Editorial Comment for Maurice et al.

I t can be argued that little has changed in the endoscopic management of bladder tumors since the application of the Oudin current by Beer and the introduction of the resectoscope loop by Stern and McCarthy. Periodically, a novel approach to a clinical problem is rediscovered (re-searched) and brought to the attention of clinicians. The Case Western group has dusted off a previously described approach to papillary bladder cancer (reference 3), clothed it in current cancer management theory, and enhanced its application by the introduction of adjunctive technology (retrieval bag).

Our group was first introduced to the snare resection technique during the 2011 North Central Section meeting of the American Urological Association. We have since incorporated the techniques described herein into our clinical management of selected patients with papillary bladder cancer.

Our experience confirms the authors' findings as to the utility of this approach. Snare resection has been especially useful in combination with the flexible cystoscope in the management of anterior wall tumors that are difficult to reach with the standard resectoscope. The entrapment bag capitalizes on the use of a similar approach for specimen delivery in laparoscopy. It is not hard to imagine the extension of this technology for endoscopic management of selected papillary tumors in the ureter and renal pelvis.