Is it necessary and feasible to increase the efficiency of 2-µm thulium laser resection of the prostate?

T wo-mm thulium laser has become widely accepted because of the resultant excellent homeostasis and rapid vaporization in prostatectomy. It is necessary for us to increase the surgical efficiency because of increasing numbers of larger-sized, elderly and high-risk BPH patients. We have made efforts to achieve this goal through continued improvement of the 2-mm thulium laser equipment, innovative methodstangerine technique, reasonable teaching mode and easily grasped learning curve. We prove it necessary and feasible to increase the efficiency of 2-mm thulium laser resection of the prostate. Transurethral resection of the prostate (TURP) is generally considered the ‘gold standard’ for the surgical treatment of benign prostatic hyperplasia (BPH), but its use is generally restricted to smalland mediumsized prostates. The complications and morbidities that have been related to this procedure, which include blood loss and disturbances in the fluid balance, have created a need for the development and investigation of newer techniques. Several laser devices working at various wavelengths have been introduced in the last few decades. One of these, the 2-mm thulium laser, is a surgical laser with optional continuousor pulsewave modes and a wavelength tunable from 1.75 to 2.22 mm. This laser presents many advantages over the holmium laser, such as an improved spatial beam quality, a more precise tissue incision and the capacity to operate in optional continuous-wave or pulse modes. Since 2004, we have used the thulium laser in clinical practice primarily for urogenital endoscopic procedures, and its use has become widely accepted because of the resultant excellent homeostasis and rapid vaporization.