New surgical developments in prostate surgery appeared with the frequent use of laser technology. Successful results with popularity created a new method called Holmium Laser Prostatectomy (HoLEP).
HoLEP is a totally endoscopic surgical procedure allowing for the removal of the entire prostate tissue. Results of the surgery are similar to those of open old fashion surgical approach.
This procedure enables the removal of grown prostate tissue from its capsule through normal urinary tract. With the help of a special device, the removed prostate tissue is fragmented in the bladder and taken out.
HoLEP has become the gold-standard surgery in prostate hyperplasia treatment due to its advantages. Both in the USA and Europe, HoLEP has been commonly used during the last decade. Because of the use of 120W holmium laser in this method, a high technological infrastructure is needed. Therefore, a few centers can perform this method in Turkey.
As an energy source, 120W Holmium: YAG laser (Pulse 120H, Lumenis Inc.),550-µm fiber (SlimLine TM 550, Lumenis Inc.) is used. Laser device enables the separation (enucleation) of prostate tissue from its capsule and bleeding is controlled (hemostasis) with a two-pedal control system. Prof. Tunc has organized live surgery courses in Ankara with the participation of many specialists from Germany, Italy and the United Kingdom where HoLEP is widely used. In 2016, he performed live HoLEP surgery at the European Association of Urology (EAU) Urotechnology Unit (ESUT) Congress in Athens with high regards from participants.
Moreover, Prof. Tunc was elected as one of the 30 global HoLEP mentors of the Holmium Academy. (http://holmiumacademy.com/en-us/Training/Mentorship-and-Proctorship)
With his team, Prof. Tunc has performed hundreds of successful HoLEP surgeries in our country. The team has observed appreciation, satisfaction and comfort regarding those patients.
HoLEP can be performed independently from prostate volume and is valid for every prostate size.
Patients who are candidates for prostate surgery are also candidates for HoLEP.
Spinal anesthesia (numbness below waist) is sufficient for the HoLEP procedure. As electric energy for the fragmentation of prostate, laser is used to separate prostatic tissue from its surrounding capsule. Thus, dysuria is not expected during voiding after the urethral catheter is taken out.
There is no tissue corruption as specimen of surgical tissue is obtained without the use of electric energy. Thus, pathologist can easily examine this specimen and it is not possible for him/her to misdiagnose any malignancy.
Nerves passing through both sides of the prostate are associated with sexual functions such as erection. Depth of holmium laser within tissue is at least 0.4mm so healthy tissues are not expected to be subjected to any harm. As a result, those patients are not expected to complain about a potential erectile dysfunction.
Recurrence of the disease is not expected because the prostate tissue is completely removed. With the use of laser, HoLEP is also safe for patients who cannot stop anti-aggregant treatment before the surgery.
Lower bleeding risks, shorter hospital stay and faster recoveryare the main advantages of HoLEP as patients get rid of urethral catheter in a period shorter than 24 hours and return back to their normal lives.
Last but not the least, patients state that they feel like they are back in their 30s.