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Urology BPH

Vaporisation(DiVAP)

Vaporisation of prostate with diode laser SALSA URO 250 Watt involves evaporation of the prostate tissue using a curved-ball tip fiber. The fiber must adhere at all times to the surface of the prostate, then we achieve the effect of evaporation. The procedure can be performed with distilled water; however, it is recommended to use normal saline. The use of normal saline prevents the formation of air bubbles, which greatly improves visibility and operator comfort, eliminating the risk of TUR syndrome. The procedure is technically the easiest of all treatments performed with a diode laser, and it is the natural first step for urologists who start working with the laser.

Resection (DiVARP)

Prostate resection using a diode laser SALSA URO 250 Watt consists in removing the prostate “piece after piece”, using a front-firing fibre (bare fiber). The tissue fragments are moved into the bladder, and then mechanically flushed using a syringe or Ellik bladder evacuator.

Vaporization

Enucleation (DiLEP)

For patients with prostatic hyperplasia with a volume in excess of 70 ml, it is recommended to perform enucleation with SALSA URO diode laser. This technique involves the following steps:

  • bilateral incision of the bladder neck,
  • resection of the middle lobe,
  • dissection of the lateral lobes,
  • resection of the lateral lobes,
  • optional resection of the anterior lobe,
  • vaporisation/resection of the residual adenoma,
  • evacuation of the dissected fragments from the bladder.​

Front-firing fibers are used for enucleation. The procedure is done on the border of the prostatic capsule, without interrupting its continuity. This method seems to give the best results in terms of improved maximum flow, reduced IPSS score and post-void residual volume, and most importantly, long-lasting effect of the procedure without the need to repeat.

Enucleation

Hemoglobin and water absorption

The 980nm diode laser recently appeared as an effective source of energy in the treatment of benign prostatic hyperplasia, achieving high absorption simultaneously through hemoglobin and water, due to its wavelength, thus postulating a high ablation capacity as well as good hemostasis. Its 980nm laser wavelength offers the best solution to the urologist, since SALSA URO incorporates in a single device the most advanced technology, both for vaporization and enucleation of the prostate, as well as for other urology indications.

Outcomes

Vaporization of prostate (BHP), before and after – Salsa URO 250 Watt

Bare tip fiber (front-firing fiber) – DiLEP, DiVARP

The advantage of front-firing fibres is the possibility of their repeated use. Fibre “burning-off” during the procedure can be quickly repaired by trimming, and the usable life of the fibre is only limited by its length.

Curved-ball tip fiber – DiVAP

The Curved-ball tip fiber is the new generation of urology contact fibers, developed especially for a safe and effective contact treatment of prostate with high-power laser. The Hook Shot™ fiber offers the maximum profitability for the urologist: because of its solid construction, the fiber stands long surgeries of big size prostates without any degradation affecting the procedure.

With Curved-ball tip fiber is the surgery faster than with other traditional fibers. User friendly shape of the fiber tip, allowing thus to treat the upper end of prostate without any view obstruction in a radius of 360°. This fiber simulates the hand of the surgeon thanks to the precise manipulator and ergonomic design, allowing a perfect control of the applied force and gives a Good feedback to the surgeon.

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