By Dr. Francesco Soria
Transurethral resection of the bladder (TURB) is one of the most common cancer operations and represents the standard initial treatment in case of non-muscle invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC). A well-performed TURB allows the complete removal of cancer tissue in case of NMIBC, a correct assessment of tumour grade and stage as well as of additional information (i.e. the presence of carcinoma in situ, lymphovascular invasion, and histological variants) essential for decision-making regarding additional treatments and follow-up. It has been shown that the quality of the initial TURB is of paramount importance for patients’ prognoses and to reduce the burden of bladder cancer.
In recent years, important improvements have been made in the field of surgical techniques, for instance in the use of enhanced visualization technology, bipolar energy and lasers, and through the introduction of the en-bloc resection technique (EBRT). In particular, EBRT is becoming more and more popular thanks to its ability to remove the tumour in one piece and to ensure a higher rate of detrusor muscle (a well-known marker of the quality of TURB) is present in surgical specimens compared to conventional TURB.
Hereafter, surgical videos of a conventional TURB with photodynamic diagnosis (PDD) and four different EBRTs are presented.
“How I perform standard TURB with PDD” by F. Witjes (NL)
“How I perform en-bloc resection with NBI” by B. Malavaud (FR)
“How I perform en-bloc resection with ImageS” by L. Lusuardi (AT)
“How I perform en-bloc resection with incision electrode” by M. Babjuk (CZ)
“How I perform en-bloc resection with superthulium laser” by A. Breda (ES)
The videos above were presented during the ESU-ESOU Masterclass on Non-Muscle-Invasive Bladder Cancer in February 2021. For future masterclasses, please visit https://esu-masterclasses.uroweb.org/.