EN BLOC ENUCLEATION OF PRIMARY NON MUSCLE-INVASIVE BLADDER CANCER (NIMBC) WITH A NEW OPTIMIZED THULIUM LASER

Abstract

Endoscopic en bloc tumour enucleation with laser is becoming a new modality treatment of NMIBC. Aim of this video is to show the effects and the surgical steps of a new optimized laser enucleation of NMIBC using a new Thulium:Yttrium-Aluminum-Garnet double wavelenght laser: the MultiPulse Tm+1470 provided by Jena Surgical.
The video shows how the neoplasm can be easily removed en-bloc, apart of patients where is necessary to partially divide the specimen into 2 or more fragments for retrieval. Obturator nerve reflection is avoided during laser enucleation. Bladder neoplasms around uretereal orifice can be more precisely treated with Thulium laser. Bladder detrusor can be easily provided in all cases. Hemostasis is excellent due to the diode fiber. Optimized ThuLEBT is a simple method that seems to overcome the "incise and scatter" problem associated with TURBT. Two-micron continuous-double wave thulium laser presents optimal cutting and coagulative properties. Clear and complete tumor bases were easily conserved by laser resection, which may enable pathologists to distinguish the T stages of bladder cancer more easily.