Shariat - Figure 16
Disadvantages of current TUR
FIG. 16: The current TURBT technique has multiple disadvantages that we need to address. One is cautery/thermal damage of tissue samples. Also, the pathologist is given a fragmented tumor with some crush artifacts. There may also be difficulties with a lack of spatial orientation caused by the random imbedding of bladder tissue.
Together these present difficulties for accurate pathologic evaluation and result in a high rate of missed detrusor muscle. Also, with the current TURBT technique, we cannot tell whether we have left residual tumor or an incomplete resection microscopically. Further, current resection techniques often result in "breaks" from the principles of cancer surgery while we are resecting, resulting in cutting through the tumor instead of taking it in its completeness.
