Login to Access Video or Poster Abstract: MP02-04
Sources of Funding: None

Introduction

The use of pre-operative transrectal ultrasound (TRUS) volume to size prostates prior to holmium laser enucleation of the prostate (HoLEP) surgery supports case selection during the steep learning curve. We have previously reported the use of TRUS volume as a predictive tool for enucleation and operating room (OR) times. For the established surgeon TRUS volumes can optimize theatre utilization. We represent our predicted versus actual enucleation and OR times to generate validated charts to use as an accurate predictive tool to enhance theatre utilization.

Methods

393 HoLEPs were undertaken with a 50 Watt (W) holmium laser (Auriga XL, Boston Scientific Inc., Richard Wolf Piranha Morcellator) by two HoLEP naive surgeons during their learning curve and subsequently. All patients underwent a TRUS volume pre-operatively (B-K Hawk 2102). Accurate enucleation time and total operating room (OR) time for a given TRUS volume were plotted to use as a predictive tool to enhance operating list scheduling. Using the predicted enucleation times from a original cohort of 253 cases linear regression modelling was undertaken to validate predictive enucleation & OR times with the actual enucleation times for our last 100 cases.

Results

Enucleation time and TRUS volume were plotted graphically for the 393 cases (blue shaded region) and compared to similar data previously plotted for our first 253 cases (red line). There was a clear improvement in enucleation and total operating room times indicating further improvement and accuracy in the predictive times for a given TRUS size as surgeon experience increases. This allows for the enhanced prediction of theatre time improving theatre utilization._x000D_

Conclusions

Validation of predictive TRUS volume graphs for enucleation time during HoLEP surgery can be used as a tool to enhance theatre utilization by individual surgeons. We recommend the use of this simple tool for units setting up a HoLEP service._x000D_

Funding

None