Technical innovations

Holmium Laser Enucleation of the Prostate (HoLEP): A Technical Update

Ramsay L Kuo¹ , Ryan F Paterson¹ , Samuel C Kim¹ , Tibério M Siqueira Jr¹ , Mostafa M Elhilali² and James E Lingeman¹

¹  Methodist Hospital Institute for Kidney Stone Disease and Indiana University School of Medicine Indianapolis, Indiana, USA

²  The Department of Urology McGill University Faculty of Medicine Montreal, Quebec, Canada

author email corresponding author email

World Journal of Surgical Oncology 2003, 1:6doi:10.1186/1477-7819-1-6

Published:	6 June 2003

Abstract

Introduction

Holmium laser enucleation of the prostate (HoLEP) combined with mechanical morcellation represents the latest refinement of holmium:YAG surgical treatment for benign prostatic hyperplasia (BPH). Utilizing this technique, even the largest of glands can be effectively treated with minimal morbidity. The learning curve remains an obstacle, preventing more widespread adoption of this procedure. This paper provides an outline of the HoLEP technique as is currently used at two centers in hopes of easing the initial learning curve.

Technical considerations

Detailed descriptions of the major steps of the HoLEP procedure are provided with attention to critical steps such as identification of the surgical capsule, median and lateral lobe enucleation, and morcellation of enucleated tissue.

Conclusions

HoLEP is a promising alternative for the surgical treatment of BPH which allows complete removal of intact lobes of the prostate. Obstruction is relieved immediately with superior hemostasis, no risk of TUR syndrome, and a minimal hospital stay.