Author :  Mr. Gideon Ho
Last Updated : 23 June 2003  

The objective of this project is on the treatment of Benign Prostatic Hyperplasia (BPH) using laser transurethral resection procedures, a Minimally Invasive Surgery (MIS) treatment, coupled with the aid of computer and robotics technology.

BPH is the most common non-cancerous prostate enlargement found in elderly males.  The increased prostate size hinders the flow of urine, thus leading to uncomfortable problems with urination.  In 1998, the World Health Organization (WHO) categorized Singapore as a nation with an expected life expectancy of 81 years.  As the life expectancy and population of the elderly increased proportionately, BPH among the elderly men is expected to become more predominant with time. In addition, the desire to develop more effective and efficient forms of treatment for BPH has been overwhelming.

One such treatment is Holmium Laser Resection of the Prostate (HoLRP), which is a form of thermal therapy that uses holmium-YAG laser energy to resect the enlarged prostate, thereby reducing the obstruction caused by BPH. The main advantages of HoLRP include immediate relief from bladder outlet obstruction, minimal bleeding and the ability to obtain prostatic tissue for histopathologic examination. In comparison, the main disadvantage is a longer operating time due to unfamiliarity with the laser resection technique or even when one becomes familiar, meticulous estimation to achieve resected prostate chips that can be passed out via the surgical instrument proved to be time consuming. Besides a long operating time, there is also a steep learning curve in mastering the techniques for HoLRP.

Computer Assisted Laser Resection of the Prostate (CALRP), which was designed based on an integrated system of computer, robotics and laser technology can possess complementary capabilities that could remedy many of the problems faced by surgeons in conventional HoLRP by delivering a treatment with repeatability and reliability without fatigue or tremor. In addition, the treatment can be handled by CALRP in ways that would be impossible for an unaided surgeon to handle. All these advantages can be translated into a better treatment of BPH in the area of treatment results and lesser training required of surgeons.

The CALRP system uses the Dornier Medilas Fibertom 5100 and Lasertrode lightguide (Dornier Medtech) to vaporise the prostate tissue.  Following a planned motion path, optimum sizes of prostate tissue will be resected and removed via the urethra. 

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