Versacut tissue morcellator

The operation was performed using a 550-um end-firing laser fiber (SlimLine, Lumenis Ltd, Yokneam, Israel) engaged with a 100-w holmium neodymium:yttrium-aluminum-garnet laser (VersaPulse Power-Suite, Lumenis Ltd.). Saline was used as washing fluid, and a Storz 26F (Karl Storz GmbH&Co.,Tuttlingen, Germany) continuous flow resectoscope with a laser bridge was used. A versacut tissue morcellator (Lumenis Ltd.) was used to remove enucleated tissue from the bladder. Specifically, the step-by-step procedures were as following:

TURP was performed as per standard techniques using a 26F continuous flow resectoscope (Storz, Tuttlingen, Germany). Resection was performed using a standard tungsten wire loop with a mono-polar cutting current of 120 W and coagulating current of 80 W. HoLEP was performed as described by Gilling, with some modifications [11 (link)]. After dividing the prostate into anatomical lobes, enucleation of each lobe was performed in a retrograde fashion using a high-powered holmium laser (80–100 W), delivered by a SlimLine 550-mm fiber (Lumenis, Inc., Yokneam, Israel) through the 26F continuous flow resectoscope system. For tissue morcellation and retrieval, we used a 26F nephroscope with a VersaCut Tissue Morcellator (Lumenis, Inc.). PVP was performed using an 80-W potassium-titanyl-phosphate laser delivered by a GreenLight system (GreenLight PV; Laserscope, San Jose, CA, USA). The laser was delivered through a 600-µm side-deflecting fiber. A standard 23F continuous flow resectoscope with a laser bridge was used for this procedure and sterile 0.9% saline solution for irrigation.
TURP and HoLEP were performed on hospitalized patients and PVP was performed in the day-surgery center. In the TURP and HoLEP groups, the urethral catheter was removed on the day urine became sufficiently clear and in the PVP group, on the first postoperative day.