URO 29-14 07/2014-E

The Revolution in TUR

Bipolar Resectoscope Systems from KARL STORZ
The Revolution in TUR
Bipolar Resectoscope Systems from KARL STORZ

Although technical progress has been made in recent years in the various
non-ablative treatment options, transurethral resection (TUR) remains the
gold standard in the treatment of benign prostate hyperplasia (BPH) and
in the resection of bladder tumors.
Unipolar resection can still be regarded as the standard in TUR, but
bipolar resection has also been developed in recent years.
The new Bipolar Resectoscope System from KARL STORZ sets new
standards in TUR in terms of effectiveness, patient safety, and system
reliability. It thereby revolutionizes the treatment of BPH and bladder
tumors.

Real bipolar system:

Current not returned via the sheath
Maximum efficiency with minimal, controlled current flow:
Minimal tissue penetration, significantly reduced obturator nerve
stimulation
Precise cutting:
Thanks to precise centralization of the required current and free
choice of loop diameter
Excellent initial cut:
Due to automatic HF current regulation
Efficient coagulation:
Reduced carbonization, no damage to surrounding tissue
Improved visual orientation:
Reduced bleeding thanks to optimal coagulation
Additional technique:
Bipolar vaporization
Self-cleaning loops:
Due to plasma formation
Use of saline solution:
Reduced risk of TUR syndrome, reduced time limitations
during surgery
2 3
Physician Opinions on the KARL STORZ Bipolar
Resectoscope System

In bipolar TURB, the sharp cuts prevent tissue retraction. With the hook electrode, bladder tumors can be
easily turned and completely removed together with the bladder wall (better staging).
In Bipolar TURP, even for large prostates, no carbonization was observed. In addition, the resectoscope
does not need to be removed to clean the loop, which saves time.
Bipolar techniques result in better quality tissue samples because they are free of extensive coagulation
or burnt edges, thereby enabling easier and more precise staging of superficial bladder tumors.
In bipolar systems, we observed less bleeding, fewer clots, and, as a result, better viewing conditions.
Conclusion
No learning curve, shorter operating time, less expensive irrigation solutions, reduced medical risk, and
the possibility of treating patients on anticoagulants are only a few of the advantages of using bipolar
TUR in all TUR procedures. Bipolar instruments ideally complement monopolar resectoscopes.
Prof. Pierre Conort, Department of Urology and Renal Transplantation,
Groupe Hospitalier Pitié-Salpêtrière, Paris

Everyone agrees that the initial cut in TURP corresponds to that in monopolar resection, and the loop
remains free of tissue remnants thanks to the arc created by the loop in the bipolar ionized medium
(quasi-plasma). As a result, the resection characteristics of the bipolar system are even better in
some respects. In bladder resection, this is particularly noticeable and important for the histological
preparations. Even the smallest biopsies can be precisely harvested without coagulation of the resected
tissue, which is common in monopolar resection.
In addition to this advantage, all resections are performed in isotonic NaCl solution, thereby eliminating
the risk of TUR syndrome, the risk of complications resulting from unexpected obturator reflex is much
reduced, and patients with pacemakers can be treated without disabling the device. Together, these
advantages render this system the ideal resection system with extensive safety buffer, which is desirable
in the training of residents as well as in daily clinical practice.
Conclusion
While previous experiences with other bipolar resection systems (old bipolar system [KARL STORZ],
TuRis [Olympus], Gryus [ACMI]) did not convince us to change our resection approach, the new
KARL STORZ bipolar system features such impressive intraoperative handling and cutting and
coagulation behavior that bipolar resection has become our standard procedure for specialists
and senior physicians as well as in the training of residents and fellows.
Dr. med Thomas RW Herrmann, Department of Urology and Uro-Oncology,
Medizinische Hochschule Hannover (MHH)
Bipolar Resectoscope System from KARL STORZ – Real Bipolar!

A bipolar resectoscope system consists of two electrodes, isolated from each other, connected
to the same support and close together, so constructed that, when energized, the HF current
flows mainly between these electrodes.

Extremely Safe

Active and return electrode are totally insulated

against all conductive components of the
resectoscope and therefore also primarily
insulated against the urethra.
The current flow through the patient’s tissue is
kept to a minimum.

bipolar

Convenient and Economical

To convert an existing unipolar resectoscope

system to a bipolar system, just exchange the
working element, the respective loop and the
connecting cable. Sheath, telescope and HF
generator can be retained.

HF-Generator AUTOCON® II 400

• Automatic HF current regulation: maximum

efficiency with minimal current
• New resection mode (Saline C-Cut ++ /
Saline Coag ++) for optimal resection in
saline solution
• Many treatment options, e.g., unipolar/bipolar
resection, laparoscopic, and even open
surgery
• Touch screen technology
 6 7

Bipolar Cutting Loops from KARL STORZ

The wide range of loops for the bipolar resectoscopes from KARL STORZ allows individual
instrument configurations tailored to the operative situation as well as to the surgeon’s
personal preferences for best operative results. The KARL STORZ product portfolio includes
loops for the urethra, prostate and bladder. They can be used for cutting, coagulation and for
vaporization.

