En bloc thulium laser resection of bladder tumors: 3-yr single centre experience

Giuseppe Simone1, Devis Collura1, Leonardo D'Urso1, Alessandro Giacobbe1, Rodolfo Rosso1, Emanuele Castelli1, Gian Luca Muto2, Giovanni Muto3
  • 1 Ospedale San Giovanni Bosco (Torino)
  • 2 Università Campus Biomedico (Roma)
  • 3 Ospedale San Giovanni Bosco, Università Campus Biomedico (Torino, Roma)


Introduction & Objective: To describe surgical tips of en bloc bladder tumor resection with thulium laser and to report perioperative and oncologic outcomes of a single-center series.
Materials and Methods: Data about 146 patients who underwent this technique were collected. The video highlights surgical tips of this technique in 4 different clinical scenarios. Perioperative outcomes and 3-yr oncologic outcomes were reported.
Results: Mean operative time was 26.6 minutes, mean hospital stay was 1.6 days. The overall complication rate was 5%. No grade 3 Clavien complication occurred. Obturator reflex was never observed. 3-yr recurrence free survival rate for Ta low grade tumors and papillary urothelial neoplasms of low malignant potential was 78.5%. The 3-yr recurrence free survival rate for T1 high grade tumors with a negative ReTURB was 80%.
Conclusions: Preliminary results suggest that en bloc thulium laser resection of bladder tumors is a safe and oncologically effective technique. Thulium laser allows surgeon to perform resection without obturator reflex and to spare ureteral orifices, making tumors laterally located and those involving the ureteral orifice the best targets for this technique.