Improved Patient Safety Due to Catheter-Based Gas Bubble Removal During TURBT

Background

The innovation process started by witnessing several surgical treatment of bladder cancers at the urology department of the University Clinic Magdeburg. The transurethral resection starts with a Cystoscopy examination. In TURBT surgeons perform the electro resection with the help of a resectoscope, which is inserted into the bladder. The electrode is an electrically activated wire loop that is used to cut the tissues based on the principle of diathermy. An endoscope helps to visualize the bladder cavity. Cutting is possible only with the presence of a liquid medium. Typically, a saline solution is used to fill the bladder before the electro resection. After the cutting and coagulation, the blood contained fluid including the resected tissues is removed through the outflow of the resectoscope.

One of the major problems observed during the treatment is the frequent removal of the resectoscopes working channel to clean the electrode contaminated through attached resected tissues. Through the removal of the working element the bladder is opened causing the atmospheric oxygen to enter into the cavity and at the same time blood contained fluid inside the bladder is released. The pyrolysis (thermolytic decomposition) of human tissue and electrolysis of inter cellular water can produce volatile gases that comprise mainly of hydrogen and other hydrocarbons. These gases create bubbles and becomes toxic when it reacts with oxygen at high temperatures (increases carbonization) during cutting and coagulation of tissues. The required filling of the bladder and repeated cleaning of electrode was time consuming because of the lack of an inbuilt mechanism. All problems were evaluated and analyzed and considered with valuable feedback of the clinicians for the design process.