Fast and Economic Resection

• Excellent initial cut without delay due to

automatic HF current regulation
• Precise cut in all situations, due to selective
choice of different loop diameters - dedicated
cutting loops for the bladder, color-coded
• Accurate and effective coagulation
• Additional ceramic insulation for durability
and steady performance
• Reusable and cost-effective
• Self-cleaning loops due to plasma effect

New Ball Electrode for the Efficient

Vaporization of the Prostate

• Special design of the active electrode allows

an extensive and fast vaporization with
smooth, uniform movements across the
prostate tissue
• Bifunctional for vaporization and coagulation
• Excellent hemostasis
• Cost-effective and time-saving alternative to
Greenlight-Laser vaporization
• Improved vision during vaporization due to
reduced bubble formation

Additional special loop variants, e.g. for resection on the posterior wall of the bladder or for
incision of the bladder neck, ensure no compromises need to be taken when working even
under difficult anatomic conditions.
KARL STORZ Bipolar Resectoscope

27005 BA HOPKINS® II Forward-Oblique Telescope 30°, enlarged view,

diameter 4 mm, length 30 cm, autoclavable, fiber optic light
transmission incorporated,
color code: red
27005 FA HOPKINS® II Telescope 12°, enlarged view, diameter 4 mm,
length 30 cm, autoclavable, fiber optic light transmission
incorporated,
color code: black

Motion by means of a spring

Movable thumb ring
In rest position the electrode is
inside the sheath.

27040 EBH Working Element, bipolar

including:
1 Working Element
2 Cutting Loops, bipolar
2 Coagulation Electrodes, bipolar
1 High Frequency Cord
1 Protection Tube

Motion by means of a finger grip

Movable thumb ring
In rest position, the electrode is
outside the sheath.

27040 DBH Working Element, bipolar

including:
1 Working Element
2 Cutting Loops, bipolar
2 Coagulation Electrodes, bipolar
1 High Frequency Cord
1 Protection Tube
 8 9

27050 SC Resectoscope Sheath, including connecting tubes for in- and outflow, 26 Fr.,
oblique beak, rotating inner sheath with ceramic insulation, quick-release lock,
color code: yellow

27050 SL Resectoscope Sheath, including connecting tubes for in- and outflow, 26 Fr.,
oblique beak, rotating inner tube with ceramic insulation,
color code: yellow

27241 BO Resectoscope Sheath, with central valve, including connecting tubes for in- and outflow,
24 Fr., oblique beak, with Standard Obturator 27040 OC,
color code: yellow

27040 OC Standard Obturator, for 24/26 Fr. Sheaths, 27040 BO, 27241 BO, 27240 BO,
27040 SD/SL, 27050 SL,
color code: yellow
Electrodes
Two-Stem Electrodes with Stabilizers, for Working Elements 27040 DB/EB

For use with 24/26 Fr. resectoscope sheaths

The cutting loops are delivered with a wire diameter of 0.35 mm. Loops with 30 as the last
digit of the order number indicate a wire diameter of 0.30 mm.

27040 GP1

24/26 Fr.
Distal Tip Instrument Description Bladder Prostate
color code: yellow

27040 GP1 Cutting Loop, bipolar • •

Cutting Loop, bipolar,

27040 GD1 • •
small

Cutting Loop, bipolar,

27040 BL1 • •
pointed

Special Bladder Cutting Loops

24/26 Fr.
Distal Tip color code: Instrument Description Bladder Prostate
yellow/orange

Cutting Loop, bipolar,

27040 GP130 • -
diameter 0.30 mm

Cutting Loop, bipolar,

27040 JB1 • -
longitudinal

Cutting Loop, bipolar,

27040 JB130 longitudinal, • -
diameter 0.30 mm

Vaporization Electrodes
24/26 Fr.
Distal Tip Instrument Description Bladder Prostate
color code: yellow

HALF MOON®
27040 NB Vaporization Electrode, • •
bipolar, ball-shaped

280 Protection Tube, for sterilization and storage of electrodes,

loops, curettes and knives
 10 11

AUTOCON® II 400 SCB

High Frequency Surgery Unit

20 5352 02-125 AUTOCON® II 400 SCB, High-End Set, with additional resection
module, power supply 220 – 240 VAC,
50/60 Hz
including:
Mains Cord
SCB Connecting Cable, length 100 cm

20 5352 02U125 AUTOCON® II 400 SCB, High-End Set, with additional resection
module, power supply 100 – 120 VAC,
50/60 Hz
including:
Mains Cord
SCB Connecting Cable, length 100 cm

It is recommended to check the suitability of the product for the intended procedure prior to use.

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KARL STORZ GmbH & Co. KG KARL STORZ Endoscopy-America, Inc.
Mittelstraße 8, 78532 Tuttlingen, Germany 2151 East Grand Avenue
96132013 URO 29-14 07/2014/EW-E

Postbox 230, 78503 Tuttlingen, Germany El Segundo, CA 90245-5017, USA

Phone: +49 (0)7461 708-0 Phone: +1 424 218-8100
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