title: Surgical technique for en bloc transurethral resection of bladder tumour with a Hybrid Knife(®).
abstract: BACKGROUND
  Bladder cancer is the second most common malignancy of the urinary tract and the 9th worldwide. Latin American has an incidence of 5.6 per 100,000 inhabitants per year. Seventy-five percent of newly diagnosed cases are nonmuscle invasive bladder cancer, and 25% of cases present as muscle invasive. The mainstay of treatment for nonmuscle invasive bladder cancer is loop transurethral resection. In 2013, the group led by Dr Mundhenk of the University Hospital of Tübingen, Germany, was the first to describe the Hybrid Knife(®) equipment for performing en bloc bladder tumour resection, with favourable functional and oncological results.
  
  
  OBJECTIVE
  To describe the surgical technique of en bloc bladder tumour resection with a Hybrid Knife(®) as an alternative treatment for nonmuscle invasive bladder tumours.
  
  
  METHODS
  A male patient was diagnosed by urotomography and urethrocystoscopy with a bladder tumour measuring 2×1cm on the floor. En bloc transurethral resection of the bladder tumour was performed with a Hybrid Knife(®).
  
  
  RESULTS
  Surgery was performed for 35min, with 70 watts for cutting and 50 watts for coagulation, resecting and evacuating en bloc the bladder tumour, which macroscopically included the muscle layer of the bladder. There were no complications.
  
  
  CONCLUSIONS
  The technique of en bloc bladder tumour resection with Hybrid Knife(®) is an effective alternative to bipolar loop transurethral resection. Resection with a Hybrid Knife(®) is a procedure with little bleeding and good surgical vision and minimises the risk of bladder perforation and tumour implants. The procedure facilitates determining the positivity of the neoplastic process, vascular infiltration and bladder muscle invasion in the histopathology study.
authors.affiliation: Residente de Especialidad en Urología, Escuela Militar de Graduados de Sanidad, México, México D.F., México. Electronic address: oswaldoislas_mc@hotmail.com.
authors.forename: J J O
authors.initials: JJ
authors.lastname: Islas-García
authors.affiliation: Jefe del Servicio de Urología, Hospital Central Militar, México, México D.F., México.
authors.forename: J G
authors.initials: JG
authors.lastname: Campos-Salcedo
authors.affiliation: Adscrito al Área de Medicina Interna, Hospital Central Militar, México, México D.F., México.
authors.forename: B I
authors.initials: BI
authors.lastname: López-Benjume
authors.affiliation: Adscrito al Servicio de Urología, Hospital Central Militar, México, México D.F., México.
authors.forename: J J
authors.initials: JJ
authors.lastname: Torres-Gómez
authors.affiliation: Residente de Especialidad en Urología, Escuela Militar de Graduados de Sanidad, México, México D.F., México.
authors.forename: J
authors.initials: J
authors.lastname: Aguilar-Colmenero
authors.affiliation: Residente de Especialidad en Urología, Escuela Militar de Graduados de Sanidad, México, México D.F., México.
authors.forename: I A
authors.initials: IA
authors.lastname: Martínez-Alonso
authors.affiliation: Residente de Especialidad en Urología, Escuela Militar de Graduados de Sanidad, México, México D.F., México.
authors.forename: S A
authors.initials: SA
authors.lastname: Gil-Villa
mesh_terms: D000369:Aged, 80 and over; D015653:Cystectomy / Q000295:instrumentation* / Q000379:methods*; D004867:Equipment Design; D006801:Humans; D008297:Male; D014521:Urethra; D001749:Urinary Bladder Neoplasms / Q000601:surgery*
keywords: Cuchilla híbrida Hybrid Knife(®); En bloc transurethral resection of bladder tumour; Hybrid Knife(®); Resección transuretral de tumor vesical en bloque