Mayo stand and back table instruments for Cysto biopsy with fulguration (TURBT) surgery setup

Clamping & Occluding

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  Curved Hemostat

Cutting & Dissecting

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  Straight Mayo Scissor

Grasping & Holding

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  Alligator Grasper

Misc

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  Camera Cord

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  Cystoscope 30 Degree

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  Cystoscope Sheath

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  Cystoscopy Bridge

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  Ellick Evacuator

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  Light Cord

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  Obturator

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  Resectoscope

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  Surgical Spoon

Suctioning

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  Suction Irrigator

What to expect during Cysto biopsy with fulguration (TURBT)

A diagnostic or therapeutic procedure during which a small bladder tumor can be biopsied and destroyed.

A biopsy is a procedure in which a doctor takes a tissue sample from the area where cancer may exist. During the biopsy procedure, the doctor also will try to remove the cancerous growth. This is called resecting. The entire bladder tumor biopsy and resection procedure is known as Transurethral Resection of Bladder Tumor (TURBT), or sometimes just transurethral resection (TUR).

Position: Low lithotomy
Anesthesia: Spinal; general
Skin Prep: Pubic area including scrotum & perineum
Draping: Cystoscopy drape & leggings

For this case, we have already done our first scrub of the day. We are then able to use the hand sanitizer on the wall to open-glove & set up our back table, being careful not to touch anything, except with our gloved hands, since we are not gowned just yet.

Surgical Procedure:
1- Instill topical Lidocaine that will numb the urethra.
2- Lubricate the tip of the cystoscope & insert it into the urethra & advance into the bladder. The obturator is removed & a urine specimen may be obtained while the bladder is drained.
3- Irrigation tubing is connected to the cystoscope & the fluid from the bags is allowed to flow into the bladder.
4- Insert ureteral catheter through cystoscope port to view upper urinary tract. Contrast media (50/50 mixture of saline & Isovue in 20mL syringe) is injected & fluoroscopy is used to view the upper urinary tract. *Don’t forget to wear your lead apron!*
5- Removal of tumors etc. may be done at this time… biopsy…
6- Remove scope & insert Foley catheter with a drainage bag.

Setups may vary. Our surgeon changes her mind about things she wants to use all the time. It can be hard to keep up with.