LASER ENUCLEATION OF THE PROSTATE ( HoLEP) - NEWEST "GOLD STANDARD" OF TREATMENT
The most up-to-date methodology for surgical treatment of prostate adenoma is holmium laser resection and enucleation (HOLEP). Just like the transurethral prostatic resection, the surgery is carried out through the urethra with no sections.
Using a laser fiber guidewire and optics (endoscope) for the purpose of control, adenomatous tissues are removed in whole fractions; at that, the size of adenoma doesn’t matter and may in fact be very large - over 200 cm3. Then, the removed fractions are evacuated with a special device called morcellator, which shreds larger fractions of the removed tissue into small bits like a chopping machine and removes these bits from the urinary bladder using powerful suction. 100% visual control is maintained.
The surgery usually lasts for 1.5-2 hours at most.
Anesthesia – spinal or general.
The surgery is carried out in the day care facility and requires a patient to stay therein for the duration
of 23 hours at most!!
Patients are discharged from the clinic on the second day already and restore their working capabilityin 5 to 7 days.
This methodology allows removing adenomatous prostate tissues in a bloodless way with a number of advantages over transurethral prostatic resection: there are no restrictions as to the size of adenoma, taking blood thinners is not a contradiction, so there’s no need to interrupt the course; no danger of the TUR syndrome, minimum time at hospital and recovery period.
It is sure to say that this brand new methodology is becoming the “GOLD STANDARD” in benign prostatic hyperplasia treatment.
From 2013 year the experts of our Clinic were the first in Baltic countries to master and implement the latest methodology, which was successfully used in everyday practice in more than 2000 cases.
LASER KIDNEY STONE LITHOTRIPSY
Nowadays, the most advanced lithotripsy method is laser lithotripsy. This method combines laser therapy with the endoscopic method for curing renal calculus. The endoscope is taken through the urethra and ureter to the calculus. Then, a laser is activated to evaporate the calculus. Essentially, this is a revolutionary method of destroying renal calculi, which is bound to replace the traditional lithotripsy method based on shock wave technology in the nearest future.
This lithotripsy method offers a number of benefits:
- Higher efficiency in complicated cases of renal calculi,
- High efficiency rate ensured by one-time procedure,
- Considerable lower risk of leaving any fragments of the calculi that may provoke calculus recurrence.
Laser lithotripsy is done using a special holmium laser. The laser lithotripsy technology causes less complications, bleeding, calculus displacement, and is effective with calculi of any chemical composition. At that, holmium laser does no damage to the surrounding tissue. This is due to the fact that it only penetrates living tissue to a very small depth (less than 0.5 mm!).
Apart from that, the entire procedure is visually controlled using endoscopic equipment, which also decreases the risk of accidental laser damage to the surrounding tissues.
One of the peculiar features of laser lithotripsy is the fact that is applicable with the smallest calculi, when the traditional remote shock wave lithotripsy is inefficient.
Laser lithotripsy virtually “grinds calculi to dust”, leaving no fragments that would otherwise have to be extracted with urine.
This methodology has become a standard for urolithiasis treatment at our Centre and is used for shattering renal, ureteral or vesical calculi of any size.