En Bloc Enucleation of the Prostate Using a Surgical 532-nm Laser (GreenLEP) Technique: Initial Results

Abstract

Objectives:

To describe 532-nm Green laser enucleation of the prostate (GreenLEP) and assess its feasibility, safety, and short-term outcomes.

Patients and Methods:

Thirty consecutive patients with a prostate volume >80 cc and who underwent GreenLEP (by one surgeon) between July 2013 and March 2014 were prospectively evaluated. GreenLEP was conducted using the GreenLight HPS^™ device (AMS, Minnetonka, MN), and morcellation was conducted using a Wolf^™ morcellator. Clinical data on preoperative assessment, operative characteristics, and postoperative assessments of 6- to 12-month functional outcomes and complications were entered into a database.

Results:

GreenLEP was conducted effectively in all but one case, necessitating a conversion into open surgery for adenoma and clot removal. The median operative time was 60 minutes (range: 50–100). Perioperative complications included perforation of the prostatic capsule in five cases. The median hospital stay was 2 days (range: 2–5). Nine-month follow-ups found that the International Prostate Symptom Score and postvoid residual volume decreased after the procedure, whereas the maximum urinary flow rate was greatly improved. The median enucleated tissue weight was 80 g (range: 50–110) (overall, 80% reduction in initial prostate volume). There were five postoperative cases of transient urinary incontinence. The main limitations were a short follow-up period and the absence of a comparison arm.

Conclusions:

GreenLEP is feasible and safe for the surgical management of benign prostatic obstruction in patients with a prostate volume >80 cc. Further studies are warranted to assess the potential role of GreenLEP in the surgical armamentarium.

No competing financial interests exist.

This video was presented at the 108th National Congress of the French Association of Urology in November 2014.

Runtime of video: 9 mins 41 secs