V1882: TRANSURETHRAL VAPORIZATION OF BLADDER TUMORS WITH THE ACMI PLASMAKINETIC "BUTTON" ELECTRODE

Video

Introduction and Objectives
Transurethral resection of bladder tumors (TURBT) is widely recognized as the standard of care in the evaluation and treatment of urothelial carcinoma of the bladder. We investigate the use of the ACMI button electrode and provide tips on the use of this new modality in the transurethral treatment of bladder cancer.

Methods
At our institution, patients diagnosed with urothelial carcinoma of the urinary bladder are given the option of transurethral resection of bladder tumor (TURBT) with the standard monopolar loop or to undergo treatment with the bipolar button electrode. The initial two cases performed at our institution were evaluated.

Results
In our initial two cases, the operative times were 23 minutes and 50 minutes. Specimens obtained by cold cup biopsy included muscularis propria which was uninvolved by malignant cells in both cases. Pathologic grade and stage for the first case was low grade Ta and for the second case was low grade T1. There was minimal blood loss in each case. There was simple destruction of satellite lesions in both cases. There was a small bladder perforation in each case due to an obturator reflex.

Conclusions
Bladder tumors can be effectively analyzed and detroyed by transurethral vaporization with the ACMI plasmakinetic button electrode. Care must be taken to avoid perforation due to an obturator reflex. This technique is especially useful in very large tumors and in tumors located within or adjacent to bladder diverticulae.

Funding: none