Abstract
Introduction:
Bipolar and laser (thulium and holmium) enucleation of the prostate are nowadays commonly performed procedures. 1 They represent an optimal minimally invasive alternative to open adenomectomy and transurethral resection of the prostate that is still the therapeutic gold standard according to European Association of Urology guidelines for benign prostatic obstruction. 2 One of the major concerns about enucleation of the prostate is the second critical step of the procedure, morcellation. 3 Morcellation is necessary to extract the prostatic adenoma detached during the procedure and several factors could impact on its performance. First, visibility could be suboptimal because of intraoperative bleeding and it could affect the operatory time and the patient safety. Second, in large prostates the morcellation time is not trivial and it might increase the risk of bladder damages. Third, the type of morcellator that allows the best performance has not been yet recognized. Different types of morcellator are now available on the market with different characteristics. The most commonly used are the Richard Wolf Piranha, with a rotating toothed blade, the Karl Storz DrillCut, 4 with an oscillating toothed blade and the Lumenis Versacut with a nontoothed guillotine blade. The Richard Wolf Piranha and the Karl Storz DrillCut are oscillating morcellator, whereas the Lumenis Versacut is a reciprocating morcellator. These morcellators are different, but none of them is completely disposable.
Materials and Methods:
In this study, we present our early experience of thulium enucleation of prostate with Quanta System Cyber™ 200 W and with morcellation using the Quanta System Cyber Blade™ Morcellator System a whole disposable system. The device is a single-use rotating toothed-blade morcellator. Blade length is 370 ± 5 mm and blade diameter is 4.5 mm. We treated five consecutive patients with this technique.
Results:
No complications occurred during the procedures. However, the morcellator suction channel was blocked by prostatic tissue during two procedures and was subsequently immediately replaced. Finally, the quality of the pathologic specimen was comparable with nondisposable devices.
Conclusion:
The Quanta System Cyber Blade Morcellator System is the first disposable morcellator and appears to have a good safety and operative profile. Moreover, it could improve infection rates and allows to rapidly replace the whole system in case of damages. However, further studies are needed to determine the clinical value of this instrument.
No competing financial interests exist.
Runtime of video: 4 mins
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