The treatment of superficial bladder tumours under local anaesthetic using suction diathermy electrodes.

Daycase cystoscopy under local anaesthetic is commonly used in screening patients with superficial transitional cell carcinoma of the bladder. Treatment of any lesions found, however, often requires a further cystoscopy under general or regional anaesthesia. Recent reports suggest that small lesions can be diathermied without anaesthesia with only mild patient discomfort. Suction diathermy electrodes, introduced for the treatment of small superficial bladder tumours, have significant advantages over conventional methods. Firstly, most of the superficial tumour fronds can be removed painlessly by suction alone. Diathermy, the uncomfortable component of treatment, is sparingly used to treat the tumour base. Larger tumours can therefore be treated by suction diathermy, with less patient discomfort, than by standard cystodiathermy methods. Secondly, by eliminating tumour debris within the bladder during treatment and reducing tissue damage due to diathermy, suction diathermy minimizes the risk of tumour recurrence due to implantation. In this preliminary report the ease and efficacy of using suction diathermy electrodes under local anaesthesia is assessed.

Porcine dermal collagen repair of incisional herniae.

Dermal collagen implants have been used to repair large incisional hernias in 11 patients (7 women, 4 men). The youngest was 37 years and the oldest 67, with a mean age of 49.9 years. Single-, or double-layered dermal collagen was used to bridge the defect, secured with interrupted 3/0 Prolene. Postoperatively, three patients required single aspiration of seromas and one, exploration of a sinus to remove a suture. There were no recurrences during a median follow-up period of 4.75 years. It is suggested that collagen implants are a good alternative to other methods of repair.