What is HoLEP Technology?

The technology behind HoLEP involves using a holmium laser system, specialised surgical instruments, and imaging guidance.

Holmium Laser System

The holmium laser is the key technology used in HoLEP. It emits high-energy pulses of light at a wavelength of 2100 nm, which is highly absorbed by water and tissue, making it ideal for precise tissue ablation.

The holmium laser system consists of a laser generator, a flexible fibre-optic delivery system, and a handpiece with various settings for controlling laser energy, pulse duration, and frequency.

During HoLEP, the laser energy is delivered through a flexible fibre-optic laser fibre inserted into the prostate gland via a cystoscope, allowing the surgeon to precisely target and vaporise obstructive prostate tissue while minimising damage to surrounding structures.

Surgical Instruments

Specialised surgical instruments are used during HoLEP to manipulate, dissect, and remove prostate tissue. These instruments include a resectoscope (a cystoscope with an attached laser), a tissue morcellator (for fragmenting and suctioning prostate tissue), and various grasping instruments.

The resectoscope is inserted into the urethra and advanced to the level of the prostate gland, allowing the surgeon to visualise and access obstructive tissue within the prostate.

The tissue morcellator fragments and aspirates prostate tissue, allowing larger fragments to be removed through the narrow instruments.

Continuous Flow Irrigation

Continuous flow irrigation is used during HoLEP to maintain a clear surgical field, cool the laser fibre, and flush out vaporised debris from the bladder.

A sterile saline solution is infused continuously through the resectoscope and evacuated through a suction channel, ensuring optimal visualisation and efficient removal of prostate tissue during the procedure.

HoLEP Laser Systems

HoLEP can be performed using various holmium laser systems manufactured by different companies, including Boston Scientific (formerly Lumenis). Many companies offer state-of-the-art holmium laser technology designed for surgical procedures like HoLEP.

Examples of high-powered lasers include the VersaPulse® PowerSuite™ Holmium laser system for HoLEP and other urological procedures such as stone surgery.

The VersaPulse PowerSuite laser system features advanced laser technology with high pulse energy, short pulse duration, and variable frequency settings for precise tissue ablation and excellent hemostasis.

The VersaPulse PowerSuite laser system is designed to efficiently vaporise obstructive prostate tissue while preserving the integrity of surrounding structures and minimising the risk of complications.

Boston also offers the Moses™ Holmium laser technology, which enhances the efficiency and safety of holmium laser lithotripsy and HoLEP procedures by optimising energy transmission and reducing movement in stone surgery. 

Urologists worldwide use High-powered Holmium lasers for HoLEP and other urological procedures due to their advanced technology, excellent clinical outcomes, and patient safety profiles.

HoLEP Morcellators

In HoLEP, a morcellator is a critical instrument used to fragment and suction out the prostate tissue that the holmium laser has vaporised. Two commonly used brands of morcellators for HoLEP are Storz (KARL STORZ SE & Co. KG) and Richard Wolf GmbH.

Storz Morcellator

Storz is a well-established medical equipment manufacturer known for producing high-quality surgical instruments and devices.

Storz offers a range of morcellators specifically designed for urological procedures like HoLEP. These morcellators feature cutting-edge design and technology to ensure efficient tissue fragmentation and removal.

Storz morcellators are compatible with various holmium laser systems and can seamlessly integrate into the HoLEP surgical workflow.

Storz morcellators are simple to use and have a high morcellation efficiency rate. 

Richard Wolf (Piranha) Morcellator

Richard Wolf is another reputable manufacturer of surgical instruments and equipment, including morcellators for urological procedures.

Piranha morcellators are designed to complement the HoLEP surgical technique, allowing for efficient and controlled removal of vaporised prostate tissue.

Piranha morcellators feature advanced cutting mechanisms and suction capabilities to facilitate the fragmentation and evacuation of prostate tissue while maintaining excellent visualisation of the surgical field.

Richard Wolf morcellators are known for their reliability, precision, and ease of use, making them a preferred choice among many urologists performing HoLEP procedures.

Storz and Richard Wolf morcellators are widely used by urologists for HoLEP and have demonstrated excellent performance and safety profiles. Both morcellators are designed to enhance the efficiency and effectiveness of HoLEP procedures, leading to improved patient outcomes and satisfaction.