Background and purpose: The application of a water-jet dissector for mucosal elevation was shown to improve resection of lesions of the gastrointestinal tract. We present the first prospective clinical trial on the application of a combined water-jet dissector and needle-knife (HybridKnife) in transurethral dissection (TUD) of urothelial carcinoma of the bladder (UCB).
Patients and methods: Thirty separate urothelial tumors of the bladder in 17 unselected patients were elevated and dissected with the HybridKnife. The goal was to determine the safety, effectiveness of resection, and overall applicability of the HybridKnife.
Results: No perforation or other complication was seen. All tumors could be dissected from the bladder wall en bloc. TUD of UCB by using the HybridKnife is technically feasible and safe in the resection of papillary and solid tumors.
Conclusion: The application of the HybridKnife in TUD of UCB appears to be a feasibly safe and applicable for en-bloc dissection technique potentially following principles of oncologic surgery in transurethral removal of UCB. It seems to facilitate histopathologic assessment. A possibly improved oncologic outcome has to be addressed in further studies.