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). The other word, “Lite”, refers on one hand to the lightweight and micro-invasiveness of the treatment, and on the other, the therapeutic source (Light, therefore Laser).

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

Suitability

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 on 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 does not employ surgical lasers. Indeed, 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

  • reduction in volume of the enlarged prostate tissue with consequent improvement of local symptoms for patients suffering from BPH due to the Laser Induced CytoReduction (LICR) process;
  • complete ablation of malignant tumours, with a sufficient safety margin.

What is it?

The SoracteLite  treatment consists in 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 heats the tissues until they are destroyed. This is 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. To facilitate insertion, the system has a dedicated multi-applicator Guiding System for a transrectal ultrasound probe with the 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 an improvement of the local symptoms, without changing the physiology of the prostatic gland.

Clockwise:
1. TRT33 Esaote Probe with multi-fibre guiding system  / 2. Biopsy Software
3./4. TRT33 Esaote Probe equipped with the 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, non-traumatic needles with transperineal approach
no general anaesthesia
short duration of the treatment (few minutes)
rapid recovery
no or insignificant post-treatment pain
absence of erectile dysfunction or complications associated with 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
  • No complications

Images 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.

 

 

 

Transperineal Laser Ablation for Treatment of LUTS Due to Benign Prostatic Obstruction

 

Registry of Transperineal Laser Ablation for Treatment of Lower Urinary Tract Symptoms With Use of the Echolaser® Device: A Multicentre, International Registry to Evaluate the Treatment of Lower Urinary Tract Symptoms in Terms of Long-term Efficacy, Functional Outcomes and Safety

  • No. of Patients:500
  • Sponsor: Academisch Medisch Centrum – Universiteit van Amsterdam (AMC-UvA)
  • State of the Study: patients recruitment
  • Registered on ClinicalTrial.gov: ClinicalTrial.gov: https://clinicaltrials.gov/ct2/show/NCT03776006

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

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

 

Applicazioni

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