EN-BLOC: laser removal of bladder cancer

The Department of Urology at Sechenov University is the only one in the country that performs this high-tech operation

En-bloc laser enucleation is indicated for patients with non-muscle invasive bladder cancer - the muscle layer of the bladder wall is not affected. If the tumor has grown into deep tissues, a radical cystectomy (bladder removal) is performed.

The tumor is removed entirely without abdominal incision, under gentle anesthesia

Unlike transurethral resection of bladder tumor (TURB), when the cancerous formation is cut off in layers by electric loop, en-bloc surgery is cut off the tumor at the base at once. As a result, there is no bleeding, which can make it difficult for the surgeon to review during a TURB that the operation is stopped and hemostatic measures are taken.

The laser gently burns blood vessels and has a good hemostatic effect that on the eve of the operation you cannot cancel the blood thinning drugs for patients who have previously been getting a special therapy for the prevention of heart attack or stroke.

Laser surgery is less likely to recur

Probability of a relapse after transurethral resection of bladder tumor is 16% to 71% depending on the stage of the cancer. The cut-off fragments freely float in the bladder for some time, the mucous membrane can be absorbed, which leads to the new foci formation. The percentage of laser surgery complications has not been calculated yet, however early studies perform the significantly lower risk.

Laser eliminates injury due to obturator internus syndrome

Obturator internus syndrome is an involuntary movement of the leg when the electric loop touches the obturator nerve. Due to an unexpected sudden movement, the instrument can severely damage the bladder wall or lead to rupture. In the latter case, an urgent laparotomy (opening the abdominal cavity for suturing the bladder wall) is necessary.

En-bloc surgery helps to evaluate the tumor process for proper treatment

The decision to preserve or remove the organ is based on a size of the tumor and a depth of germination. MRI, which must be done on the eve of the operation, shows a conditionally accurate image. Real information can be perform with only morphological study. Morphologists study the tissue removed during the operation under a microscope. Therefore, a quality of the pieces is very important. Tumor must be removed with a thin layer of non-malignant tissue to ensure rid the body of tumor cells. The electric loop is too “rough”, so it is difficult for a morphologist to conclude that the tumor has been completely removed. Laser fiber is not thicker than a sewing needle; it separates high quality material easy.

Benefits of en-bloc surgery in compare with transurethral resection of bladder tumor:

• Better quality of morphological study
• Less bleeding and risk of injury during surgery
• Lower chance of recurrence and tumor progression

The surgery is performed with a new thulium laser without harming non-malignant tissues

The laser fiber separates tumor tissue like a knife, it makes delicate due to its size and physical properties. The technology is new, there are units of such operations in the world. Our doctors worked a lot to choose the right regimens and work out a methodology. Today we have this unique technology.

Laser surgery is similar to TURB in technical aspect. An instrument with a diameter of a ballpoint pen is passed through the urethra under gentle spinal anesthesia. We extract the removed tumor with special forceps through the endoscopic instrument. The catheter, which is installed at the end of the operation to remove urine, is removed after one day. Hospital stay is three days.

Cost of en-bloc resection of bladder tumor

We carry out en-bloc surgery for Russian citizens free due to high-tech assistance channel. Our doctors will help you fill out the necessary documents. The cost of en-bloc resection of bladder tumor through paid medical services, including non-Russian citizens, is around 90 thousands rubles.