Mp62-17 Increased Oscillation Rate Improves Morcellation Efficiency in Holmium Laser Enucleation of the Prostate

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology IV (MP62)1 May 2024MP62-17 INCREASED OSCILLATION RATE IMPROVES MORCELLATION EFFICIENCY IN HOLMIUM LASER ENUCLEATION OF THE PROSTATE Cameron McCaline, Max Shelton, Andrew Adeola, David Dalton, Austen Slade, R. J. Caras, Deepak Agarwal, and Marcelino Rivera Cameron McCalineCameron McCaline , Max SheltonMax Shelton , Andrew AdeolaAndrew Adeola , David DaltonDavid Dalton , Austen SladeAusten Slade , R. J. CarasR. J. Caras , Deepak AgarwalDeepak Agarwal , and Marcelino RiveraMarcelino Rivera View All Author Informationhttps://doi.org/10.1097/01.JU.0001008904.63948.3b.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Tissue morcellation has become increasingly efficient, yet remains a rate limiting step in holmium enucleation of the prostate (HoLEP). Limited data exists on how the rate of oscillation by the morcellator blades affects morcellation efficiency (ME). METHODS: A retrospective review was performed of our HoLEP procedures performed by two surgeons from 7/1/2019 to 8/25/2022. All morcellation was performed with the Wolf Piranha device and enucleation was performed with Moses 2.0 technology. Surgeon 1 routinely uses 1500 oscillations/min (low rate) and Surgeon 2 uses a rate of 6000 oscillations/min (high rate). The primary endpoint was morcellation efficiency (grams/minute). Secondary endpoints include enucleation efficiency, mean tissue specimen weight, and preoperative prostate volume. The data was also subgrouped into <80 gm, 80-150 gm, and >150 gm specimen to delineate any differences based on amount of tissue. RESULTS: 894 HoLEPs were analyzed, 302 by Surgeon 1 and 592 by Surgeon 2. Surgeon 2 had larger preoperative prostate volumes (126 vs 101; p<0.001) and specimen tissue weights (86.0 vs 61.1; p<0.001). Morcellation time was longer in the low rate group (11.3 vs 6.1 min, p<0.001) and ME was lower in the low rate group (9.3 vs 12.1 g/min, p<0.001). The difference in ME was inversely proportional to specimen weight. When the data was sub-grouped by intraoperative resected tissue weight, there was a significant difference for LR and HR groups <80 grams (9.63 vs 12.81 g/min; p<0.001) and 80-150 grams (8.90 vs 10.60 g/min, p<0.001); however, there was no difference above 150 grams (8.66 vs 9.36 g/min; p=0.339). CONCLUSIONS: Increased oscillation rate during morcellation leads to a decrease in morcellation time and increased morcellation efficiency during prostate enucleation. Future prospective studies will serve to evaluate this finding across a larger numbers of institutions, and evaluate ways to increase ME in large prostate cohorts (i.e. >150 gms). Download PPTDownload PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1028 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Cameron McCaline More articles by this author Max Shelton More articles by this author Andrew Adeola More articles by this author David Dalton More articles by this author Austen Slade More articles by this author R. J. Caras More articles by this author Deepak Agarwal More articles by this author Marcelino Rivera More articles by this author Expand All Advertisement PDF downloadLoading ...