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Proceedings Paper

Perspectives of holmium laser resection of the prostate: cutting effects with the holmium:YAG laser
Author(s): Rolf H. Eichenauer; Gerit Droege; Ralf Brinkmann; Malte Neuss; Evariste Gafumbegete; Dieter Jocham
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Paper Abstract

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/vaporization effects) was analyzed with regard to pulse energy (speed of incision, angle of incision) and fiber diameter. Fast flash photography was performed to analyze 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 syndrome, short time for catheterization. Further technical approvement may significantly improve holmium laser prostate resection. We present a new application system for the laser resection.

Paper Details

Date Published: 1 July 1998
PDF: 11 pages
Proc. SPIE 3245, Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems VIII, (1 July 1998); doi: 10.1117/12.312271
Show Author Affiliations
Rolf H. Eichenauer, Medical Univ. Luebeck (Germany)
Gerit Droege, Medical Laser Ctr. Luebeck GmbH (Germany)
Ralf Brinkmann, Medical Laser Ctr. Luebeck GmbH (Germany)
Malte Neuss, Medical Laser Ctr. Luebeck GmbH (Germany)
Evariste Gafumbegete, Medical Univ. Luebeck (Germany)
Dieter Jocham, Medical Univ. Luebeck (Germany)


Published in SPIE Proceedings Vol. 3245:
Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems VIII
Graham M. Watson; Harvey Lui; Lou Reinisch; Penny J. Smalley; Kenneth Eugene Bartels; R. Rox Anderson; Lawrence S. Bass; Kenneth Eugene Bartels; C. Gaelyn Garrett; Lloyd P. Tate; Sharon L. Thomsen; Reza S. Malek; Aaron P. Perlmutter; R. Rox Anderson; Lawrence S. Bass; C. Gaelyn Garrett; Kenton W. Gregory; Harvey Lui; Reza S. Malek; Aaron P. Perlmutter; Lou Reinisch; Penny J. Smalley; Lloyd P. Tate; Sharon L. Thomsen; Graham M. Watson, Editor(s)

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