Bipolar resection of the bladder and prostate--initial experience with a newly developed regular sized loop...

Bipolar transurethral resection (TUR) has been introduced in the clinical practice nowadays. Benefits from bipolar TUR are represented by the use of saline irrigation, which avoids hypoosmotic hyperhydration (TUR-Syndrome), as well as by the reduced risk of obturator nerve stimulation. However, the previously introduced smaller bipolar resection loop caused prolonged operating-time. We report our initial experience with a newly developed regular sized loop for a bipolar resectoscope.

Different loop calibers and configurations were tested and compared to a previously introduced bipolar system and conventional resection devices in TUR of benign prostate hyperplasia (BPH) and bladder tumors (TURP and TURBT). The resected tissue was pathologically examined for thermal damage and compared to a control group of monopolar conventionally resected tissue.

The handling of the resectoscope was comparable to that of the conventional ones. Cutting control, cutting speed and coagulation effectiveness were excellent, and no obturator nerve stimulation occurred. The resection area could easily be assessed and tissue examination showed no differences in terms of quality and quantity of thermal damages, since tissue carbonization was reduced. There was no sticking of the resected tissue on the loop.

Regular sized loop bipolar resection is safe and efficient. Coagulation and cutting extent control seem superior to conventional TUR. Due to reduced carbonization, the resection ground can be easily assessed. The risk of obturator nerve stimulation is reduced. The histological quality of the tissue is not impaired. This device combines the advantage of a regular size resection loop with bipolar resection in normal saline. It has the potential to become a valuable alternative to monopolar TUR.