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Step-by-step HoLEP with Pulse Modulated Technology
Dr. Karin Lehrich performs a Step-by-step HoLEP with Pulse Modulated Technology with the Lumenis Pulse 120H.
Case Record:
- Prostate vol 69 cc
- Post void volume 170 ml
- Flow rate 7 ml/sec
- AUA symptom score 23
Clinical History:
- 72 y.0.patient
- Dysuria, nycturia 2-3 times/night
- BPH, faílure of drug therapy (Tamsulosin)
- Episode of retention
- PSA 0,96 ng/ml
Other History:
Appendectomy
Technique Description:
- 1) 2 - lobe technique
- 2) Continuous flow resectoscope 26 F, passive, 12°optical lense
- 3) 120 Watt Holmium Laser with Moses technology
- 4) Enucleation: 1,2 J, 60 Hz; haemostasis: 1,2 J, 40 Hz
- 5) General anaesthesia
Procedure Steps:
- 1) Omega cut around the veromontanum
- 2) Incision at 5 o`clock towards the bladder neck
- 3) Attaching the median lobe to the right lobe
- 4) Enucleation of the left lobe with early apical release
- 5) Enucleation of the right lobe
- 6) Morcellation
Learning Points:
- 2-lobe technique
- Sphincter protection
- Early apical release
- Anatomical landmarks
