About 166,000 cases of bladder cancer resulting in 59,000 deaths per year are registered in Europe. Transurethral resection (TUR) is an especially patient-friendly, minimally-invasive surgical method in the treatment of bladder tumors. To that end, medical instruments are inserted through the urethra without an external incision. The advantage of the transurethral resection of tumors, diverticula, or foreign bodies from the bladder wall (TURB) over alternative approaches is, that the minimally-invasive procedure promises a quick and complication-free convalescence of the patient.
However, given a certain size, a tumor cannot be removed en-bloc using TURB, instead it is typically "shaved off" by an electrocautery device (resectoscope). This is in disagreement with the established principle of tumor resection to minimize the likelihood of spreading tumor cells during the surgical procedure. Thus, TURB suffers from high recurrence rates. Furthermore, pathological conditions not restricted to the mucosa, but infiltrating the detrusor muscle cannot be optimally treated by TURB, as this would lead to a perforation of the bladder wall. Existing innovative, en-bloc TURB procedures can therefore not be applied here. In this case, the bladder has to be removed and replaced by a neo-bladder, with significant effects on the patient's quality of life.
The goal of this project is to establish the basis for a new surgical procedure, enabling transurethral partial bladder wall resection (TUPBR). With TUPBR, the pathological tissue within the bladder wall is mechanically attached to a transurethrally inserted instrument. This enable the en-bloc resection and extrication of the grasped part of the bladder wall (mucosa and detrusor). The resulting opening in the bladder wall is then seald in a controlled manner.
This novel TUPBR surgery approach enables the patient-friendly TUR treatment for muscle-invasive tumors, which cannot be treated transurethrally today. The strict en-bloc handling promises advantageous recurrence rates. Both aspects have the potential to significantly increase the patient's quality of life.