title: A new transurethral resection system: operating in saline environment precludes obturator nerve reflexes.
abstract: OBJECTIVE
  We developed a transurethral resection system comprising a uniquely designed resectoscope and high frequency wave generator. The obturator nerve is free of electrical stimulation during transurethral resection since high frequency current is delivered via a resection loop to the sheath of the resectoscope in saline irrigation. Preclinical verification of the system was performed in an animal model to ensure its efficacy and operational safety.
  
  
  METHODS
  The swine bladder wall was transurethrally resected using the system in a saline environment. Results were subsequently compared with data on identical resection performed with the conventional system in sorbitol solution irrigation. Electrolyte contents were measured after resection for comparative evaluation with corresponding pre-resection data. Also, the depth of heat degeneration was measured in resected tissue.
  
  
  RESULTS
  No additional skills were required for bladder resection performed with the new system versus the conventional system. No lower limb adductor contraction was noted except minimal creeping during resection of a site close to the urethra. There were no apparent anomalies of blood electrolytes after transurethral resection. No difference was observed in the mean depth of heat degenerated tissues compared with the conventional system.
  
  
  CONCLUSIONS
  The newly developed transurethral resection system was effective in a saline irrigated environment, which inhibited the obturator nerve reflex when applied in an animal model. This finding suggests promising potential for the system as a safe and cost-effective alternative compared with conventional transurethral resection.
authors.affiliation: Department of Urology, Tokyo Medical University Hachioji Medical Center, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shiozawa
authors.forename: Taku
authors.initials: T
authors.lastname: Aizawa
authors.forename: Takaaki
authors.initials: T
authors.lastname: Ito
authors.forename: Makoto
authors.initials: M
authors.lastname: Miki
mesh_terms: D000818:Animals; D004573:Electrolytes / Q000097:blood; D004598:Electrosurgery / Q000295:instrumentation*; D009776:Obturator Nerve / Q000502:physiology*; D012965:Sodium Chloride; D013012:Sorbitol; D013525:Surgical Instruments; D013552:Swine; D007507:Therapeutic Irrigation; D001743:Urinary Bladder / Q000601:surgery*
chemical_list: D004573:Electrolytes; D012965:Sodium Chloride; D013012:Sorbitol