W Klinice Urologii Świętokrzyskiego Centrum Onkologii (ŚCO) wdrożono nową technologię operacyjną – laserową enukleację gruczolaka prostaty. Rozwiązanie umożliwia przeprowadzenie zabiegu bez cięcia powłok brzusznych, co zapewnia pacjentowi szybki powrót do zdrowia.
Pierwsze zabiegi z wykorzystaniem lasera holmowego – enukleacje gruczolaka stercza drogą przezcewkową – zostały przeprowadzone w dniach 24-25 lutego 2022 r. u trzech pacjentów z łagodnym rozrostem gruczołu krokowego. Schorzenie to dotyka mężczyzn, powodując problemy z oddawaniem moczu, uczucie nie całkiem opróżnionego pęcherza moczowego, konieczność wstawania w nocy, aby opróżnić pęcherz, parcia naglące, zatrzymanie moczu.
Praktycznie bezkrwawa operacja usunięcia gruczolaka prostaty
Dr n. med. Jarosław Jaskulski, FEBU, specjalista urologii, kierownik Kliniki Urologii ŚCO, podkreśla, że nowoczesna i małoinwazyjna metoda nie narusza ciągłości tkanek, nie ma konieczności cięcia powłok brzusznych, by dostać się do gruczołu krokowego. Operacja jest więc praktycznie bezkrwawa.
– Cały zabieg operacyjny odbywa się przez cewkę moczową. Za pomocą lasera holmowego jesteśmy w stanie usunąć całego gruczolaka prostaty, tak jak w klasycznej operacji. Wyłuszczony w ten sposób gruczolak zostaje przemieszczony do pęcherza moczowego, gdzie jest poddawany morceleracji czyli rozkawałkowaniu, żeby można było wszystkie jego elementy usunąć z pęcherza moczowego – wyjaśnia specjalista.
Laserowa enukleacja gruczolaka (HoLEP) pozwala również w bardziej radykalny sposób usunąć gruczolaka prostaty w porównaniu do dotychczas stosowanej metody TURP (przezcewkowa elektroresekcja mono lub bipolarnym prądem elektrycznym). Ponadto, jak podkreślają specjaliści, operacje w wykorzystaniem lasera to mniejsze ryzyko krwawienia po zabiegu, a więc do operacji kwalifikują się pacjenci ze zwiększonym ryzykiem wystąpienia zaburzeń krzepliwości.
Sam zabieg trwa nieco dłużej, niż stosowane dotychczas metody operacyjne – około 2 godziny. Wynika to z faktu, że urolodzy poruszają się w dość ograniczonej przestrzeni między gruczolakiem a torebką gruczołu krokowego. Impuls laserowy precyzyjnie rozwarstwia tkanki oddzielając tkanki gruczolaka od właściwej tkanki prostaty w tzw. torebce chirurgicznej. W ten sposób minimalizuje się ryzyko krwawienia. Ponadto metoda HoLEP pozwala na pobranie całej objętości gruczolaka do oceny histopatologicznej.
Pacjenci już w pierwszej dobie od zabiegu mogą wyjść do domu
Dr Jaskulski podkreśla, że po zabiegu pacjenci bardzo szybko dochodzą do siebie, a większość już w pierwszej dobie pooperacyjnej ma usuwany cewnik, może wyjść do domu i powrócić do normalnej aktywności. Po 2-4 tygodniach pacjenci mogą wrócić do sprawności seksualnej.
U niewielkiego odsetka pacjentów (0,5 – 2 proc.) może dojść do niezbyt nasilonego, przemijającego nietrzymania moczu, które ustępuje samoistnie bez konieczności wdrażania rehabilitacji. Zaburzenie to obserwowane jest niekiedy również podczas operacji metodą otwartą lub endoskopową.
Laser holmowy służy do przeprowadzania wielu innych zabiegów chirurgicznych
Świętokrzyskie Centrum Onkologii dzięki dofinansowaniu z Urzędu Marszałkowskiego Województwa Świętokrzyskiego mogło zakupić laser holmowy i wdrożyć małoinwazyjną metodę operacyjną. Urządzenie kosztowało 389 700 zł, natomiast Urząd Marszałkowski wsparł placówkę kwotą 331 245 zł.
Laser holmowy to urządzenie uniwersalne, które można wykorzystać w różnego rodzaju zabiegach chirurgicznych. Oprócz enukleacji gruczolaka prostaty, laser służy również usuwaniu guzów z pęcherza moczowego i górnych dróg moczowych, nacinaniu zwężeń cewki moczowej i moczowodów, a także kruszeniu kamieni w każdym odcinku dróg moczowych. W ŚCO zabiegi z wykorzystaniem lasera wykonywane są w ramach procedur refundowanych przez Narodowy Fundusz Zdrowia.
Źródło: Świętokrzyskie Centrum Onkologii
Przeczytaj także: Bezpłatne leczenie nowotworów prostaty z wykorzystaniem mało inwazyjnej technologii
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