Simulator Trains Surgeons in Holmium Laser Enucleation of the Prostate

A computer-guided interactive Holmium Laser Enucleation of the Prostate (HoLEP) training simulator allows more physicians to be trained on the procedure.

The HoLEP surgical training simulator works by displaying haptically and graphically deformable virtual prostates to the surgeons, using computer-based three-dimensional (3D) modeling procedures. By using the simulator, surgeons can practice HoLEP, based on the Lumenis VersaPulse PowerSuite laser with the VersaCut Morcellator system. HoLEP has been shown to provide superior outcomes and long-term durability in treating benign prostatic hyperplasia (BPH) of all gland sizes; bladder calculi, if present, are easily vaporized by the holmium laser at the same time. Utilizing this technique, even the largest of glands can be effectively treated with minimal morbidity. However, the learning curve remains an obstacle, preventing more widespread adoption of the technique, which created the demand for a training simulator. The Lumenis VersaPulse PowerSuite laser, the VersaCut Morcellator system, and the HoLEP training simulator are all products of Lumenis (Yokneam, Israel).

"The HoLEP simulator is the future of surgical training,” said James Lingeman, M.D., a clinical professor of urology at Indiana University School of Medicine (Indianapolis, USA). "This learning approach allows physicians to practice the procedure and first achieve a standard level of competence before operating live. This new training technology will benefit physicians and patients alike.”

"The clinical data supporting the superiority of the HoLEP procedure is significant,” said Dov Ofer, CEO of Lumenis. "Lumenis is committed to providing the state-of-the-art training tools so that more urologists can become proficient with the HoLEP procedure and make it available to patients worldwide.”

Holmium lasers are ideal for precisely and cleanly ablating without charring or overheating tissue, since the holmium absorption depth is only 0.5 mm or less. This causes the tissue to be ablated rapidly, before it can conduct heat, which minimizes thermal damage to the surrounding healthy tissue. Additionally, the localized coagulation effect of the holmium laser "seals” the tissue and provides hemostasis and fluid absorption that have been found to be superior to electrocauterization.

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