The "Wedge" resection device for electrosurgical transurethral prostatectomy

Area of Science:

• Urology
• Surgical Technology
• Medical Devices

Background:

• Transurethral prostatectomy (TURP) is a common procedure for benign prostatic hyperplasia.
• Standard loop devices can cause bleeding, affecting intraoperative vision.
• A need exists for improved hemostasis and surgical ease in TURP.

Purpose of the Study:

• To evaluate the safety and efficacy of the Wedge device for TURP.
• To compare Wedge TURP with standard loop TURP.
• To assess the impact of the Wedge device on hemostasis, surgical vision, and patient outcomes.

Main Methods:

• The Wedge, a novel electroresection device, was used in a canine model and in 65 human patients.
• Histologic examination assessed tissue coagulation and damage.
• Clinical outcomes included hematocrit drop, serum sodium levels, peak flow rate, AUA Symptom Score, and complications.

Main Results:

• The Wedge device demonstrated simultaneous cutting and coagulation, creating a 2-mm coagulation zone in canine models.
• No significant difference in adjacent tissue damage or capsular temperature rise was observed compared to standard loops.
• In patients, Wedge TURP showed a 101% increase in peak flow rate and a 6.1 AUA Symptom Score one year postoperatively, with a 3% rate of urethral strictures.

Conclusions:

• Wedge TURP is as safe and effective as standard loop TURP.
• The Wedge device significantly improves intraoperative hemostasis and surgical field clarity.
• This device offers potential for minimizing patient morbidity and increasing surgical ease during TURP.