Laser Surgery

Laser surgery in urology

Laser is an acronym for Light Amplification by the Stimulated Emission of Radiation. Albert Einstein proposed the concept of stimulated emission of radiation but it was not until 1960 that T.H. Maimen produced the first visible light laser.

Recent advances in lasers and fiberoptics make them ideally suited to travel through the smallest tube or cavity in the human body. With widespread use of small-caliber endoscopic instruments, urology has been drastically and positively influenced by this technology, perhaps more so than any other surgical discipline..

How does laser work in surgery ?

Urologistuse lasers for 2 different effects—thermal and mechanical. The most common utilization is the thermal effect, whereby light energy is absorbed and transformed into heat. This lead to tissue protein changes at 42-65°C, the shrinkage of blood vessels at 70°C, cell dehydration at 100°C and finally tissue vaporization at 300°C.

The mechanical effect results, for example, when a very high power laser is directed at a urine stone and a column of electrons is freed rapidly at the stone surface. This creates a plasma bubble that swiftly expands and acts like a sonic boom to disrupt and break the stone.
Our centre specializes in laser surgery and we use laser in three areas: prostate and stone surgery.

Laser prostate surgery

Laser prostate surgeryuses the thermal effect to vaporize enlarged prostate tissue.  We perform Photoselective Vaporization ofProstate using a green light laser. This laser, also known as a potassium-titanyl phosphate (KTP) laser, yields a green visible light beam of 532 nm.
It is a form of minimally invasive endoscopy therapy
. It uses a unique high power laser energy, which is selectively absorbed by blood (hemoglobin) within the prostate tissue. The laser energy is transformed in to thermal energy, leading to vaporization and removal of the tissue. This results in an open the channel for passage of urine from the bladder.
As the laser energy is selectively absorbed by blood, the laser seals blood vessels beneath the area of vaporization, which results in substantially less bleeding, compared to traditional transurethral resection of prostate (TURP) surgery. There are much fewer side effects and recovery is much quicker.

Laser stone surgery

Laser stone surgeryuses the mechanical effect to break all types of stones in the kidney or ureter. It uses a Holmium:YAG (Ho:YAG) that emits a beam of 2150 nm. The laser energy is delivered by a silica fiber in a pulsed manner. Using a thermo mechanical action, it superheats water, which heavily absorbs light energy at this wavelength. This creates a vaporization plasma bubble at the tip of the fiber that expands rapidly and shatters the stone in contact.
The absorption depth in tissue is only 1-2 mm, minimizing damage to the surrounding structures. The laser fiber is introduced via a fine surgical instrument called an ureteroscope, which is placed into the urine passage tube. The ureter stone is identified and broken down by laser by direct contact. Fragmentation with laser is very precise.