Best laser for prostatectomy in the year 2013

Maheshwari, Pankaj N; Joshi, Nitin; Maheshwari, Reeta P

doi:10.4103/0970-1591.117286

Cited by 15 publications

(10 citation statements)

References 47 publications

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“…As there is still a lack of studies regarding the learning curve for applying thulium laser surgery to BOO, we tried to compare our data to those obtained using other techniques, such as ThuVEP [ 12 , 13 ] and HoLEP [ 8 ]. HoLEP has been proven to be an effective, minimally invasive, size-independent procedure for the surgical treatment of benign prostatic hyperplasia (BPH).…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of the learning curve for thulium laser enucleation of the prostate with the aid of a simulator tool but without tutoring: comparison of two surgeons with different levels of endoscopic experience

et al. 2015

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BackgroundThe aim of this study was to determine the learning curve for thulium laser enucleation of the prostate (ThuLEP) for two surgeons with different levels of urological endoscopic experience.MethodsFrom June 2012 to August 2013, ThuLEP was performed on 100 patients in our institution. We present the results of a prospective evaluation during which we analyzed data related to the learning curves for two surgeons of different levels of experience.ResultsThe prostatic adenoma volumes ranged from 30 to 130 mL (average 61.2 mL). Surgeons A and B performed 48 and 52 operations, respectively. Six months after surgery, all patients were evaluated with the International Prostate Symptom Score questionnaire, uroflowmetry, and prostate-specific antigen test. Introduced in 2010, ThuLEP consists of blunt enucleation of the prostatic apex and lobes using the sheath of the resectoscope. This maneuver allows clearer visualization of the enucleation plane and precise identification of the prostatic capsule. These conditions permit total resection of the prostatic adenoma and coagulation of small penetrating vessels, thereby reducing the laser emission time. Most of the complications in this series were encountered during morcellation, which in some cases was performed under poor vision because of venous bleeding due to surgical perforation of the capsule during enucleation.ConclusionsBased on this analysis, we concluded that it is feasible for laser-naive urologists with endoscopic experience to learn to perform ThuLEP without tutoring. Those statements still require further validation in larger multicentric study cohort by several surgeon. The main novelty during the learning process was the use of a simulator that faithfully reproduced all of the surgical steps in prostates of various shapes and volumes.

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Section: Discussionmentioning

confidence: 99%

“…Because this plane is now more easily distinguishable with ThuLEP, the surgeon is able to remove the adenoma accurately at the level of the surgical capsule. Virtually any prostate size can be removed transurethrally using this technique [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the learning curve for thulium laser enucleation of the prostate with the aid of a simulator tool but without tutoring: comparison of two surgeons with different levels of endoscopic experience

et al. 2015

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“…Various lasers at different wavelengths and power settings have been used for benign prostatic hyperplasia (BPH) as proven alternatives to the gold standard transurethral resection of the prostate (TURP) (1). Laser vaporization and vaporesection are more widely used due to a relatively short learning curve compared to enucleation.…”

Section: Introductionmentioning

confidence: 99%

Diode 980 nm Laser Vaporesection of the Prostate: A Comparison of 150 to 250 Watt

Erol¹,

Keskin²,

Başok³

et al. 2018

jus

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The aim of this study is to compare the efficacy and morbidity of the diode 980 nm laser at two different power settings for vaporesection of the prostate. Materials and Methods: A retrospective evaluation of patients who were operated for benign prostatic enlargement by the same surgeon at two different laser power settings. A hundred thirty six patients included in the study were consecutively randomized into 2 groups by certain time periods. The first group consisted of 57 patients with benign prostatic hyperplasia who were treated with 150 Watt and the remaining 79 treated with 250 Watt. International Prostate Symptom Score (IPSS), IPSS-quality of life (QoL), prostate volume, postvoid residual urine, maximum flow rate (Q max) and prostate specific antigen (PSA) levels were recorded preoperatively and at 3 and 12 months postoperatively. Total energy consumption, lasing times and complications were noted. Results: IPSS, Q max and IPSS-QoL improved significantly in both groups in accordance with the decrease in prostate volume, postvoid residual and PSA levels. IPSS, Q max improvement and prostate volume reduction were greater in the second group at the 12 th month. Early postoperative irritative symptoms such as dysuria and urge incontinence were significantly more common in the first group (p<0.05). Infravesical obstruction due to necrotic prostate tissue, which required secondary intervention, solely occurred in 5 patients of the second group. Conclusion: Both power settings provided adequate patient satisfaction and significant improvements in objective outcome parameters in the long term, however, high power settings would be preferred for bigger glands for greater volume reduction.

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“…The surgical treatment of laser vaporesection for BPH treatment is gradually accepted by clinicians due to its apparent advantages. [ 3 ] This study is aimed to introduce the development of medical lasers used to treat BPH.…”

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confidence: 99%