Technique of Using the Instruments
General PLASMA Resection Principles for NMIBC Management
- Incise the bladder wall at the desired depth under direct vision control before developing the plane of dissection.
- Perform prograde dissection using both intermittent activation of cutting mode and blunt dissection.
- In contrast to standard resection take advantage of the three degrees of freedom of your loop.
Standard Retrograde TURBT
1.5° of freedom.Three Degrees of Freedom and Blunt Dissection
Axial
Axial movement should be performed in a prograde direction to allow direct vision of the plane of dissection.It is especially helpful in the dissection of tumors located at the bladder neck, trigone and lateral aspects of the bladder.
Transverse
Mainly used in conjunction with axial movement to develop the plane of dissection after incision.
Coronal
Coronal movements are necessary for initiating the dissection of tumors of the bladder dome by a sharp circular incision.
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