Laser vaporization of the prostate in vivo: Experience with the 150-W 980-nm diode laser in living canines
✍ Scribed by Malte Rieken; Hyun Wook Kang; Ed Koullick; George R. Ruth; Alexander Bachmann
- Publisher
- John Wiley and Sons
- Year
- 2010
- Tongue
- English
- Weight
- 201 KB
- Volume
- 42
- Category
- Article
- ISSN
- 0196-8092
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✦ Synopsis
Abstract
Background and Objective
Anatomic, tissue ablation and coagulation, and histopathologic outcomes of the 150‐W 980‐nm diode laser selective light vaporization (SLV™) of the prostate in the first survival study of living canines were analyzed.
Study Design/Materials and Methods
Ten dogs underwent anterograde SLV™ with the 150‐W 980‐nm laser delivered by its side‐firing fiber (Fusion™). Postoperatively, two dogs were euthanized at 3 hours as planned, six at 2–7 days due to complications, and two, without complications, at 8 weeks as planned. Laser energy and time were recorded. Prostates were sectioned, measured, and histologically analyzed after hematoxylin and eosin (H&E), triphenyltetrazolium chloride (TTC), or Gomori trichrome (GT) staining.
Results
SLV™ acutely and hemostatically created a 0.6 ± 0.3 cm^3^ cavity in the 3‐hour group accompanied by H&E‐ and TTC‐identified coagulation necrosis of up to 9.5 mm (6.1 ± 1.2 mm) that led to prostatic slough‐induced obstruction and perforation in six of eight (75%) surviving animals, necessitating unplanned euthanasia within 2–7 days. H&E‐ and GT‐stained prostates at 8 weeks postoperatively showed large (9.6 ± 1.4 cm^3^) re‐epithelialized prostatic cavities with persistent diffuse interstitial Prostatitis and collagenous fibrosis.
Conclusion
SLV™ with the 150‐W 980‐nm diode laser in living canines produced small cavities acutely, and was accompanied by deeply necrotic prostatic slough‐induced obstruction and perforation in a majority of animals. A minority survived SLV and had favorable anatomic outcomes whereas histology revealed persisting inflammation. Further in vivo studies and a cautious clinical approach are recommended to finally evaluate the potential of SLV™ with the 150‐W 980‐nm diode laser. Lasers Surg. Med. 42:736–742, 2010 © 2010 Wiley‐Liss, Inc.