Perspectives of holmium laser resection of the prostate; Cutting effects with the holmium:YAG laser

Rolf H. Eichenauer*, Gerit Dröge, Ralf Brinkmann, Malte Neuss, Evariste Gafumbegete, Dieter Jocham

*Corresponding author for this work


Laser prostatectomy shows an improvement in peak urinary flow rates, in post-void residual urine volumes and also a symptomatic improvement when compared to the transurethral resection of the prostate (TUR-P). Time to achieve symptomatic improvement is delayed with many established laser procedures compared to standard resection. However, this disadvantage can be solved with a new resection technique using a pulsed holmium laser. Nevertheless, this advanced technique shows a few problems in a first clinical trial. Besides this clinical study, in vitro experiments were carried out in order to determine the optimal irradiation parameters with respect to resection rate, incision/ablation quality and handling. Prostate tissue of radical prostatectomies and chicken breast as model were irradiated with a pulsed holmium-laser in vitro with different laser parameters using a bare fiber in contact to tissue. The incision quality (depths and coagulation/vaporisation effects) was analysed with regard to pulse energy (speed of incision, angle of incision) and fiber diameter. Fast flash photography was performed to analyse thermo-mechanical side-effects. Fast flash photography reveals cavitation bubble up to 7 mm length in water and dissections in tissue. The ablation rate increases proportional to the laser pulse energy. The Holmium Laser Resection of the Prostate (HOLRP) in humans with available instrumentation right now shows equieffective results compared to the transurethral resection, no need for transfusion, no transurethral resection syndrom, short time for catheterization. Further technical approvement may significantly improve holmium laser prostate resection. We present a new application system for the laser resection.

Original languageEnglish
JournalProceedings of SPIE - The International Society for Optical Engineering
Pages (from-to)64-74
Number of pages11
Publication statusPublished - 01.07.1998
EventLasers in Surgery: Advanced Characterization, Therapeutics, and Systems VIII
- San Jose, United States
Duration: 24.01.199825.01.1998
Conference number: 59702

Research Areas and Centers

  • Academic Focus: Biomedical Engineering


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