Thulium laser offers high cutting capacity and high coagulation power due to its wavelength. It may be used for prostate operations following three different strategies:
1. Tissue vaporisation
It fulgurates the tissue and opens a working channel.
It is not a suitable laser for this technique. It should only be used on very small-sized prostates. We do not recommend it.
2. Prostate vaporesection
The prostate adenoma is cut into small fragments to be extracted through the urethra.
It is a valid option for small prostates. Professionals who use this technique usually do so because of their lack of experience in completely enucleating the adenoma and/or lack of equipment and/or experience morcelling the adenoma.
3. Enucleation of the prostate adenoma
Mimics open surgery and the entire prostate adenoma is removed. It is then inserted into the bladder and morcelled (it is crushed to remove it through the urethra).
We consider it an excellent choice. The disadvantage in comparison to the Holmium laser is that it does not allow breaking stones.