HoLEP (Holmium Laser Enucleation of the Prostate)

Lumenis has partnered with key luminaries to provide world-class training centers for urologists to learn this breakthrough technique firsthand from the experts. Live surgical demonstrations feature both the high-power VersaPulse PowerSuite Holmium laser and the VersaCut tissue morcellator, giving surgeons a clinical edge with this remarkable technology.

Here's what the experts have to say about holmium laser treatment for BPH:

"The HoLEP has replaced standard TURP completely and unreservedly in our hospital. There is nothing out there that has been shown to be better."

Peter Gilling, MD, Consulting Urologist at Tauranga Hospital, Tauranga, New Zealand and holmium laser prostatectomy pioneer

"Use of the Ho:YAG laser for treatment of BPH is an important new technique that offers significant advantages over TURP....In a phrase, HoLEP compared with TURP provides 'maximal benefit with minimal morbidity'....I would envision that every significant urology department will have a holmium laser at their disposal. It is a basic tool for stones and BPH, two of the most common conditions urologists treat."

Products

The VersaPulse PowerSuite system provides unparalleled performance, procedure after procedure. Its technology and state-of-the-art features were designed to meet the needs of today's urologists. Available in several upgradeable configurations, the VersaPulse PowerSuite system offers the highest power and widest range of treatment settings available today. Its speed and precision can be tailored to address very specific clinical conditions while its high-power attribute enables physicians to treat even large prostates rapidly and hemostatically. And the dual-wavelength laser combines two lasers into one system, enabling surgeons to precisely cut and ablate with holmium and achieve deeper penetration and hemostasis with the Nd:YAG wavelength.

Designed for use with a broad selection of reusable and disposable delivery devices, the VersaPulse PowerSuite system allows surgeons to select the exact tools needed for each and every procedure.* Whether performing lithotripsy, prostatectomy or treating benign or malignant lesions, surgeons can rapidly complete a full spectrum of minimally invasive procedures.
* Reference provided in publications

Accessories

The VersaCut tissue morcellator works together with the VersaPulse PowerSuite system, providing rapid endoscopic removal of prostatic tissue and reduced operating time. And the compact VersaCut morcellator easily fits the operating room environment.

SlimLine and DuoTome fibers deliver either holmium or Nd:YAG laser wavelengths with the touch of a pedal. Both fibers are compatible with flexible, semi-rigid and rigid endoscopes. The rugged resusable SlimLine fiber lowers costs per case and can be used for multiple soft tissue applications and stone fragmentation. SlimLine fibers are available in 200, 365, 550 and 1000 micron diameter sizes and come with blue outer jackets to enhance endoscopic visibility during surgery.

DuoTome fibers direct laser energy at a 70° angle and are used in a fluid environment, making them ideal for use in endoscopic urology.

Holmium Prostatectomy Doctor FAQs

(Answers from "Endourologic use of the Holmium Laser" by Dr. Akhil Das and Dr. Demetrius H. Bagley)

Q: What are the disadvantages of HoLEP?
A: There are several disadvantages to HoLEP. Clinically, there is a higher incidence of stress urinary incontinence for HoLEP (10-15%) as compared to TURP, especially in patients with larger prostates (>100 gm). However, this problem is virtually resolved in all patients after 6 weeks. Second, there is a high learning curve for HoLEP (approximately 15 to 20 cases) before the surgeon becomes efficient with this technique. This equates to an investment in time and equipment for the surgeon to learn HoLEP.

Q: What are the advantages of HoLEP over TURP?
A: The benefits of HoLEP include shorter catheter time, shorter hospital stay, minimal risk of blood transfusion, the rare need for perioperative bladder irrigation and quicker return to full activity.

Q: Can you use the holmium laser to coagulate specific areas of bleeding during the enucleation of the prostate?
A: Yes, by placing the fiber tip 2-3 mm away from the bleeding point and then activating the laser for 8-10 seconds. This is also known as defocusing the laser beam.

Q: How often do you see TURP syndrome with holmium laser prostatectomy?
A: Almost never. The holmium laser coagulates as it cuts tissue, which minimizes fluid absorption. In addition, normal saline, which is more physiologic, is used during holmium laser prostatectomy.