not show significant differences with regard to study outcomes between the groups. There was no case of TUR syndrome in the 2 arms. The residual tumors' rate was similar between the 2 groups. Conclusions: Our results showed that efficacy and safety of the monopolar and bipolar methods seems to be comparable in patients with bladder tumors.

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Bipolar Transurethral Resection in Saline (TURis^®): Outcome and Complication Rates After the First 1000 Cases

Abstract: TURis offers the patient the same results as monopolar technology guaranteeing maximum safety without increasing the incidence of urethral strictures.

Cited by 66 publications

References 15 publications

Prospective evaluation of plasma kinetic bipolar resection of bladder cancer: comparison to monopolar resection and pathologic findings

Prospective evaluation of plasma kinetic bipolar resection of bladder cancer: comparison to monopolar resection and pathologic findings

Bipolar Versus Monopolar Transurethral Resection of Nonmuscle-Invasive Bladder Cancer: A Meta-Analysis

Comparison of Monopolar and Bipolar Transurethral Resection of Non-Muscle Invasive Bladder Cancer

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Bipolar Transurethral Resection in Saline (TURis®): Outcome and Complication Rates After the First 1000 Cases

Abstract: TURis offers the patient the same results as monopolar technology guaranteeing maximum safety without increasing the incidence of urethral strictures.

Cited by 66 publications

References 15 publications

Prospective evaluation of plasma kinetic bipolar resection of bladder cancer: comparison to monopolar resection and pathologic findings

Prospective evaluation of plasma kinetic bipolar resection of bladder cancer: comparison to monopolar resection and pathologic findings

Bipolar Versus Monopolar Transurethral Resection of Nonmuscle-Invasive Bladder Cancer: A Meta-Analysis

Comparison of Monopolar and Bipolar Transurethral Resection of Non-Muscle Invasive Bladder Cancer

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Bipolar Transurethral Resection in Saline (TURis^®): Outcome and Complication Rates After the First 1000 Cases