[Video-guided TUR].

Abstract

Video-TUR has become a very important new technique in urology, causing far less discomfort than conventional techniques for the surgeon. A mini-chip camera (Olympus OTVS-2) is attached to the lens system of a continuous-flow resectoscope (Olympus). A television monitor (Sony PVM 1442) provides reliable guidance for the cutting loop when resection is necessary for the treatment of benign hypertrophy or carcinoma of the prostate or carcinoma of the bladder. To maintain a good intravesical flow system, which is very important for a clear field of view, a suprapubic cystostomy should be placed. The surgeon sits in a comfortable position with both eyes on the screen so that eye-strain, back pain and mental stress can be reduced. The excellent depth perception is due to a 50-times enlargement by the camera, so that tissue-orientated TUR is possible. Even when it is not possible to place the patient in an optimal position, because of scrotal hernia or coxarthrosis, TUR can still easily be performed. In 120 transurethral prostate resections and 30 transurethral bladder tumour resections, the video technique has proved comfortable for the surgeon and safe for the patient. Video-TUR has been helpful in the presentation of this technique in urologic teaching. TUR of the prostate has been freed from much of its mystique, since the procedure can be watched while it is in progress. The video technique has opened up a new epoch in endourology, whose importance cannot yet be realized.