最后更新: 2026年5月18日

In this topic, I will classify the pros and cons of Ho-ERBT (Holmium laser En-Bloc Resection of Bladder Tumor) compared with the conventional TURBT (Transurethral Resection of Bladder Tumor). Let’s start with understanding the conventional operation first.

Ho-ERBT Holmium laser bladder tumor resection
Holmium laser technology used in Ho-ERBT bladder tumor en-bloc resection.

The conventional TURBT involves passing a scope via the urethra and using a small electrical surgical knife to scoop the bladder tumor piece by piece — sometimes requiring hundreds of scoops in a single operation. Each scoop risks bleeding and the procedure carries a risk of bladder perforation due to the “Obturator reflex”: the electrical current can trigger an involuntary lower body muscle contraction during cutting, which can result in bladder perforation and potential emergency open surgery. Ho-ERBT eliminates this risk because the Holmium laser does not trigger an obturator reflex.

Endoscopic view of bladder tumor
Endoscopic view of bladder tumor.

Ho-ERBT uses Holmium YAG laser technology to excise the entire bladder tumor in a single en-bloc specimen — rather than piece by piece as in conventional TURBT. This provides a superior pathological specimen with intact deep margins for accurate staging.

Ho-ERBT 的优点

  1. 出血更少——铥激光同时切除和止血,减少术中出血
  2. Shorter hospitalization – confirmed reports show Ho-ERBT patients are discharged significantly faster (2 days vs. 4 days for conventional TURBT)
  3. Lower risk of bladder perforation – no obturator reflex with laser energy
  4. Less postoperative irritative urinary symptoms
  5. Better pathological specimen – en-bloc resection preserves the detrusor muscle layer for accurate T-staging

Ho-ERBT 的缺点

  1. Steep learning curve – at least 25 cases are required to achieve adequate proficiency in Ho-ERBT
  2. Specialized equipment required – Holmium laser systems are expensive and not available in all centers, making the procedure more costly than conventional TURBT
Ho-ERBT surgical team
一个足够的 Ho-ERBT 操作至少需要 25 个学习曲线。

In conclusion, Ho-ERBT is one of the best endoscopic bladder tumor removal operations available today and requires a well-trained urologist with dedicated laser equipment. Any questions, you should discuss with your trusted urologist.

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Frequently Asked Questions About TURBT and Ho-ERBT

What is the difference between TURBT and Ho-ERBT?

TURBT (Transurethral Resection of Bladder Tumor) is the conventional endoscopic bladder tumor removal technique that uses electrical energy to scoop the tumor in multiple fragments. Ho-ERBT (Holmium laser En-Bloc Resection of Bladder Tumor) uses Holmium YAG laser technology to excise the entire tumor as a single en-bloc specimen. The en-bloc approach provides a superior pathological specimen with intact deep margins, enabling more accurate tumor staging compared to the fragmented specimens from conventional TURBT.

What are the advantages of Ho-ERBT over conventional TURBT?

Ho-ERBT offers several clinical advantages: less intraoperative bleeding (laser coagulates simultaneously with cutting), shorter hospitalization (2 days vs. 4 days), no risk of obturator reflex-related bladder perforation (since laser energy does not trigger this reflex), fewer postoperative irritative urinary symptoms, and superior pathological specimen quality for staging. These benefits make Ho-ERBT increasingly preferred at centers with the required expertise and equipment.

Is Ho-ERBT available at Bangkok Hospital?

Yes, Ho-ERBT and advanced endoscopic bladder tumor resection are available at Bangkok Hospital Headquarters under Dr. Soarawee Weerasopone, a urologic oncologist trained in minimally invasive and laser urological surgery. The procedure requires specialized Holmium laser equipment and a surgeon with dedicated training, both of which are available at the center. For bladder tumor concerns, early specialist evaluation is recommended.

If you have been diagnosed with a bladder tumor or would like a urologic oncology consultation, Dr. Soarawee Weerasopone offers specialist consultations at Bangkok Hospital Headquarters. 预约咨询.

**免责声明:** 本内容由曼谷医院总院的认证泌尿科医生 Soarawee Weerasopone 医生撰写和审阅。本内容仅用于教育目的,不构成医疗建议。在开始任何医疗治疗前,请务必咨询合格的医疗专业人士。.

医学撰写与审阅: 素瓦瑞·维拉宋蓬医生(Pom医生)— 曼谷医院总部认证泌尿科医生。 国际学者:贝勒医学院(美国)· 顺天堂大学(日本)· 长庚纪念医院(台湾)。.

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