Tulio Laser

What is the Tulio Laser?

Tulium laser for prostate enucleation

Since the first Holmium laser enucleation of the prostate (HoLEP) in 1995, several laser treatments for benign prostatic hyperplasia (BPH) have been developed that have become potent challenges to the standard reference surgical techniques. In this regard, Thulium Laser Enucleation of the Prostate, also known as ThuLEP, is one of the optimal minimally invasive surgical options to treat this pathology.

Tulio laser enucleation of the prostate, like the HoLEP technique, consists of complete removal of the prostatic adenoma through the urethra. The hyperplastic tissue is dissected, the pathological adenoma is separated from the prostate capsule and, at the same time as the adenoma is dissected, the blood vessels are sealed, preventing bleeding. The adenoma is introduced into the bladder, where it is crushed by an apparatus called a morcellator, and from there it is removed.

The difference between Tulium and Holmium lasers lies in the wave frequency. While that of the Holmium laser is pulsed, that of the Tulium laser is continuous. This makes the Tulium laser more effective in cutting but makes it difficult to identify surgical planes.

Tulium laser enucleation of the prostate is a surgical technique suitable for all prostate sizes, and manages to remove the entire adenoma in its entirety, without leaving tissue remnants that may cause future recurrences. It is, therefore, a minimally invasive, definitive and effective solution that achieves the same functional results as open surgery, but minimizing the complications of the intervention. In addition, it makes it possible to treat other concomitant pathologies such as bladder tumors or urethral stenosis, and to submit the removed tissue to histopathological analysis to diagnose the presence of an incidental prostate tumor in patients with no previous data of suspicion for this disease. The disadvantage with the Holmium laser is that it does not allow stone breaking.

Tulium laser for lithofragmentation

The Thulium Laser is a very efficient and effective technology for lithotripsy, that is, to break stones formed in the kidney, bladder or ureter into tiny pieces that will then be expelled through the urine.

The 3 elements to understand why the Thulium laser is poised to become the ultimate tool for next-generation lithofragmentation are: it uses smaller fibers, lower energy and high pulse rate.

Although the holmium laser is still considered the "gold standard" technique in lithofragmentation, it has some limitations in terms of the size of the fragments generated and the speed of pulverization that the Tulium laser solves by using smaller fibers, lower energy and high pulse frequency. This combination results in higher ablative capacity, higher powder production capacity, faster fragmentation and lower back-pulsing.

In our Lithiasis unit we have this technology, and we are pioneers in Spain in the use of thulium laser applied to lithiasis, having performed more than 70 lithotripsies with superpulsed thulium laser with excellent results.