R.A.S HEMAT, MB;BCh, FRCSI, DUL.

3 factors that are important in today's surgical procedure:

1- the development of the incandescent lamp by Edison in 1879.

2- the development of a high-frequency electrical current, by Hertz in 1888.

3- the concept of a fenestrated tube introduced in 1909.

 

Advantages of Video TURs

-The entire team participate in the procedure, facilitate teaching and patient’s care.

-With clear field and up to 50X magnification on 20" monitor, control of bleeders are easier.

-There is no need to interrupt surgery for teaching purposes.

-Light is provided by a high-intensity 300 W halogen light source with a flexible 4.5 mm diameter fibreoptic cable.

-The ability to document events on tape or hard copy.

-The lesser risk of contamination of the surgeon with blood and urine.

THE PROCEDURE

Large adenoma 30-50 gm is more appropriate for teaching purposes.

The surgeon must view the monitor instead of looking through the resectoscope.

The camera must remain at 12 o'clock position.

The non-dominant hand holds the camera steady.

Stage one, the resection of the bladder neck and the immediately adjacent prostatic adenoma.

Stage two, the resection of the bulk of the adenoma.

Stage three, reestablish the critical landmarks.

The operation should always be systematically undertaken, completing resection and hemostasis in one area of the fossa before moving to the next.

A considerable volume of the prostate gland remains after TURP.

1- The dynamic pressure at tip of the resectoscope.

2- The static pressure in the bladder and prostatic fossa.

TURP is complicated by

1- Overdistension of the prostatic fossa.

2- Overhydration of the tissue.

3- Perforation, dehiscence.

4- Ureteral reflux.

Jan, 2001

Note: The information in this article has been excerpted from the following books: urotext-ebook simplifying urology, Principles of modern urology, by Dr. R.A.S HEMAT. Permission is granted to copy and redistribute this document electronically as long as it is unmodified. This article may not be sold in any medium, including electronic, CD-ROM, or database, or published in print, without the explicit, written permission of Dr. R. A. S. Hemat.

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Dr. R.A.S HEMAT declares no conflicts of interest or financial interests in any product or service mentioned in this article, including grants, employment, stock holdings, gifts, or honoraria.