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Enhancing the Quality of Transurethral Resection: The Importance of a Complete TURB and the En-Bloc Resection

  • Rodolfo Hurle
  • Carmen Maccagnano
Chapter

Abstract

Trans-Urethral Resection of Bladder (TURB) is one of the first endoscopic procedures executed by training residents, but the limits of classical TURB has always to be considered, i.e.: risk of tumor seeding, incomplete resection, thermal damage of specimen’s margin, and, above all, the absence of DM. As a matter of fact, being a senior surgeon, the use of both “Bladder Diagram” and “Bladder Tumour Checklist” may help to overcome these limits, performing a “Good-quality TURB”.

The “En-Bloc Resection of Bladder Tumour” (ERBT) may additionally overcome these limits, representing the best surgical technique to perform a “Good-quality TURB”, also because TURB and ERBT do not differ significantly regarding peri-operative morbidity.

Nevertheless, ERBT requires specific instrumentation and dedicated surgeon. In this context, a specific teaching program, consisted in the presence of a consultant physician during all TURB performed by residents, the institution of a video-TURB archive for revisions, and weekly multidisciplinary discussion meetings between urologists and genito-urinary pathologist may significantly contribute to perform a “Good Quality TURB”.

Keywords

Trans-urethral resection of bladder En-bloc resection Bladder tumour checklist Good quality trans-urethral resection of bladder Detrusor muscle 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of UrologyIstituto Clinico Humanitas IRCCS, Clinical and Research HospitalMilanItaly
  2. 2.Division of Urology, Department of SurgeryASST Lariana, Sant’Anna HospitalComoItaly

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