Rotoresect: new technique for resection of the prostate: experimental phase.
We developed a new resection device-the Rotoresect -with the aim of reducing morbidity during transurethral resection of the prostate (TURP). During rotoresection, a rotating ablator electrode enables simultaneous tissue coagulation by high-frequency current and mechanical tissue ablation. The tissue ablation rate and the extent of bleeding were quantified ex vivo using a blood-perfused porcine kidney (N = 30) and then compared with loop resection and electrovaporization (grooved roller/Rollerball). Additionally, transurethral rotoresection of the prostate and open partial resection of the liver were carried out in five dogs. With the blood-perfused porcine kidney, we demonstrated that the tissue ablation rate increases with increasing of the coagulation current and rotation speed of the ablator electrode. The Rotoresect achieved a tissue ablation rate comparable to that of the resection loop (5.5-6.0 g/min), which was more than twice the rate achieved by electrovaporization (1.7-2.0 g/min). The extent of bleeding during standard loop resection was many times higher (16.5-18.0 g/min) than that induced by rotoresection and electrovaporization (< 2.3 g/min). In our in vivo canine trials, we performed transurethral prostate resection and open segmental liver resection with minimal bleeding. The Rotoresect is a promising instrument for ablation of parenchymal organs during transurethral, laparoscopic, and open surgical procedures.
Michel
M S
MS
Department of Urology, Klinikum Mannheim of the University of Heidelberg, Germany.
Köhrmann
K U
KU
Weber
A
A
Krautschick
A W
AW
Alken
P
P
D000818:Animals; D017115:Catheter Ablation / Q000295:instrumentation / Q000379:methods; D004285:Dogs; D004598:Electrosurgery / Q000295:instrumentation / Q000379:methods; D066298:In Vitro Techniques; D007668:Kidney / Q000601:surgery; D008099:Liver / Q000601:surgery; D008297:Male; D011467:Prostate / Q000601:surgery; D011468:Prostatectomy / Q000379:methods*; D013552:Swine