Skip to main content
Top
Published in: World Journal of Urology 2/2010

01-04-2010 | Topic Paper

New alternatives for laser vaporization of the prostate: experimental evaluation of a 980-, 1,318- and 1,470-nm diode laser device

Authors: Felix Wezel, Gunnar Wendt-Nordahl, Nina Huck, Thorsten Bach, Christel Weiss, Maurice Stephan Michel, Axel Häcker

Published in: World Journal of Urology | Issue 2/2010

Login to get access

Abstract

Purpose

Several diode laser systems were introduced in recent years for the minimal-invasive surgical therapy of benign prostate enlargement. We investigated the ablation capacities, hemostatic properties and extend of tissue necrosis of different diode lasers at wavelengths of 980, 1,318 and 1,470 nm and compared the results to the 120 W GreenLight™ HPS laser.

Methods

The laser devices were evaluated in an ex vivo model using isolated porcine kidneys. The weight difference of the porcine kidneys after 10 min of laser vaporization defined the amount of ablated tissue. Blood loss was measured in blood-perfused kidneys following laser vaporization. Histological examination was performed to assess the tissue effects.

Results

The side-firing 980 and 1,470 nm diode lasers displayed similar ablative capacities compared to the GreenLight™ HPS laser (n.s.). The 1,318-nm laser, equipped with a bare-ended fiber, reached a higher ablation rate compared to the other laser devices (each P < 0.05). A calculated ‘output power efficiency per watt’ revealed that the 1,318-nm laser with a bare-ended fiber reached the highest rate compared to the side-firing devices (each P < 0.0001). All three diode lasers showed superior hemostatic properties compared to the GreenLight™ HPS laser (each P < 0.01). The extend of morphological tissue necrosis was 4.62 mm (1,318 nm), 1.30 mm (1,470 nm), 4.18 mm (980 nm) and 0.84 mm (GreenLight™ HPS laser), respectively.

