Laser-therapy - Boston Scientific

The GreenLight XPS™ Laser Therapy System is a 180W, 532nm wavelength laser for the treatment of benign prostatic hyperplasia (BPH) and uses the GreenLEP technology. The clinical benefits of the GreenLight™ Laser Therapy experience in treating benign prostatic hyperplasia (BPH) have been well documented in over 1,000 publications.¹

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Benefits of GreenLight™²:

Equivalent outcomes to transurethral resection of the prostate (TURP)
Fewer serious adverse events
Shorter patient recovery
Faster return to stable health
Cost-effective treatment option³

“It is an effective therapy with very little side effects”

Dr. med. Claus Brunken, Department of Urology, Asklepios Westklinikum Hamburg, Germany

The technology

Laser vaporisation uses higher-density laser thermal energy. GreenLight™ Laser Therapy combines an optimal 532 nm wavelength with advanced laser technology for the safe, effective and efficient treatment of BPH^2-5. 180 watts of maximum power output allows for efficient lasing. The FiberLife™ automatic safety system feature helps to detect conditions such as excessive heat before they cause fibre damage.

In addition, TruCoag™ haemostatic control feature uses pulsating light to cauterize ruptured vessels, reducing bleeding fast and in multiple situations.⁴ Lastly, what makes GreenLight so efficient is the MoXy™ Liquid Cooled Fibre with Active Cooling Cap™ technology, allowing for saline flow over and around the fiber to help minimize power loss from fibre tip degradation.⁵

Technology animation video

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“For patients with comorbidities, GreenLight shows less risk of bleeding during the procedure, whereas with TURP, you have a high risk of bleeding and a high risk of re-intervention after this, the surgery”

Dr. med. Hannes Cash, Department of Urology, Charité, Berlin, Germany

Watch Dr. med. Hannes Cash, Department of Urology, Charité, Berlin, Germany, talking about patients’ comorbidities

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Contraindications

The laser system is contraindicated for patients who:

are contraindicated for surgery
have calcified tissue
require haemostasis in >2mm vessels
have uncontrolled bleeding disorders
have prostate cancer
have acute urinary tract infection (UTI)
have severe urethral stricture
when appropriate anesthesia is contraindicated by patient history
when laser therapy is not considered the treatment of choice

Side effects

Possible risks and complications include, but are not limited to:

Haematuria
Short term dysuria
Urinary tract infections
Irritation of the urethra and of the bladder
Retrograde ejaculation

Are you interested in learning more about GreenLight™?

A workshop offered by Boston Scientific includes procedural videos regarding GL vaporisation, GL enucleation and dedicated hands on training with our new GreenLight XPS™ simulators, on which new users can familiarise themselves with the fundamentals of efficient vaporisation. We review the data for patient outcomes and safety, providing virtual reality and wet-lab simulation of the techniques. The workshop is intended for surgeons who plan to adopt GreenLight laser vaporisation into their practice.

Training and educational offer

Live Surgeries

Find out when Boston Scientific performs their next live surgery and see how the technology is used throughout the procedure.

Auriga XL™ – the no-incision treatment⁷

The second laser technique is enucleation. Some differences were noted between the two techniques (GreenLEP and HoLEP), including the finding that GreenLEP was associated with a tendency towards a shorter learning curse compared with HoLEP.⁶ The Auriga XL laser can be used to perform HoLEP procedures.

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The technique - HoLEP⁷

The Auriga™ XL is a universal, 50 watt holmium laser that delivers high-peak pulse output and performs a range of benign prostatic hyperplasia (BPH) procedures.
It delivers up to 50 watts – with a maximum of 25Hz and 4200mJ of high-peak pulse energy. The laser automatically detects the type of LightTrail™ Fiber connected, creating a precise optical fit between fiber and console. An adjustable green aiming beam helps to visualize the surgical target.

Indications

Any patient suffering from BPO (any prostate volume, normal PSA, Qmax <15 ml/sec, IPSS>10, PVR <300 cc) can undergo HoLEP.

For the first HoLEP cases, it is better to choose medium-sized prostates (about 50 grams of estimated weight, with no particular events in the medical history such as prostate biopsies, past acute prostatitis or suspect prostate cancer).

Contraindications

Patients may not be candidates for the HoLEP procedure if⁸:

they have bleeding problems.
they have had certain types of prior prostate treatments.
they cannot lie on their back with their legs raised. This position is required for the procedure.

Interested in learning more about Auriga™ XL?

Holmium Laser Enucleation of the Prostate (HoLEP) is an effective technique for the management of symptomatic LUTS due to BPE. This course is intended for surgeons who have an Auriga XL console and are beginning to perform HoLEP, looking to understand the OR set up, learning curve and training process, as well as the technique. Attendees will participate in the operating room on the second day and must comply with local requirements in regard to exposure prone procedure screening and MRSA.

Training and educational offer