URO 42-1 03/2014-E En-bloc Excision of Papillary Bladder Tumours with the new KARL STORZ Needle-Electrode Needle-Electrode for En-Bloc Excision of Papillary Bladder Tumours Transurethral resection of bladder tumours using a wire loop and diathermy is considered the gold standard treatment for tumour removal but in truth may be seriously flawed. Recurrence rates following TURBT are astronomically high and in any other tumour type this level of local occurrence would be considered unacceptable. The goal of TURBT appears straightforward: to remove all visible tumor and obtain tissue for histological diagnosis with minimal morbidity to the patient. The goal of all urologists should be to be continually driving down the recurrence rates in their population of patients. This recurrence, in theory, could be due to unresected residual tumour either adjacent to or distant from the dominant tumour; implantation of cells shed during surgery or to tumour cells arising in visibly apparently normal areas of the bladder due to a ‘field effect’. The basic principle of all oncological surgery is to remove the tumour en-bloc by dissecting through normal tissue to prevent scatter of malignant cells. The principle is completely ignored during conventional TURBT when the technique is essentially one of ‘incise and scatter’, showering tumour cells around the bladder. The Sand Wedge Electrode offers the chance to perform en-bloc excision of some papillary bladder tumours. This, we think, could lead to a lower risk from seeding but this remains to be proven. The shape and length of the electrode, and the availability of loops individually shaped for resecting on the left and right sides of the bladder, optimises the chance of achieving safe en bloc transurethral excision of bladder tumours. It‘s not appropriate for all tumours but works well for many, particularly those on a narrower base. Use of the Sand Wedge Electrode with meticulous attention to good quality initial resection, early re-resection where appropriate and technologies such as Photo Dynamic Diagnosis could lead to improved surgical clearance and higher quality surgery. Mr. Tim O’Brien Consultant Urological Surgeon Guy’s & St Thomas’ Hospital London, UK 2 3 Needle-Electrode for En-Bloc Excision of Papillary Bladder Tumours – Sand Wedge Electrode This needle-electrode can be used for the treatment of tumors in the bladder, especially papillary tumors. The geometrical form of the cutting wire allows thereby to recite the tumor en-bloc of the bladder wall. The special resection-technique opens up the possibility to avoid the bursting of tumor cells and reduce the recurrence rate. The needle-electrode can be used with the consisting unipolar working elements 27050 E/D/C and the corresponding resectoscope sheath in conjunction with a 12° or 30° telescope. Special Features: • En-bloc excision of papillary tumors leads to a lower risk of seeding • The acicular design and the specific wire geometry assures a maximal variety to treat papillary bladder tumors • Exact positioning of the needle-electrode within the visual field • Two designs: left and right curved, so that all bladder walls can be reached 27050 TL Cutting Loop for Bladder Tumors, left curved, 24/26 Fr., colour code: yellow 27050 TR Cutting Loop for Bladder Tumors, right curved, 24/26 Fr., colour code: yellow Notes 4 5 Notes Notes 6 7 Notes It is recommended to check the suitability of the product for the intended procedure prior to use. Consent to receive electronic information 96132026 URO 42-1 03/2014/EW-E q Yes, I agree to receive future information by email at the following address: Email Name Department / Practice Street address ZIP, Town Signature I agree to my data being stored at KARL STORZ for this purpose. I can withdraw my consent at any time and without giving reasons by emailing KARL STORZ at [email protected]. KARL STORZ will not make these data available to third parties. KARL STORZ Endoscopy-America, Inc. 2151 East Grand Avenue El Segundo, CA 90245-5017, USA Phone: +1 424 218-8100 Phone toll free: 800 421-0837 (US only) Fax: +1 424 218-8525 Fax toll free: 800 321-1304 (US only) E-Mail: [email protected] 96132026 URO 42-1 03/2014/EW-E KARL STORZ GmbH & Co. KG Mittelstraße 8, 78532 Tuttlingen, Germany Postbox 230, 78503 Tuttlingen, Germany Phone: +49 (0)7461 708-0 Fax: +49 (0)7461 708-105 E-Mail: [email protected] www.karlstorz.com