To evaluate the technique and preliminary experiences of thulium laser en bloc resection in the treatment of non-muscle invasive bladder cancer by laser controller.

The data of 57 patients with NMIBC admitted to Shanghai East Hospital from October 2021 to June 2022 were retrospectively analyzed, including 51 males and 6 females. The median tumor diameter was 2 cm (0.4~6 cm), 27 patients had single tumor and 30 patients had multiple tumors. The muscle of the base of the tumor was pushed directly at the muscle fiber level by the laser controller. In case of bleeding or muscle fibers could not be pushed away, the fiber was extended to coagulate or cut off, and the tumor was eventually en-bloc resected.

All 57 operations were successfully completed. There was no conversion to traditional TURBT. The median operation time was 30 min (range: 15 min to 90 min). No obturator nerve reflex and obvious bladder perforation occurred during the operation. In 57 patients with 89 tumor specimens, detrusor muscle could not be detected in 3 specimens, and the proportion of detrusor muscle retrieval was 96.6%(86/89). The pathological diagnosis was affected by cauterization of the resection margin in 1 case specimen, and the pathological evaluation was not affected by cauterization of the remaining 88 specimens.

Bloc resection in the treatment of non-muscle invasive bladder cancer by laser controller is a feasible technique with low complication rate, high safety, high proportion of specimens with detrusor muscle, and low incidence of specimen cauterization, which will affect pathological evaluation.