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World Journal of Surgical Oncology

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Open Access 01-12-2003 | Technical innovations

Holmium Laser Enucleation of the Prostate (HoLEP): A Technical Update

Authors: Ramsay L Kuo, Ryan F Paterson, Samuel C Kim, Tibério M Siqueira Jr, Mostafa M Elhilali, James E Lingeman

Published in: World Journal of Surgical Oncology | Issue 1/2003

Abstract

Introduction

Holmium laser enucleation of the prostate (HoLEP) combined with mechanical morcellation represents the latest refinement of holmium:YAG surgical treatment for benign prostatic hyperplasia (BPH). Utilizing this technique, even the largest of glands can be effectively treated with minimal morbidity. The learning curve remains an obstacle, preventing more widespread adoption of this procedure. This paper provides an outline of the HoLEP technique as is currently used at two centers in hopes of easing the initial learning curve.

Technical considerations

Detailed descriptions of the major steps of the HoLEP procedure are provided with attention to critical steps such as identification of the surgical capsule, median and lateral lobe enucleation, and morcellation of enucleated tissue.

Conclusions

HoLEP is a promising alternative for the surgical treatment of BPH which allows complete removal of intact lobes of the prostate. Obstruction is relieved immediately with superior hemostasis, no risk of TUR syndrome, and a minimal hospital stay.

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Kirby RS: The natural history of benign prostatic hyperplasia: what have we learned in the last decade?. Urology. 2000, 56: 3-6. 10.1016/S0090-4295(00)00747-0.CrossRefPubMed

Jacobsen SJ, Girman CJ, Guess HA, Rhodes T, Oesterling JE, Lieber MM: Natural history of prostatism: longitudinal changes in voiding symptoms in community dwelling men. J Urol. 1996, 155: 595-600. 10.1097/00005392-199602000-00053.CrossRefPubMed

Grasso M: Experience with the holmium laser as an endoscopic lithotrite. Urology. 1996, 48: 199-206. 10.1016/S0090-4295(96)00158-6.CrossRefPubMed

Gilling PJ, Fraundorfer MR: Holmium laser prostatectomy: a technique in evolution. Clin. Opin. Urol. 1998, 8: 11-15. 10.1097/00042307-199801000-00003.CrossRef

Chan KF, Vassar GJ, Pfefer TJ, Teichman JM, Glickman RD, Weintraub ST, Welch AJ: Holmium:YAG laser lithotripsy: A dominant photothermal ablative mechanism with chemical decomposition of urinary calculi. Lasers Surg Med. 1999, 25: 22-37. 10.1002/(SICI)1096-9101(1999)25:1<22::AID-LSM4>3.3.CO;2-Y.CrossRefPubMed

Gilling PJ, Cass CB, Malcolm AR, Fraundorfer MR: Combination holmium and Nd:YAG laser ablation of the prostate: initial clinical experience. J Endourol. 1995, 9: 151-153.CrossRefPubMed

Kabalin JN, Gilling PJ, Fraundorfer MR: Holmium:yttrium-aluminum-garnet laser prostatectomy. Mayo Clin Proc. 1998, 73: 792-797.CrossRefPubMed

Chun SS, Razvi HA, Denstedt JD: Laser prostatectomy with the holmium: YAG laser. Tech Urol. 1995, 1: 217-221.PubMed

Gilling PJ, Cass CB, Cresswell MD, Malcolm AR, Fraundorfer MR: The use of the holmium laser in the treatment of benign prostatic hyperplasia. J Endourol. 1996, 10: 459-461.CrossRefPubMed

10.

Kabalin JN: Holmium:YAG laser prostatectomy: results of U.S. pilot study. J Endourol. 1996, 10: 453-457.CrossRefPubMed

11.

Kabalin JN: Holmium: YAG laser prostatectomy canine feasibility study. Lasers Surg Med. 1996, 18: 221-224. 10.1002/(SICI)1096-9101(1996)18:3<221::AID-LSM1>3.0.CO;2-U.CrossRefPubMed

12.

Mottet N, Anidjar M, Bourdon O, Louis JF, Teillac P, Costa P, Le Duc A: Randomized comparison of transurethral electroresection and holmium: YAG laser vaporization for symptomatic benign prostatic hyperplasia. J Endourol. 1999, 13: 127-130.CrossRefPubMed

13.

Gilling PJ, Cass CB, Cresswell MD, Fraundorfer MR: Holmium laser resection of the prostate: preliminary results of a new method for the treatment of benign prostatic hyperplasia. Urology. 1996, 47: 48-51. 10.1016/S0090-4295(99)80381-1.CrossRefPubMed

14.

