HOW I DO IT

• How I do it: Aquablation in very large prostates (> 150 mL)

  Helfand T. Brian, Kasraeian Ali, Sterious Steve, Glaser P. Alexander, Talaty Pooja, Alcantara Miguel, Alcantara Mola Kaitlyn, Higgins Andrew, Ghiraldi Eric, Elterman S. Dean Department of Surgery, NorthShore University Health System, Evanston, Illinois, USA

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  Aquablation has been well-studied in prostates sizes up to 150 mL. Recently, American Urological Association guidelines distinguish surgical interventions for men with large prostates (80 mL-150 mL) and now very large prostates (> 150 mL). Readers will gain an understanding of how to use Aquablation in the very large prostate size category.

  Keywords: robotics, LUTS, BPH, aquablation, prostate surgery, urology,

  Apr 2022 (Vol. 29, Issue 2 , Page 11111)
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• How I do it: Balloon tamponade of prostatic fossa following Aquablation

  Aljuri Nikolai, Gilling Peter, Roehrborn Claus, MD PROCEPT BioRobotics Corporation, Redwood Shores, California, USA

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  Since its first report in the 1870s, control of bleeding after transurethral resection of the prostate (TURP) has remained a concern. Foley's initial report of a urinary catheter involved placement of the balloon into the prostatic fossa following TURP. Removal of prostate tissue with a high-velocity saline stream (Aquablation) is a recently reported alternative to TURP. As Aquablation is heat-free, alternatives to non-thermal hemostasis were sought to optimize the procedure. We report use of a balloon catheter in the prostatic fossa after Aquablation as a post-resection hemostatic method.

  Keywords: benign prostatic hyperplasia, aquablation, bladder outlet obstruction, minimally invasive robotic surgery, balloon catheter, TURP,

  Aug 2017 (Vol. 24, Issue 4 , Page 8937)
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• How I do it: Aquablation of the prostate using the AQUABEAM system

  MacRae Catriona, Gilling Peter, MD Department of Urology, Tauranga Hospital, Tauranga, New Zealand

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  Benign prostatic hyperplasia (BPH) represents one of the most common conditions encountered in urological practice. For many years, transurethral resection of the prostate (TURP) has been considered the gold standard for surgical management of symptoms in prostates of 30 cc-80 cc. Although TURP provides excellent functional outcomes, there is significant morbidity associated with the procedure, particularly with regards to bleeding, electrolyte imbalance and sexual dysfunction. Emerging technologies aim to maintain the excellent functional results of TURP whilst decreasing the adverse events experienced by the patient. Aquablation is a novel therapy using a high-velocity waterjet and real-time ultrasound imaging with robotic assistance for targeted removal of prostate tissue. We present our experiences with this new technique, the equipment required and steps involved.

  Keywords: benign prostatic hyperplasia, transurethral resection of prostate, ablation techniques, aquablation, bladder outlet obstruction,

  Dec 2016 (Vol. 23, Issue 6 , Page 8590)
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