2 - Lobe Big Prostate HoLEP

Clinical History:

•  85-year-old male patient with a relevant medical history of diabetes only. He has a 120 gr prostate.

Technique description:

• 2-lobe anatomic enucleation of the prostate with Holmium Moses 2.0 laser.

Procedure steps:

1. Urethrocystoscopy
2. Early apical release through white line
3. Bilateral posterior plane enucleation
4. Lateral left plane enucleation
5.  Anterior left plane enucleation trespassing to the right anterior plane.
6. 6 o'clock incision
7. 12 o'clock incision
8. Complete left lobe enucleation
9. Lateral right plane enucleation
10. Complete right love enucleation
11. Hemostasis with Holmium
12. Morcellation.

Training Objectives:

1. Avoid traction injury to the urinary sphincter by correctly performing the "white line" incision.
2. Safely perform an anatomic endoscopic enucleation of the prostate.
3. Avoid bladder neck Injury by performing 2-lobe technique in large and wide prostates.