Shiozawa Hiroaki, Aizawa Taku, Ito Takaaki, Miki Makoto
Department of Urology, Tokyo Medical University Hachioji Medical Center, Japan.
J Urol. 2002 Dec;168(6):2665-7. doi: 10.1016/S0022-5347(05)64240-1.
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.
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.
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.
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.
我们开发了一种经尿道切除系统，该系统包括一个设计独特的切除镜和高频波发生器。在经尿道切除过程中，由于高频电流通过切除环在生理盐水冲洗下传递到切除镜鞘，闭孔神经不会受到电刺激。在动物模型中对该系统进行了临床前验证，以确保其有效性和操作安全性。
在生理盐水环境下，使用该系统经尿道切除猪膀胱壁。随后将结果与在山梨醇溶液冲洗下使用传统系统进行相同切除的数据进行比较。切除后测量电解质含量，以便与相应的切除前数据进行比较评估。此外，还测量了切除组织中的热变性深度。
与传统系统相比，使用新系统进行膀胱切除不需要额外的技能。除了在切除靠近尿道的部位时有轻微蠕动外，未观察到下肢内收肌收缩。经尿道切除后，血液电解质无明显异常。与传统系统相比，热变性组织的平均深度没有差异。
新开发的经尿道切除系统在生理盐水冲洗环境中有效，在动物模型中应用时可抑制闭孔神经反射。这一发现表明，与传统经尿道切除术相比，该系统作为一种安全且经济高效的替代方案具有广阔的应用前景。
