
MOLEP (MOSES HOLEP) EN BLOQUE CON LIBERACIÓN APICAL PRECOZ Y PRESERVACIÓN DE LA MUCOSA ESFINTERIANA. EVOLUCIÓN DE LA TÉCNICA QUIRÚRGICA Y LA TECNOLÓGICA QUE PERMITEN UN NUEVO PARADIGMA DE ENUCLEACIÓN ENDOSCÓPICA ANATÓMICA DE PRÓSTATA
Socarrás Moisés Rodríguez, Álamo Julio Fernández del, Rivas Juan Gómez, Sancha Fernando Gómez
MOLEP (MOSES HOLEP) EN BLOQUE CON LIBERACIÓN APICAL PRECOZ Y PRESERVACIÓN DE LA MUCOSA ESFINTERIANA. EVOLUCIÓN DE LA TÉCNICA QUIRÚRGICA Y LA TECNOLÓGICA QUE PERMITEN UN NUEVO PARADIGMA DE ENUCLEACIÓN ENDOSCÓPICA ANATÓMICA DE PRÓSTATA
Endoscopic enucleation of the prostate was first described by Hiraoka in 1986, using a monopolar resectoscope. His contribution was largely ignored until Gilling and Fraundorfer published their three-lobe enucleation technique with the Holmium laser in 1998, that ended establishing itself as a reliable option for the treatment of HBP, backed by ample scientific evidence. Later on, enucleation performed with other lasers, as well as bipolar energy, have shown concordance in their clinical results. As a result, the term AEEP (anatomic endoscopic enucleation of the prostate) emerged to encompass all these techniques. During the last few years there have been significant advances in two areas: first, technology, with the development of pulse modulation for Holmium generators (MOSES) as well as high-speed morcellators. Second, the development of new surgical techniques that recog- nize the importance of the early release of the sphincter from the apex of the adenoma during the operation as well as the careful preservation of the external sphincter’s mucosa, to avoid early stress incontinence. In this paper, we review the recent evolution of both technology and surgical technique. AEEP has been risen to a new level, reducing operative time significantly, usually under one hour, and radically reducing the incidence of early temporary stress incontinence, and maybe also facilitating the learning curve of AEEP.
HoLEP / En Bloc HoLEP / BPH / Moses / Laser / Holmium {{custom_keyword}} /
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