Korean J Urol.  2015 Mar;56(3):227-232. 10.4111/kju.2015.56.3.227.

A novel transurethral resection technique for superficial flat bladder tumor: Grasp and bite technique

• Oh KJ
• Choi YD
• Chung HS
• Hwang EC
• Jung SI
• Kwon DD
• Park K
• Kang TW

• KMID: 2133291
• DOI: http://doi.org/10.4111/kju.2015.56.3.227

Abstract

PURPOSE
Transurethral resection of bladder tumor (TURBT) can be a challenging procedure for an inexperienced surgeon. We suggest an easy technique for TURBT, which we have named the "grasp and bite" technique. We describe this technique and compare its effectiveness and safety with that of conventional TURBT.
MATERIALS AND METHODS
Monopolar TURBT (24-Fr Karl Storz) was performed in 35 patients who had superficial bladder tumors. After defining the tumor margin, the tumor and surrounding mucosa were grasped by use of a loop electrode and resectoscope sheath. With tight grasping, linear moving resection was performed. The patients' demographic, intraoperative, and postoperative data were analyzed between the conventional and grasp and bite TURBT groups.
RESULTS
Of 35 patients, 16 patients underwent conventional TURBT (group 1), and the other 19 patients underwent grasp and bite TURBT (group 2). Both groups were similar in age, tumor multiplicity, size, anesthesia method, and location. Grasp and bite TURBT could be performed as safely and effectively as conventional TURBT. There were no significant differences in irrigation duration, urethral catheterization, postoperative hemoglobin drop, or length of hospital stay. No significant side effects such as bladder perforation, severe obturator reflex, or persistent bleeding occurred. There were no significant pathological differences between specimens according to the type of resection technique.
CONCLUSIONS
The grasp and bite TURBT technique was feasible for superficial bladder tumors. It may be a good tool for inexperienced surgeons owing to its convenient and easy manner.

Keyword

Transurethral resection; Urinary bladder neoplasms; Urologic surgical procedures

MeSH Terms

Aged
Cystoscopy
Electrodes
Female
Humans
Male
Middle Aged
Postoperative Complications
Urinary Bladder/pathology/*surgery
Urinary Bladder Neoplasms/pathology/*surgery
Urologic Surgical Procedures/instrumentation/*methods

Figure

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  Fig. 1 Grasp and bite technique. Define the tumor margin and grasp the tumor with the loop and end portion of the resectoscope sheath. The photos and illustrations demonstrate the technique schematically: (A, a) defining tumor, (B, b) "grasp" step, and (C, c) after "bite" step. Scan this QR code to see the accompanying video, or visit www.kjurology.org or http://youtu.be/2xJDgSpZvY4.

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  Fig. 2 Histologic findings of resected tumors in the grasp and bite group. (A) H&E stain shows papillary urothelial carcinoma containing muscularis mucosae (×100). (B) Muscularis mucosae bundles stained intensely with smoothelin (×40).

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