Holmium Laserenucleation of the prostate (HoLEP)

Peeling out

The principle of HoLEP is the enucleation of the prostate. This means that the constricting prostate tissue (adenoma tissue) is peeled out from inside the prostate capsule. The instrument is inserted through the urethra and enucleation is performed with the holmium laser.

Morcellation

Once the adenoma tissue is dissolved, it is morcellated in the bladder. That means, it is sucked in via a special instrument and cut into small tissue pieces. These are rinsed over the shaft and finally sent to the histological examination.

Advantages

The advantage of this surgical method is the complete removal of the obstructing adenoma tissue. This is possible because the surgery is done along the given anatomical layers. Similar to the orange when it is peeled with your finger. As a result, this operation is also significantly less bleeding than, for example, the transurethral resection of the prostate. There are now various tools and methods to perform this operation.

The advantage of the holmium laser lies in its physical property. It is a pulsed laser. The laser energy forms water bubbles that push the tissue in front of the lasertip. Like the finger that dulls the orange peel from the pulp. Of course, the laser can also run sharp cuts – if necessary.

Animated film: Procedure of the operation

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John's testimonial

John is one of my patients who has been operated in 2017. In this testimonial he describes his way before and after surgery.

I am sending my appreciation to him for allowing me to post his interview.

Tobias