Pantuck AJ et al. (2007) A novel resectoscope for transurethral resection of bladder tumors and the prostate. J Urol 178: 2331–2336

Understaging and incomplete tumor removal are common problems with transurethral resection (TUR) of bladder tumors, and TUR is also associated with complications such as bladder perforation and sphincter damage. Pantuck et al. have evaluated a novel resectoscope, in which the linear movement of the handgrip is converted into a bidirectional lateral rotating motion of the cutting element. Different sizes of cutting loop are available, depending on the procedure to be performed.

The study included 80 patients, 38 with bladder cancer and 42 with benign prostatic hyperplasia. No safety concerns were evident, and the surgeons adapted easily to the new instrument. No bladder perforations were reported, and some surgeons noted reduced bleeding compared with standard TUR. For bladder tumor resection, the lateral movement permitted accurate depth of penetration into the bladder wall. The ability to control resection depth might reduce the risk of perforation and improve assessment of depth of invasion. For prostate resection, dissection of the adenoma adjacent to the verumontanum and prostatovesical junction was facilitated by the new element, possibly reducing the risk of injury to the urinary sphincter and bladder neck.

The authors conclude that the lateral-cutting resectoscope might lead to improved outcomes in TUR procedures, permitting more accurate bladder resection and fewer complications than existing instruments.