الفهرس | Only 14 pages are availabe for public view |
Abstract The technique of enucleation of the prostate is not a new one and has been used since the advent of open prostatectomy. However, its adoption to an endoscopic procedure represents a paradigm shift in the surgical management of BPH. Although conceptualized originally for the holmium laser, it has become clear that alternative point sources of energy, delivered in a safe manner, might be equally able to achieve the same end of enucleation, with the tissue cleared in a similar manner using the morcellator device. To supplant the holmium laser as a preferred energy source, alternatives would need to provide at least equivalent results with some perceived advantage in outcome measures. In favor of the holmium laser are its versatility (usable in stone, prostatic, and stricture disease) and proven safety and efficacy. It provides appropriate hemostatic and incisional properties, allowing for excellent visibility and tissue clearance during prostate surgery. To its detriment are the initial capital costs and the perception of a significant learning curve, estimated at 20 to 30 cases |