UPDATE - Issue 35 - Autumn 2008
BPH training trip down under
In August 2008, newly appointed Watford consultant urologist Freddie Banks travelled to Tauranga in New Zealand to consolidate his experience in Holmiun Laser Enucleation of the Prostate (HoLEP).
This technique was pioneered in Tauranga in the mid 1990s by world experts Peter Gilling and Mark Fraundorfer as a modern technique of performing benign prostate surgery for urinary symptoms. In essence, it is a modern technique for performing TURP that offers much reduced blood loss and a much shorter hospital stay. If the prostate is likened to a small orange then conventional surgery involves shaving the orange out from the central core to the skin, effectively with a hot paper clip! Not surprisingly it can get a bit messy! With the laser technique the plane between the skin and the orange segment is dissected to remove the orange segments intact, which once disconnected from their blood supply can be minced up and removed (not so messy). The main advantage is that patients are typically allowed home the next day without a catheter and feeling well, as opposed to a 3 - 4 day stay in hospital feeling tired and exhausted. A huge advantage all round!
There is no substitute for experience, and the team in Tauranga are the most experienced in the world as demonstrated by seeing 17 cases in ten days which offered fantastic exposure to the technique. This operative exposure combined with long discussions on the subtlety of the technique in different situations was of huge value to me and has given me the confidence to offer the service as I take up post this October. I am hugely grateful to Prostate UK for sponsoring this visit which was of immense benefit to my surgical development.