Abstract
Introduction and Objectives:
Since 2010, Herrmann and colleagues 1 introduced thulium laser enucleation of the prostate (ThuLEP) as a versatile minimally invasive enucleation procedure, followed by number of studies that have confirmed its feasibility and efficacy such as holmium laser enucleation of the prostate (HoLEP). Our aim is to present a self-taught, ThuLEP, learning curve for a single surgeon with no previous HoLEP 2 experience.
Methods:
Between February and August 2018, a well-trained endourologist, who did not perform laser enucleation of the prostate before, started reviewing the available literature, attended >15 procedures at another hospital, and participated in 3 laser enucleation of prostate workshop. A total of 18 patients with prostate size between 80 and 120 g underwent ThuLEP for the first time. We used Revolix DUO™ machine with a 40 watt setting for both cutting and coagulation with a 550μm fiber for all cases.
Results:
In the first four cases, the surgeon was unable to completely enucleate the first lobe and ended with open prostatectomy. In the following four cases, one lobe was completely enucleated and morcellated, whereas the other lobe was finished by bipolar resection. The remaining cases were effectively enucleated and morcellated. All patients had a satisfactory voiding outcome with mean Qmax of 24.5 after surgery.
Conclusion:
ThuLEP extraordinary hemostatic effect and its limited penetration depth may allow it to be an appropriate start for a beginner surgeon, while the after effect charring outcome may mask the capsular outline and would be its major drawback that could be avoided with lower watt and limited incisions.
No competing financial interests exist.
Runtime of video: 5 mins 29 secs
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