How is the procedure performed?
This is normally performed under general or spinal anaesthetic. The bladder is inspected with a small telescope then a laser fibre is inserted down the telescope, connected to a 80-100 Watt Holmium laser (pictured right).
The laser is used to cut the prostate away from its surroundings, releasing the prostate tissue in several large "chunks" which wash forward into the bladder. The laser also allows sealing of any blood vessels encountered during the procedure.
Once the prostate has been cleared, a morcellator is inserted down the telescope to "chew up" the prostate tissue in the bladder and to extract it for microscopic analysis in the pathology laboratory.
Video - Holmium laser enucleation of the prostate (HoLEP)
Features of this video (courtesy of Mr Tevita Aho)
- The laser fibre (blue)
- The laser beam marked by a red "pilot" laser to allow it to be seen
- Separation of the prostate and release into the bladder
- At the end of the video, "morcellation" of the prostate tissue and extraction by suction down the morcellator tubing