World Journal of Urology, 2010, Vol.28(2), pp.181-186
Byline: Felix Wezel (1), Gunnar Wendt-Nordahl (2), Nina Huck (1), Thorsten Bach (1), Christel Weiss (3), Maurice Stephan Michel (1), Axel Hacker (1) Keywords: Benign prostatic enlargement; Diode laser; KTP laser; TURP; Minimal invasive Abstract: Purpose Several diode laser systems were introduced in recent years for the minimal-invasive surgical therapy of benign prostate enlargement. We investigated the ablation capacities, hemostatic properties and extend of tissue necrosis of different diode lasers at wavelengths of 980, 1,318 and 1,470 nm and compared the results to the 120 W GreenLight[TM] HPS laser. Methods The laser devices were evaluated in an ex vivo model using isolated porcine kidneys. The weight difference of the porcine kidneys after 10 min of laser vaporization defined the amount of ablated tissue. Blood loss was measured in blood-perfused kidneys following laser vaporization. Histological examination was performed to assess the tissue effects. Results The side-firing 980 and 1,470 nm diode lasers displayed similar ablative capacities compared to the GreenLight[TM] HPS laser (n.s.). The 1,318-nm laser, equipped with a bare-ended fiber, reached a higher ablation rate compared to the other laser devices (each P 〈 0.05). A calculated 'output power efficiency per watt' revealed that the 1,318-nm laser with a bare-ended fiber reached the highest rate compared to the side-firing devices (each P 〈 0.0001). All three diode lasers showed superior hemostatic properties compared to the GreenLight[TM] HPS laser (each P 〈 0.01). The extend of morphological tissue necrosis was 4.62 mm (1,318 nm), 1.30 mm (1,470 nm), 4.18 mm (980 nm) and 0.84 mm (GreenLight[TM] HPS laser), respectively. Conclusion The diode lasers offered similar ablative capacities and improved hemostatic properties compared to the 120 W GreenLight[TM] HPS laser in this experimental ex vivo setting. The higher tissue penetration of the diode lasers compared to the GreenLight[TM] HPS laser may explain improved hemostasis. Author Affiliation: (1) Department of Urology, Mannheim Medical Center, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany (2) Department of Urology, Hospital Sindelfingen-Boblingen, Arthur-Gruber-Str. 70, 71065, Sindelfingen, Germany (3) Department of Medical Statistics, Faculty of Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany Article History: Registration Date: 11/12/2009 Received Date: 02/08/2009 Accepted Date: 10/12/2009 Online Date: 25/12/2009 Article note: F. Wezel and G. Wendt-Nordahl have contributed equally to this work.
Benign prostatic enlargement ; Diode laser ; KTP laser ; TURP ; Minimal invasive
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