MP3-03 IMAGE GUIDED ROBOTIC WATERJET ABLATION (AQUABLATION) OF THE PROSTATE: CLINICAL EXPERIENCE OF A NOVEL TECHNOLOGY FOR BPH

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology I1 Apr 2015MP3-03 IMAGE GUIDED ROBOTIC WATERJET ABLATION (AQUABLATION) OF THE PROSTATE: CLINICAL EXPERIENCE OF A NOVEL TECHNOLOGY FOR BPH Mihir Desai, Abhishek Laddha, Raed A. Azhar, Shashikant Mishra, Mahesh Desai, and Ravindra Ravindra Sabnis Mihir DesaiMihir Desai More articles by this author , Abhishek LaddhaAbhishek Laddha More articles by this author , Raed A. AzharRaed A. Azhar More articles by this author , Shashikant MishraShashikant Mishra More articles by this author , Mahesh DesaiMahesh Desai More articles by this author , and Ravindra Ravindra SabnisRavindra Ravindra Sabnis More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.106AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To report the clinical experience in patients with symptomatic BPH undergoing image-guided waterjet ablation of the prostatic adenoma using a novel technology called Aquablation (PROCEPT BioRobotics, Redwood Shores, CA METHODS The Aquablation System delivers a high-velocity saline stream (the AquaBeam®) under precise electromechanical control and live ultrasound guidance to ablate prostatic glandular tissue without the production of heat. Using the real-time transrectal ultrasound image and an integrated planning station, the target region for excision is registered within the prostate and the target tissue contour and depth are programmed by the surgeon. The surgeon guided AquaBeam ablates the prostatic tissue accurately following a preprogrammed routine, and the ablated prostatic tissue is simultaneously collected for post-procedure analysis. To obtain hemostasis if necessary, a low-power blue laser beam is captured in a low-pressure water column to perform surface coagulation of the fossa. In the present study Aquablation was performed in 9 patients with symptomatic BPH (Mean age 68 years, prostate volume 37 cc and median lobe present in 56%). All patients had urodynamic confirmation of bladder outlet obstruction. RESULTS All procedures were technically successful with a mean operative time of 49 minutes and Aquablation time of 12.2 minutes. Waterjet-guided laser fulguration was required in 3 cases. There were no peri-operative complications and no patients had dysuria after catheter removal after 24 hours. Functional outcomes are summarized in the Table. CONCLUSIONS We report a novel robotic image guided technology that provides rapid ablation of prostate tissue in patients with symptomatic BPH. Use of waterjet-guided blue laser technology was determined to be of limited value as this initial clinical experience suggests that Aquablation alone requires minimum hemostasis resulting in no postoperative dysuria. 1, 3, 6 and 12 month follow-up confirm significant improvement in IPSS, QoL and peak flow rates. Clinical trials with larger number of patients are currently ongoing. Table 1. Baseline 1-month 3-months 6-months 1-year % improvement IPSS 22.1 5.9 2.5 4.0 2.3 90% QOL 5.7 1.3 0.6 1.1 0.7 88% Qmax 7.0 15.1 15.1 16.7 14.1 101% © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e20 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mihir Desai More articles by this author Abhishek Laddha More articles by this author Raed A. Azhar More articles by this author Shashikant Mishra More articles by this author Mahesh Desai More articles by this author Ravindra Ravindra Sabnis More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...