Surgery

Biography

Biography: Tawfik A Zein

Abstract

Fifty patients were evaluated in our clinic for symptoms of bladder outlet obstruction and were scheduled for laser ablation of the prostate utilizing the Protouch 1470 laser.

All patients failed medical treatment, five presented with urine retention.  Preoperative evaluation included ultrasound, cystoscopy, flow rate and the BPH scoring system.

Operative time was markedly shorter than the gold standard TURP.  Time of resection ranged from ten minutes to 45 minutes depending on the size of the prostate. The glands ranged in size between 30gms and 120gms.

No intraoperative complications took place and no post-operative bleeding was noted. No post-operative fluid absorption was verified by post-operative blood work and no patient demonstrated an altered mental status while being observed at the hospital. All patients ate on the same day of surgery and were ambulated when spinal anesthesia worn off. Most patients had spinal anesthesia unless contraindicated or refused by the patient.

All patients left the hospital following an overnight stay.  The Foley catheter was removed on the second morning before discharge except in two patients; no manual bladder irrigation was needed. No patient presented to Emergency Department after discharge with bleeding or other complications.

The technology used for these procedures was the Protouch 1470 Diode Laser, which is manufactured by Convergent Laser Technologies located in Alameda, CA. The Protouch operates on the 1470 wavelength. The wattage ranged from 85 to 100, the recommended setting is 90 watts. A setting of 45 watts in Super Pulse mode was found to be optimal for the resection of bladder tumors.

This laser can be used in any operating room that has a standard 110V line. It reduces hospital expenses through decreased intraoperative times and reduced lengths of stay for patients