Conclusion

The diode lasers offered similar ablative capacities and improved hemostatic properties compared to the 120 W GreenLight™ HPS laser in this experimental ex vivo setting. The higher tissue penetration of the diode lasers compared to the GreenLight™ HPS laser may explain improved hemostasis.
Literature
1.
go back to reference Madersbacher S, Marberger M (1999) Is transurethral resection of the prostate still justified? BJU Int 83(3):227–237CrossRefPubMed Madersbacher S, Marberger M (1999) Is transurethral resection of the prostate still justified? BJU Int 83(3):227–237CrossRefPubMed
2.
go back to reference Rassweiler J et al (2006) Complications of transurethral resection of the prostate (TURP)—incidence, management, and prevention. Eur Urol 50(5):969–979 discussion 980CrossRefPubMed Rassweiler J et al (2006) Complications of transurethral resection of the prostate (TURP)—incidence, management, and prevention. Eur Urol 50(5):969–979 discussion 980CrossRefPubMed
3.
go back to reference Madersbacher S et al (2004) EAU 2004 guidelines on assessment, therapy and follow-up of men with lower urinary tract symptoms suggestive of benign prostatic obstruction (BPH guidelines). Eur Urol 46(5):547–554CrossRefPubMed Madersbacher S et al (2004) EAU 2004 guidelines on assessment, therapy and follow-up of men with lower urinary tract symptoms suggestive of benign prostatic obstruction (BPH guidelines). Eur Urol 46(5):547–554CrossRefPubMed
4.
go back to reference Fried NM (2007) New laser treatment approaches for benign prostatic hyperplasia. Curr Urol Rep 8(1):47–52CrossRefPubMed Fried NM (2007) New laser treatment approaches for benign prostatic hyperplasia. Curr Urol Rep 8(1):47–52CrossRefPubMed
5.
6.
go back to reference Bachmann A et al (2005) Photoselective vaporization (PVP) versus transurethral resection of the prostate (TURP): a prospective bi-centre study of perioperative morbidity and early functional outcome. Eur Urol 48(6):965–971 discussion 972CrossRefPubMed Bachmann A et al (2005) Photoselective vaporization (PVP) versus transurethral resection of the prostate (TURP): a prospective bi-centre study of perioperative morbidity and early functional outcome. Eur Urol 48(6):965–971 discussion 972CrossRefPubMed
7.
go back to reference Hai MA (2009) Photoselective vaporization of prostate: five-year outcomes of entire clinic patient population. Urology 73(4):807–810CrossRefPubMed Hai MA (2009) Photoselective vaporization of prostate: five-year outcomes of entire clinic patient population. Urology 73(4):807–810CrossRefPubMed
8.
go back to reference Gomez Sancha F et al (2007) Photoselective vaporization of the prostate (GreenLight PV): lessons learnt after 3500 procedures. Prostate Cancer Prostatic Dis 10(4):316–322CrossRefPubMed Gomez Sancha F et al (2007) Photoselective vaporization of the prostate (GreenLight PV): lessons learnt after 3500 procedures. Prostate Cancer Prostatic Dis 10(4):316–322CrossRefPubMed
9.
go back to reference Wendt-Nordahl G et al (2007) 980-nm Diode laser: a novel laser technology for vaporization of the prostate. Eur Urol 52(6):1723–17238CrossRefPubMed Wendt-Nordahl G et al (2007) 980-nm Diode laser: a novel laser technology for vaporization of the prostate. Eur Urol 52(6):1723–17238CrossRefPubMed
10.
go back to reference Michel MS et al (1996) Rotoresect: new technique for resection of the prostate: experimental phase. J Endourol 10(5):473–478CrossRefPubMed Michel MS et al (1996) Rotoresect: new technique for resection of the prostate: experimental phase. J Endourol 10(5):473–478CrossRefPubMed
11.
go back to reference Wendt-Nordahl G et al (2008) Systematic evaluation of a recently introduced 2-microm continuous-wave thulium laser for vaporesection of the prostate. J Endourol 22(5):1041–1045CrossRefPubMed Wendt-Nordahl G et al (2008) Systematic evaluation of a recently introduced 2-microm continuous-wave thulium laser for vaporesection of the prostate. J Endourol 22(5):1041–1045CrossRefPubMed
12.
go back to reference Reich O et al (2004) Experimental comparison of high power (80 W) potassium titanyl phosphate laser vaporization and transurethral resection of the prostate. J Urol 171(6 Pt 1):2502–2504CrossRefPubMed Reich O et al (2004) Experimental comparison of high power (80 W) potassium titanyl phosphate laser vaporization and transurethral resection of the prostate. J Urol 171(6 Pt 1):2502–2504CrossRefPubMed
13.
14.
go back to reference Malek RS, Barrett DM, Kuntzman RS (1998) High-power potassium-titanyl-phosphate (KTP/532) laser vaporization prostatectomy: 24 h later. Urology 51(2):254–256CrossRefPubMed Malek RS, Barrett DM, Kuntzman RS (1998) High-power potassium-titanyl-phosphate (KTP/532) laser vaporization prostatectomy: 24 h later. Urology 51(2):254–256CrossRefPubMed
15.
go back to reference Bouchier-Hayes DM et al (2006) KTP laser versus transurethral resection: early results of a randomized trial. J Endourol 20(8):580–585CrossRefPubMed Bouchier-Hayes DM et al (2006) KTP laser versus transurethral resection: early results of a randomized trial. J Endourol 20(8):580–585CrossRefPubMed
