Clinical evaluation of a newly developed endoscopic resection device (Rotoresect): physical principle and first clinical results.
BACKGROUND
Endoscopic resection techniques on benign prostatic tissue aim at a high ablation rate and a minimal bleeding rate. Although commercial resection electrodes are effective, they either cause high blood loss (loop electrode) or reduce the bleeding rate with a compromised ablation rate (electrovaporization electrode). To resolve these problems, a new electrosurgical resection device, The Rotoresect, has been developed.


METHODS
The Rotoresect incorporates a specially designed working element. The resection electrode is driven by a micromotor with a high-frequency current that enables simultaneous coagulation and vaporization during rotoresection. To date, 40 patients with benign prostatic hyperplasia have undergone transurethral rotoresection of the prostate with this new device.


RESULTS
The actively rotating resection electrode enables tissue coagulation and vaporization as well as mechanical tissue ablation. Only slight bleeding was observed during the entire resection procedure. Postoperatively, no significant changes in hemoglobin and sodium concentration were detected. The deobstructive effect of the Rotoresect was comparable to that of the standard loop.


CONCLUSIONS
The simultaneous tissue vaporization, coagulation, and mechanical removal by the Rotoresect enables a high ablation rate combined with minimal blood loss. Initial clinical results gained in the transurethral resection of benign prostatic tissue are promising.
Michel
M S
MS
Department of Urology, University Hospital Mannheim, Theodor-Kutzer-Ufer 1-3, D-68135 Mannheim, Germany. maurice-stephan.michel@uro.ma.uni-heidelberg.de
Koehrmann
K U
KU
Knoll
T
T
Hoang-Böhm
J
J
Alken
P
P
D000368:Aged; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods; D020684:Cystoscopes; D004566:Electrodes; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009017:Morbidity; D011183:Postoperative Complications / Q000209:etiology; D011470:Prostatic Hyperplasia / Q000453:epidemiology / Q000601:surgery*; D020728:Transurethral Resection of Prostate / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D014550:Urinary Incontinence, Stress / Q000209:etiology; D014552:Urinary Tract Infections / Q000209:etiology