Clinical development of holmium:YAG laser prostatectomy

John N. Kabalin M.D.

doi:10.1117/12.240021

17 May 1996 Clinical development of holmium:YAG laser prostatectomy

John N. Kabalin M.D.

Proceedings Volume 2671, Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems VI; (1996) https://doi.org/10.1117/12.240021
Event: Photonics West '96, 1996, San Jose, CA, United States

Abstract

Holmium:YAG (Ho:YAG) laser vaporization and resection of the prostate offers advantages in immediate tissue removal compared to the Neodymium:YAG (Nd:YAG) laser. Ongoing development of appropriate operative techniques and Ho:YAG laser delivery systems suitable for endoscopic prostate surgery, including side-firing optical delivery fibers, have facilitated this approach. We performed Ho:YAG laser prostatectomy in 20 human subjects, including 2 men treated immediately prior to radical prostatectomy to assess Ho:YAG laser effects in the prostate. A total of 18 men were treated in an initial clinical trial of Ho:YAG prostatectomy. Estimated excess hyperplastic prostate tissue averaged 24 g (range 5 - 50 g). A mean of 129 kj Ho:YAG laser energy was delivered, combined with a mean of 11 kj Nd:YAG energy to provide supplemental coagulation for hemostasis. We have observed no significant perioperative or late complications. No significant intraoperative changes in hematocrit or serum electrolytes were documented. In addition to providing acute removal of obstructing prostate tissue, Ho:YAG laser resection allowed tissue specimen to be obtained for histologic examination. A total of 16 of 18 patients (90%) underwent successful removal of their urinary catheter and voiding trial within 24 hours following surgery. Immediate improvement in voiding, comparable to classic transurethral electrocautery resection of the prostate (TURP), was reported by all patients. Ho:YAG laser resection of the prostate appears to be a viable surgical technique associated with minimal morbidity and immediate improvement in voiding.

Citation Download Citation

John N. Kabalin M.D. "Clinical development of holmium:YAG laser prostatectomy", Proc. SPIE 2671, Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems VI, (17 May 1996); https://doi.org/10.1117/12.240021

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