980nm 1470nm Urology Laser Treatment BPH

Urology Laser Treatment

In the past few decades, laser technology has been increasingly recognized in the treatment of urological diseases such as benign prostate hyperplasia (BPH), bladder tumors, urolithiasis, urinary tract stricture, and renal cell carcinoma. The first article reporting the application of laser in urology treatment was written by STAETHLER in 1976. Today, with the development of technology, the advancement of equipment, manufacturers’ better understanding of the clinical needs of urologists, and the continuous accumulation of surgical experience by urologists, laser technology has begun to challenge traditional surgical methods.

Benign Prostate Hyplerlapsia (BPH)

Benign Prostate Hyplerlapsia (BPH) is one of the most common diseases of the urinary system.The pathology of BPH is that the epithelial cells and mesenchymal stromal cells of the migratory zone of the prostate around the posterior urethra of the male appear to be hyperplastic and hypertrophic, and nodular adenomatous tissues are formed, which will compress the rest of the gland and form the so-called “surgical envelope” in the surgery, there is a clear boundary between them, it is the sign of prostate surgery, inward compression leads to the prolongation of the posterior urethra, narrowing and deformation and increased urethral resistance, which leads to increased pressure in the bladder and the associated obstruction of urinary function.

Bladder Tumors

DILRBT(Diode laser resection of bladder tumor) is one of the most established urological procedures for the treatment of the primary non-muscle-invasive bladder cancer (NMIBC). The efficacy of diode laser technology, such as the 980-nm and 980-/1470-nm systems, in bladder tumor ablation is of considerable interest because of its capacity to minimize complications compared with conventional TURBT. Previous studies have suggested that laser en bloc resection may be superior to conventional TURBT in terms of diminished complication and recurrence rates. Moreover, the precise tumor stage and grade obtained through laser en bloc resection can provide further insight into the effectiveness of this form of treatment.

Prostate Tumors

About 81.5% of patients with advanced prostate cancer suffer from urinary retention, and 90.2% suffer from bladder outlet obstruction (BOO). For patients with limited prostate cancer (tumour inside the prostate peritoneum) and those who have contraindications to surgery and radiotherapy, local ablation of the prostate is definitely a good choice. Focal laser ablation (FLA), It is a new technology in local ablation, and laser equipment has many advantages over other equipment, such as easy transport, flexible energy output, and small space occupied by the instrument.

Stricture

When the urethra is subjected to different traumas, the most basic pathological changes are fibrotic changes in the mucosal and submucosal layers of the urethra to varying degrees. Injury to the urethral mucosa can result in scarring repairs, especially when the injury is deeper and reaches the muscularis propria, which can cause scarring and lead to urethral stricture. Laser technology, however, has a relatively good ability to vaporize the hard scar tissue completely, with no collateral damage to the normal urethral tissue under proper operation, and at the same time cuts the urethral tissue under the scar with millimetre-level fineness, so that the urethral mucosa grows back again, avoiding the formation of scarring again.

Laparoscopic Partial Nephrectomy (LPN)

Compared with conventional laparoscopic partial nephrectomy, laparoscopic laser partial nephrectomy does not require clamping the renal artery, which avoids renal ischemic injury and enables the operator to resect the tumour tissues with ease. There is no need to convert various kinds of luminal instruments in the intraoperative operation, which avoids cumbersome preparation and operation of the instruments in the operation. The laser operation requires the operator to have a certain amount of spatial imagination in judging the position of the tumour and the depth of cutting, so that the laser can resect the tumour along the edge of about 0.5cm.

980nm 1470nm Diode Laser in Urology Laser Treatment

The 980nm laser is at the end of the absorption curve by haemoglobin, there is a lower haemoglobin absorption rate, at the same time, the laser is also located in the laser by the water absorption of a small low peak, so the 980nm laser can be absorbed by both water and haemoglobin.

The 1470nm near-infrared laser is at the position of a water absorption peak in the laser absorption spectrum, and the water absorption is 40 times that of 980nm. When it is absorbed by the water in the tissue, it causes its temperature to rise rapidly, resulting in a cell bursting effect, so it is capable of high-precision vapour cutting, in addition, the 1470nm semiconductor laser also has the characteristics of double absorption of haemoglobin and water, and the efficiency of its vapor cutting, hemostasis is also more thorough. The coagulation layer produced during vapor cutting is 0.4-0.6mm, causing little damage to healthy tissue.

The 1470nm laser was initially designed to meet the demand for surgical treatment of benign prostatic hyperplasia, which is by far the most widely used field in urology. Based on the advantages of small trauma, low bleeding, easy operation, and no local electric field effect, the 1470nm laser has also been applied to the surgical treatment of non-muscle invasive bladder tumours, and has achieved satisfactory results.

Clinical Advantages of Urology Laser Surgery

Controlled and focussed penetration depth with less thermal spread.
Excellent hemostatic properties,clear vision,and delicate surgical operations.
Atraumatic fiber tip enables a smooth insertion and protects the working channel.
The fastest possible soft tissue vaporization, which effectively removes unwanted tissue while ensuring zero damage to the preserved tissue.
Easy to operate, shortening the operation time and reducing the probability of complication.

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