Bipolar vaporization – Advantages of a new technique in bladder cancer endoscopic treatment

Objectives: We aimed to evaluate the surgical efficacy and safety as well as the tumoral staging capabilities of a new technique in large bladder tumors, the bipolar plasma vaporization (BPV). Description of the technique: The main stages of the procedure consisted of tumor biopsy of a tissue specimen including the underlying muscle layer performed with a thin resection loop, followed by plasma vaporization of the tumoral bulk until clearly exposing the muscular layer of the bladder wall. The last steps were represented by the bipolar resection of the center and margins of the tumoral bed and the coagulation of the resection area and its margins. Results: BPV was performed in 80 consecutive patients with bladder tumors larger than 3 cm. The mean tumoral volume was 14.8 ml. The mean operative time was 19.2 minutes, the mean postoperative hemoglobin decrease was 0.2 g/dl and the rate of obturator nerve stimulation was 2.5%. The mean catheterization period was 2.5 days and the mean hospital stay was 3.5 days. Conclusions: BPV seems to represent a promising endoscopic treatment alternative for NMIBC patients, with good efficacy and reduced morbidity in cases of large bladder tumors. The technique provided the advantages of excellent visualization during surgery and remarkable maneuverability.