Cresswell MD, Cass CB, Fraundorfer MR, Gilling PJ: Holmium:YAG laser resection of the prostate: preliminary experience with the first 400 cases. N Z Med J. 1997, 110: 76-78.PubMed

15.

Gilling PJ, Kennett KM, Fraundorfer MR: Holmium laser resection v transurethral resection of the prostate: results of a randomized trial with 2 years of follow-up. J Endourol. 2000, 14: 757-760.CrossRefPubMed

16.

Gilling PJ, Mackey M, Cresswell M, Kennett K, Kabalin JN, Fraundorfer MR: Holmium laser versus transurethral resection of the prostate: a randomized prospective trial with 1-year followup. J Urol. 1999, 162: 1640-1644. 10.1097/00005392-199911000-00018.CrossRefPubMed

17.

Kabalin JN, Mackey MJ, Cresswell MD, Fraundorfer MR, Gilling PJ: Holmium: YAG laser resection of prostate (HoLRP) for patients in urinary retention. J Endourol. 1997, 11: 291-293.CrossRefPubMed

18.

Matsuoka K, Iida S, Tomiyasu K, Shimada A, Noda S: Transurethral holmium laser resection of the prostate. J Urol. 2000, 163: 515-518.CrossRefPubMed

19.

Matsuoka K, Iida S, Tomiyasu K, Shimada A, Suekane S, Noda S: Holmium laser resection of the prostate. J Endourol. 1998, 12: 279-282.CrossRefPubMed

20.

Mackey MJ, Chilton CP, Gilling PJ, Fraundorfer M, Cresswell MD: The results of holmium laser resection of the prostate. Br J Urol. 1998, 81: 518-519. 10.1046/j.1464-410x.1998.00618.x.CrossRefPubMed

21.

Gan E, Costello A, Slavin J, Stillwell RG: Pitfalls in the diagnosis of prostate adenocarcinoma from holmium resection of the prostate. Tech Urol. 2000, 6: 185-188.PubMed

22.

Fraundorfer MR, Gilling PJ: Holmium:YAG laser enucleation of the prostate combined with mechanical morcellation: preliminary results. Eur Urol. 1998, 33: 69-72. 10.1159/000019535.CrossRefPubMed

23.

Moody JA, Lingeman JE: Holmium laser enucleation for prostate adenoma greater than 100 gm.: comparison to open prostatectomy. J Urol. 2001, 165: 459-462. 10.1097/00005392-200102000-00025.CrossRefPubMed

24.

Hochreiter WW, Thalmann GN, Burkhard FC, Studer UE: Holmium laser enucleation of the prostate combined with electrocautery resection: the mushroom technique. J Urol. 2002, 168: 1470-1474. 10.1097/00005392-200210010-00040.CrossRefPubMed

25.

Gilling PJ, Kennett K, Das AK, Thompson D, Fraundorfer MR: Holmium laser enucleation of the prostate (HoLEP) combined with transurethral tissue morcellation: an update on the early clinical experience. J Endourol. 1998, 12: 457-459.CrossRefPubMed

26.

Moody JA, Lingeman JE: Holmium laser enucleation of the prostate with tissue morcellation: initial United States experience. J Endourol. 2000, 14: 219-223.CrossRefPubMed

27.

Gilling PJ, Kennett KM, Fraundorfer MR: Holmium laser enucleation of the prostate for glands larger than 100 g: an endourologic alternative to open prostatectomy. J Endourol. 2000, 14: 529-531.CrossRefPubMed

28.

Kuntz RM, Lehrich K: Transurethral holmium laser enucleation versus transvesical open enucleation for prostate adenoma greater than 100 gm.:: a randomized prospective trial of 120 patients. J Urol. 2002, 168: 1465-1469. 10.1097/00005392-200210010-00039.CrossRefPubMed

Title: Holmium Laser Enucleation of the Prostate (HoLEP): A Technical Update
Authors: Ramsay L Kuo
Ryan F Paterson
Samuel C Kim
Tibério M Siqueira Jr
Mostafa M Elhilali
James E Lingeman
Publication date: 01-12-2003
Publisher: BioMed Central
Published in: World Journal of Surgical Oncology / Issue 1/2003
Electronic ISSN: 1477-7819
DOI: https://doi.org/10.1186/1477-7819-1-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Holmium Laser Enucleation of the Prostate (HoLEP): A Technical Update

Abstract

Introduction

Technical considerations

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Technical considerations

Conclusions

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