Visual Laser Ablation of the Prostate (VLAP) Using a Rotational Technique

Abstract

We describe here a new operative technique for performing visual laser ablation of the prostate in which neodymium:YAG (Nd:YAG) energy is applied continuously by a laser fiber rotating around a central point. Delivering 40 W of power for 4 min using a new angle-delivery device (Urotek™) produced results comparable to those of other previously reported techniques with two added advantages: (1) a more even application of heat resulting in non "popcorn" effect and (2) a more reliably predictable area of coagulative necrosis within a given axial plane. These advantages translate to a reduced likelihood of prostatic capsular rupture or bleeding caused by entering a venous sinus and a more consistent and uniform ablation of prostatic tissue in the axial plane. This technique should provide additional safety for the urologist performing transurethral laser ablation of the prostate.