16.
go back to reference Sandhu JS et al (2004) High-power potassium-titanyl-phosphate photoselective laser vaporization of prostate for treatment of benign prostatic hyperplasia in men with large prostates. Urology 64(6):1155–1159CrossRefPubMed Sandhu JS et al (2004) High-power potassium-titanyl-phosphate photoselective laser vaporization of prostate for treatment of benign prostatic hyperplasia in men with large prostates. Urology 64(6):1155–1159CrossRefPubMed
17.
go back to reference Malek RS et al (2009) Greenlight photoselective 120-Watt 532-nm lithium triborate laser vaporization prostatectomy in living canines. J Endourol Malek RS et al (2009) Greenlight photoselective 120-Watt 532-nm lithium triborate laser vaporization prostatectomy in living canines. J Endourol
18.
go back to reference Woo H et al (2008) Outcome of GreenLight HPS 120-W laser therapy in specific patient populations: those in retention, on anticoagulants, and with large prostates (≥80 ml). Eur Urol Suppl 7(4):378–383CrossRef Woo H et al (2008) Outcome of GreenLight HPS 120-W laser therapy in specific patient populations: those in retention, on anticoagulants, and with large prostates (≥80 ml). Eur Urol Suppl 7(4):378–383CrossRef
19.
go back to reference Leonardi R (2009) Preliminary results on selective light vaporization with the side-firing 980 nm diode laser in benign prostatic hyperplasia: an ejaculation sparing technique. Prostate Cancer Prostatic Dis Leonardi R (2009) Preliminary results on selective light vaporization with the side-firing 980 nm diode laser in benign prostatic hyperplasia: an ejaculation sparing technique. Prostate Cancer Prostatic Dis
20.
go back to reference Seitz M et al (2009) Preliminary evaluation of a novel side-fire diode laser emitting light at 940 nm, for the potential treatment of benign prostatic hyperplasia: ex-vivo and in-vivo investigations. BJU Int 103(6):770–775CrossRefPubMed Seitz M et al (2009) Preliminary evaluation of a novel side-fire diode laser emitting light at 940 nm, for the potential treatment of benign prostatic hyperplasia: ex-vivo and in-vivo investigations. BJU Int 103(6):770–775CrossRefPubMed
21.
go back to reference Seitz M et al (2008) Ex vivo and in vivo investigations of the novel 1,470 nm diode laser for potential treatment of benign prostatic enlargement. Lasers Med Sci Seitz M et al (2008) Ex vivo and in vivo investigations of the novel 1,470 nm diode laser for potential treatment of benign prostatic enlargement. Lasers Med Sci
22.
go back to reference Costello AJ et al (1992) Laser ablation of the prostate in patients with benign prostatic hypertrophy. Br J Urol 69(6):603–608CrossRefPubMed Costello AJ et al (1992) Laser ablation of the prostate in patients with benign prostatic hypertrophy. Br J Urol 69(6):603–608CrossRefPubMed
23.
go back to reference Ruszat R et al (2009) Prospective single-centre comparison of 120-W diode-pumped solid-state high-intensity system laser vaporization of the prostate and 200-W high-intensive diode-laser ablation of the prostate for treating benign prostatic hyperplasia. BJU Int Ruszat R et al (2009) Prospective single-centre comparison of 120-W diode-pumped solid-state high-intensity system laser vaporization of the prostate and 200-W high-intensive diode-laser ablation of the prostate for treating benign prostatic hyperplasia. BJU Int
24.
go back to reference Erol A et al (2009) High power diode laser vaporization of the prostate: preliminary results for benign prostatic hyperplasia. J Urol 182(3):1078–1082CrossRefPubMed Erol A et al (2009) High power diode laser vaporization of the prostate: preliminary results for benign prostatic hyperplasia. J Urol 182(3):1078–1082CrossRefPubMed
25.
go back to reference Seitz M et al (2007) The diode laser: a novel side-firing approach for laser vaporisation of the human prostate—immediate efficacy and 1-year follow-up. Eur Urol 52(6):1717–1722CrossRefPubMed Seitz M et al (2007) The diode laser: a novel side-firing approach for laser vaporisation of the human prostate—immediate efficacy and 1-year follow-up. Eur Urol 52(6):1717–1722CrossRefPubMed
26.
go back to reference Kang HW et al (2008) Laser vaporization of bovine prostate: a quantitative comparison of potassium-titanyl-phosphate and lithium triborate lasers. J Urol 180(6):2675–2680CrossRefPubMed Kang HW et al (2008) Laser vaporization of bovine prostate: a quantitative comparison of potassium-titanyl-phosphate and lithium triborate lasers. J Urol 180(6):2675–2680CrossRefPubMed
Metadata
Title
New alternatives for laser vaporization of the prostate: experimental evaluation of a 980-, 1,318- and 1,470-nm diode laser device
Authors
Felix Wezel
Gunnar Wendt-Nordahl
Nina Huck
Thorsten Bach
Christel Weiss
Maurice Stephan Michel
Axel Häcker
Publication date
01-04-2010
Publisher
Springer-Verlag
Published in
World Journal of Urology / Issue 2/2010
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-009-0499-5

Other articles of this Issue 2/2010

World Journal of Urology 2/2010 Go to the issue