Increased oscillation rate may improve morcellation efficiency in HoLEP

Area of Science:

• Urology
• Surgical Technology
• Medical Devices

Background:

• Holmium enucleation of the prostate (HoLEP) is a leading BPH treatment.
• Tissue morcellation is a critical but time-consuming step in HoLEP.
• Limited data exists on the impact of morcellator oscillation rate on efficiency.

Purpose of the Study:

• To investigate the effect of morcellator oscillation rate on morcellation efficiency (ME) during HoLEP.
• To compare ME between low-rate (LR) and high-rate (HR) morcellation.
• To analyze secondary outcomes such as enucleation efficiency (EE) and procedure time.

Main Methods:

• Retrospective review of 894 HoLEP procedures performed by two surgeons.
• Morcellation performed using Wolf Piranha device; enucleation with Moses 2.0 technology.
• Surgeons used distinct oscillation rates: Surgeon 1 (LR: 1500 oscillations/min), Surgeon 2 (HR: 6000 oscillations/min).

Main Results:

• High oscillation rate (HR) group demonstrated significantly higher ME (12.1 g/min) compared to the low oscillation rate (LR) group (9.26 g/min).
• Morcellation time was substantially shorter in the HR group (6.09 min) versus the LR group (11.3 min).
• Enucleation efficiency (EE) was higher in the LR group, and ME was inversely proportional to specimen weight.

Conclusions:

• Increased morcellator oscillation rate during HoLEP may decrease morcellation time and enhance ME.
• Findings suggest optimizing oscillation rate is crucial for improving HoLEP efficiency.
• Further multi-institutional studies are needed to validate these findings and explore ME enhancement in large prostates.