Bipolar Resection, S(a)line

Resection in saline (NaCl) is mainly used in urology for prostate and bladder resection. The procedure is also used in gynecology for myoma and endometrium resection as an additional alternative to monopolar resection.

The key difference is the use of saline instead of glucose solution. Saline is used as an irrigation medium and conductor, eliminating the need for a neutral electrode to be connected to the patient's body. Therefore, the current does not flow through the patient, but is conducted through the cutting electrode.

Bipolar resection benefits from the generation of plasma to achieve outstanding cutting power.

A short outline of the process is provided below:

  • An electric current heats the saline solution and tissue via a loop
  • A gas bubble is generated as the saline evaporates
  • The current ionizes the gas bubble to generate plasma
  • The plasma ignites and the loop is illuminated bright yellow
  • The tissue evaporates and the loop electrode starts to cut

Indications:

  • TUR-P (Transurethral Resection of the Prostate), BPH (Benign Prostate Hyperplasia)
  • TUR-B (Transurethral Resection of the Bladder), early carcinoma of the bladder, bladder diverticular disease

Advantages:

  • Shallow coagulation
  • Minimal in-depth thermal damage
  • No impairment of histological quality

Working elements

S(a)line Resectoscopes from Richard Wolf are compatible with all resectoscope sheaths from 22 Fr. or 24 Fr. (continuous irrigation resectoscope sheaths). The innovative electrode guide allows the working elements to be used with 4 mm standard telescopes from 0° to 30°.

Electrodes

Richard Wolf supplies electrodes designed to suit the anatomy and for specific therapeutic methods. Special electrodes for bipolar resection of the prostate and bladder tumors are supplied for disposable and reusable application. We recommend electrodes with a wire diameter of 0.3 mm with a high hemostatic effect for use in prostate operations. A cutting wire diameter of 0.25 mm has been designed for use in bladder procedures to guarantee an extremely sharp and smooth cut. The structure of the electrodes ensures that the current flows from the loop to the electrode fork without causing thermal stress to the urethra.

Bipolar Vaporization Electrode “BiVAP”

A special shape of electrode was developed for bipolar vaporization technology. The specific geometry of the electrode surface means that the high-energy plasma can be used in concentrated form for fast, effective, tissue vaporization with minimal loss of blood.

Richard Wolf also offers customers 24 Fr. electrodes. The cutting characteristics of these electrodes combine with plasma formation to permit removal of much more material.

Although the popularity of the laser continues its upward trend, bipolar and monopolar resection continue to be the “Gold Standard” for prostate resection.