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Choosing a Laser
Laser Comparison Table What the Researchers are Saying Non-Clinical Considerations
What the Researchers are Saying
“In this statistically well powered randomized prospective trial, the authors have compared thulium laser prostatectomy (ThLRP) to TURP. Over a follow up of 12 months, they reported equal efficacy of the two techniques and decreased catheterization time, blood loss and hospital stay in favor of the thulium laser. Unlike KPT ThLRP retrieves prostatic tissue for biopsy, has a shorter learning curve than HoLEP. The operative technique most closely resembles TURP as compared with other lasers. Before this technique becomes widely accepted we await experience from other centers with longer follow up. However it is becoming increasingly evident that TURP is facing genuine competition and might be replaced as the gold-standard in minimally invasive surgery of the prostate.”
D. Dubey et al. in a commentary referencing work by; Xia et al., Eur Urol. 2008 Feb;53(2):382-89. Epub 2007 Jun 4.
Thulium laser versus standard transurethral resection of the prostate: a randomized prospective trial.
“The increase in HoLEP expertise worldwide and the development of lasers that are faster at ablating tissue and have other urological uses (eg thulium) may threaten the longevity of Greenlight PVP.”
Department of Urology, Addenbrooke's Hospital, Cambridge, UK. tevita.aho@addenbrookes.nhs.uk

“As we resected the prostate, the pieces were vaporized, sufficiently small to be evacuated through the resectoscope sheath, and the use of the mechanical tissue morcellator was not required. The excellent hemostasis of the thulium laser ensured the safety of TmLRP-TT [TmLRP-TT Thulium Laser Resection of the Prostate by Tangerine Technique*].”
“This procedure, which takes less operative time than standard techniques, is safe and combines efficient cutting and rapid organic vaporization, thereby showing the great superiority of the thulium fiber laser in the treatment of BPH. It has been proven to be as safe and efficient as transurethral resection of the prostate (TURP) during the 1-year follow-up.”
“It [The thulium laser*] has many advantages over the Ho:YAG, including improved spatial beam quality, more precise tissue incision and operationin optional continuous- or pulse-wave modes.”
*Added for clarification
Xia SJ.
Department of Urology, First People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200080, China. xsjurologist@163.com 

“In this standardized ex-vivo investigation, the 2-microm CW thulium laser offered a higher tissue ablation capacity and similar hemostatic properties as those of the KTP laser, and in comparison to TURP both tissue ablation and the bleeding rate were significantly reduced.”
Wendt-Nordahl G, Huckele S, Honeck P, Alken P, Knoll T, Michel MS, Häcker A.
Department of Urology, University Hospital Mannheim, Mannheim, Germany. gunnar.wendt-nordahl@uro.ma.uni-heidelberg.de

“TmLRP [Thulium Laser Resction of the Prostate*] is a safe and efficient procedure in treatment of BPH”
*Added for clarification
Xia SJ, Zhang YN, Lu J, Sun XW, Zhang J, Zhu YY, Li WG.
Institute of Urology, Shanghai Jiaotong University, First People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200080, China. 

“TmLRP-TT is an almost bloodless procedure with high efficacy and little perioperative morbidity. TmLRP-TT is superior to TURP in safety and is as efficacious as TURP in 1-yr follow-up. It is a promising technology in the clinical practice field.”
Xia SJ, Zhuo J, Sun XW, Han BM, Shao Y, Zhang YN.
Department of Urology, First People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200080, China. xsj@citiz.net

“The treatment of benign prostatic hyperplasia (BPH) with the Revolix [Thulium*] laser is effective. Its versatility enables 2 types of techniques: vaporresection and vaporization. Its chromophore target is water, like the holmium laser, with the difference that it may be used in both a continuous and pulsed mode. The continuous wave enables a precise cut and excellent hemostasis without diffusion to the neighbor tissues (0.2 mm penetration below the cut zone) with an excellent vision of the operative field”
“…the Revolix [Thulium*] laser has demonstrated being safe, easy to install, with low operative cost, and a very short learning curve. Its efficacy may be better demonstrated using vapor resection for big prostates and vaporization for smaller prostates (the smaller than 35 g). The reduction of prostatic tissue is intermediate with a slight post operative discomfort and a low complication rate.”
*Added for clarification
Mattioli S, Muñoz R, Recasens R, Berbegal C, Cortada J, Urmeneta JM, Teichmann H.
Instituto Clinico San Ambrogio, Milan, Italia


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