Literature DB >> 30526803

DrillCutTM vs VersaCutTM prostate tissue morcellation devices after holmium laser enucleation: A prospective, randomized controlled trial.

Ahmed Ibrahim1, Mostafa M Elhilali1, Mohammed A Elkoushy1,2, Sero Andonian1, Serge Carrier1.   

Abstract

INTRODUCTION: We aimed to compare efficacy, safety, and cost of disposables of the DrillCutTM morcellator with the VersaCutTM morcellator after holmium laser enucleation of the prostate (HoLEP).
METHODS: After obtaining ethical approval, consecutive patients undergoing HoLEP for symptomatic benign prostatic hyperplasia were randomized to have their enucleated prostates morcellated by either Karl Storz® DrillCutTM or Lumenis® VersaCutTM morcellators. All procedures were performed by two experienced urologists. Patients' demographics and perioperative data were recorded. Both morcellators were compared for their safety, efficacy, and cost-effectiveness.
RESULTS: Eighty-two patients were included in the study (41 per each arm). Both groups were comparable in terms of age, preoperative prostate size (114 vs. 112 mL; p>0.05), enucleation time (95.3 vs. 91.7 minutes; p>0.05), and morcellation time (22.6 vs. 17.3 minutes; p>0.05). The DrillCutTM was associated with significantly lower morcellation rate when compared with the VersaCutTM (3.6 vs. 4.9 g/min; p= 0.03). In terms of safety, there was no significant difference between both morcellators in complication rates (2.4% vs. 7.3 %; p=0.1). However, there was one case of bladder perforation requiring exploration with the VersaCutTM. The DrillCutTM was associated with significantly higher cost of disposables when compared with the VersaCutTM ($247.5 vs. $160.9; p<0.01).
CONCLUSIONS: Despite the small sample size, the DrillCut™ was associated with lower morcellation rate when compared with the VersaCutTM. However, this difference may not be clinically significant. Although both morcellators were comparable in their safety, the DrillCutTM was associated with higher cost of disposables when compared with the VersaCutTM.

Entities:  

Year:  2018        PMID: 30526803      PMCID: PMC6737746          DOI: 10.5489/cuaj.5626

Source DB:  PubMed          Journal:  Can Urol Assoc J        ISSN: 1911-6470            Impact factor:   1.862


  15 in total

Review 1.  Meta-analysis of holmium laser enucleation versus transurethral resection of the prostate for symptomatic prostatic obstruction.

Authors:  A Tan; C Liao; Z Mo; Y Cao
Journal:  Br J Surg       Date:  2007-10       Impact factor: 6.939

2.  Morcellation Efficiency in Holmium Laser Enucleation of the Prostate: Oscillating Morcellator Outperforms Reciprocating Morcellator With no Apparent Learning Curve.

Authors:  Sean McAdams; Rafael Nunez-Nateras; Christopher J Martin; Stephen Cha; Mitchell R Humphreys
Journal:  Urology       Date:  2017-05-19       Impact factor: 2.649

3.  Canadian Urological Association guideline on male lower urinary tract symptoms/benign prostatic hyperplasia (MLUTS/BPH): 2018 update.

Authors:  J Curtis Nickel; Lorne Aaron; Jack Barkin; Dean Elterman; Mahmoud Nachabé; Kevin C Zorn
Journal:  Can Urol Assoc J       Date:  2018-10       Impact factor: 1.862

4.  Holmium laser enucleation of the prostate: long-term durability of clinical outcomes and complication rates during 10 years of followup.

Authors:  Hazem M Elmansy; Ahmed Kotb; Mostafa M Elhilali
Journal:  J Urol       Date:  2011-09-23       Impact factor: 7.450

5.  Reoperation After Holmium Laser Enucleation of the Prostate for Management of Benign Prostatic Hyperplasia: Assessment of Risk Factors with Time to Event Analysis.

Authors:  Mohamed A Elkoushy; Ahmed M Elshal; Mostafa M Elhilali
Journal:  J Endourol       Date:  2015-04-02       Impact factor: 2.942

6.  Holmium laser enucleation of the prostate (HoLEP): the endourologic alternative to open prostatectomy.

Authors:  Ehab A Elzayat; Mostafa M Elhilali
Journal:  Eur Urol       Date:  2005-11-02       Impact factor: 20.096

Review 7.  Meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic enlargement.

Authors:  Sascha A Ahyai; Peter Gilling; Steven A Kaplan; Rainer M Kuntz; Stephan Madersbacher; Francesco Montorsi; Mark J Speakman; Christian G Stief
Journal:  Eur Urol       Date:  2010-06-11       Impact factor: 20.096

8.  Randomized trial comparing holmium laser enucleation of prostate with plasmakinetic enucleation of prostate for treatment of benign prostatic hyperplasia.

Authors:  Mischel G Neill; Peter J Gilling; Katie M Kennett; Christopher M Frampton; Andre M Westenberg; Mark R Fraundorfer; Liam C Wilson
Journal:  Urology       Date:  2006-11-07       Impact factor: 2.649

9.  Holmium laser enucleation of the prostate: efficiency gained by experience and operative technique.

Authors:  Michael W Dusing; Amy E Krambeck; Colin Terry; Brian R Matlaga; Nicole L Miller; Mitchell R Humphreys; Ehud Gnessin; James E Lingeman
Journal:  J Urol       Date:  2010-06-19       Impact factor: 7.450

10.  Holmium laser enucleation of the prostate versus open prostatectomy for prostates greater than 100 grams: 5-year follow-up results of a randomised clinical trial.

Authors:  Rainer M Kuntz; Karin Lehrich; Sascha A Ahyai
Journal:  Eur Urol       Date:  2007-08-28       Impact factor: 20.096

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