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Friday, June 25, 2010

Holmium Laser in Prostate Surgery

Posted by Prahallad Panda on 8:28 PM Comments

It simulates the open prostatectomy procedure in a sense that a cleavage between the adenomatous part and the rest of compressed tissue is created, and it is possible to extract the total adenomatous part. On the other hand, in trans urethral resection of prostate (TURP), a gold standard procedure at present for Benign hyperplasia of prostate (BHP) the adenomatous part is cut in small bits and removed. It is possible that some adenomatous part may be left over. The recurrence rate may be low in Holmimium laser surgery.
clipped from www.mayoclinic.org

A new approach

HoLEP is typically performed with the patient under general anesthesia. The surgeon uses the laser to enucleate the entire adenoma, leaving just the capsule in place. The surgeon pushes the excised adenoma into the bladder and then uses a morcellation device to grind up and remove the tissue.
Image of prostatic urethra with incision
Prostatic urethra with incision


  • HoLEP allows tissue preservation for pathologic examination. Because adenomatous tissue is excised rather than ablated, surgeons can examine specimens for prostate cancer or other abnormalities. Cancer is found in about 10% of HoLEP procedures, even in patients previously screened. In many cases the cancer identified is of low malignant potential.

  • Widely acknowledged as a benchmark BPH procedure, HoLEP requires specialized skills and training. Mayo Clinic is among the few medical centers in the United States that performs HoLEP procedures, at its campuses in Arizona and Minnesota.
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