Applications

Why carry out aggressive surgery on the prostate
to overcome the symptoms of PBH?

SoracteLite is ECHOLASER Therapy for treating urinary system disorders (lesions), in particular Benign Prostatic Hyperplasia (BPH).

The name of the treatment contains in a single word a connection with urologic application (“Soracte” is the name of an Italian mountain (also named in the incipit of an Horace Poem)  where there was a monastery in which the monk Nonnoso, canonized, is considered the protector of people with kidney disease) and “Lite”, which on one hand refers to the lightweight and micro-invasiveness of the treatment, and on the other, the therapeutic source (Light, therefore Laser).

The name SoracteLite allows for differentiating the procedure with ECHOLASER (micro-invasiveness and multi-fibre approach in a single system) from the other thermal ablation techniques

Indications

SoracteLite is indicated in the case of patients suffering from Benign Prostatic Hyperplasia, a disease in which the volumetric increase in the prostate gland generates a compression effect at the level of the bladder floor and the urethral canal, and also in the case of subjects who choose not to undergo surgical treatment.
When you hear the word laser in urology, you instantly may think of surgical lasers, like the green laser. These lasers are an important advancement for endoscopic, transurethral surgery of the prostate. However, SoracteLite has got nothing to do with surgical lasers; in fact, it differs in wavelength and power (our laser is not visible as opposed to green), its mode of action (cytoreduction vs surgical vaporization),  and lastly and most importantly SoracteLite is performed in a truly microinvasive approach (transperineal vs transurethral). SoracteLite represents true innovation for BPH treatment.

Despite focusing mainly on the treatment of Benign Prostatic Hyperplasia (BPH),  SoracteLite is also effective for prostate cancer that is not clinically relevant combined with active surveillance and post-prostatectomy relapse and for kidney cancer.

 

Performance

  • shrinkage of the enlarged prostate volume due to BPH with consequent gradual and steady relief from symptoms based on Laser Induced CytoReduction (LICR) process;
  • complete ablation of malignant tumours, with a sufficient safety margin

What is it?

SoracteLite  treatment consists of the percutaneous insertion of optical fibres (one or two fibres per lobe depending on the basal volume of the prostatic gland) via transperineal access, and the delivery of laser energy for several minutes which causes the heating of the tissues until they are destroyed, followed by a progressive reduction in the volume of the prostatic lobe (a reduction of at least 40% compared to the basal volume at the one-year follow-up) and subsequent disappearance of the symptoms. The planning of the treatment, the insertion of the needles and the monitoring are all carried out under ultrasound guidance. In order to facilitate the insertion manoeuvre, the system has a dedicated multi-applicator Guiding System for transrectal ultrasound probe with relative Biopsy Software that displays the guidelines on the screen.

With just one SoracteLite session it is possible to have a significant and persistent reduction in the volume of the prostatic gland and disappearance of the local symptoms, without changing the physiology of the prostatic gland.

Clockwise:
1. TRT33 Esaote Probe with multi-fibre guiding system  / 2. Multi-fibre Biopsy Software
3./4. TRT33 Esaote Probe equipped with multi-fibre guiding system

Advantages

resolution of symptoms
“in situ” thermal damage with consequent reduction of the prostatic lobe
preservation of the healthy tissue and the organ function
highly predictable and repeatable coagulation volume
use of fine, a-traumatic needles with transperineal approach
absence of general anaesthesia
short duration of the treatment (few minutes)
rapid recovery times
no or insignificant post-treatment pain
absence of erectile dysfunction or complications linked to the reproductive organs

Clinical Case no.1

Patient suffering from BPH, with a basal volume of 64 ml. Treated with two fibres per lobe.

US image before treatment

Four-month follow-up US image

The four-month follow up revealed the following:

  • volumetric reduction from 64 ml to 37 ml
  • post-urination residue reduction from 200 ml to 43 ml
  • IPSS score reduction from 29 to 10
  • Quality of Life (QoL) from 5 to 1
  • Maximum flow speed up from 4 ml/s to 14 ml/s
  • Absence of complications

Images by courtesy of Dr. Patelli (Pesenti Fenaroli Hospital, Alzano Lombardo)

 

 

Prostate

Transperineal Laser Ablation for Percutaneous Treatment of Benign Prostatic Hyperplasia: A Feasibility Study
Patelli G, Ranieri A, Paganelli A, Mauri G, Pacella CM
Cardiovasc Intervent Radiol (2017).

Kidney

Ultrasound-guided percutaneous laser ablation is safe and effective in the treatment of small renal tumors in patients at increased bleeding risk
Sartori S, Mauri G, Tombesi P, Di Vece F, Bianchi L, Pacella CM
Int J Hyperthermia. 2018 May 11:1-7.

Tolerability of percutaneous ablation Neodymium Laser in patients suffering from Benign Prostatic Hyperplasia (BPH): Prospective Observational Pilot Study

  • No. of patients enrolled: 10
  • Reference Study Centre: Pesenti Fenaroli Hospital, Alzano Lombardo (BG)
  • Promoter: Dr. Gianluigi Patelli
  • Study Status: Terminated

Applicazioni