FAQ - Lasers

Laser is one of the advancements in the filed of medicines. There is lot of confusion among the general populations regarding the laser treatment. Here are the few clarifications points for the patient guidance and understanding.
What is Laser?

Light amplification simulated emission of radiation. It is used in various fields. Its use in medical field is getting expanded day by day.

Tell us some thing more about its use in medical field

Its use is well known since last 30 years or so, however its advancements has been realized recently with the advent of various other new lasers. Today its use is extensive in the field of urology for genitourinary disorders like kidney stones, prostate enlargement, Bladder cancer, urethral strictures, and certain kind of obstruction in the urinary passages (PUJ obstruction, ureteral strictures etc.)

Is it true that laser means no cut in the body and no anesthesia is required?

No , it is not true. It is the biggest MYTH that lasers mean no intervention. In fact one needs transmitting media like rigid scopes or fibreoptic scopes to deliver the energy to targeted organs, which is best done under anesthesia. It is used inside the body to cut and removed the diseased part with precision and with out blood loss!. It is like a “cold knife”.

One of my uncle said he underwent laser with out any intervention to remove the kidney stones. Is it possible?

Your uncle might have misunderstood the whole process of treatment. Probably he might have undergone shock wave lithotripsy(ESWL). And this is not laser treatment.

OIs one laser is enough to treat all kinds of medical diseases. ?

No it is not true. Each Lasers are named depending on their wavelength and their depth of penetration into the tissues. In fact for urological disease itself there are 4-5 lasers and for prostate itself there are various lasers , like Holmium laser, KTP laser, Thullium laser, Diode lasers etc to to mention few. And for kidney stones only Holmium laser is helpful. So one needs different laser to treat different organ or the pathology.

How one goes by selecting which is best for his condition?

The treating physician decides this. One should also know that only few lasers are approved by the FDA., like Holmium and KTP lasers for prostate enlargement and Lower power holmium laser for kidney stones.

Does Columbia Asia has all Lasers that is required to treat genitourinary diorders ?

Yes we have High power holmium lasers, Low power holmium laser, Low power KTP and high Power KTP lasers under one roof which can be used for different urology dieseases like prostate enlargement, Bladder stones and bladder cancers and Low power Holmium lasers for kidney stones , ureteric stones and strictures of the urethra.

Experience and expertise At Columbia Asia

Dr T Manohar is one among a few in the world to have performed more than 10000 laser surgeries. Laser training at Columbia asia is one of the prime educational project underway and mentoring the same to fellow urologists of the country since last 6-7 years.
Nearly 78% of the procedures at Columbia Asia are being done with LASERs alone and rest are laparoscopic and open / alternative methods.
Dr T Manohar has a vast experience in treating kidneys stones be it Miniperc or RIRS. Having done more than 8000 kidney stone surgeries he has revolutionised the kidney stone management with minimum complications and maximum stone clearance (table A).
Columbia asia at yashwanthpur is one among the few centres in the world to treat big prostates, as big as 374 gms in a single sitting. Having done > more than 350 cases till date, Dr Manohar is one among the laser educational panelists across the globe to treat prostates with larger size and those with high risk cases.

Laser applications in Kidney stones :

When the laser is targeted on the stone , it gets pulverized and 70% of the stones get vapourised and 30% gets into small pieces and flow via the natural path along with urine. One needs laser transmitting media to treat these stones be it ureterosopy (URS), Fibre optic scopes (RIRS)or Percutaneous Instruments (Miniperc).

Laser applications in prostate:

There are different lasers utilized to treat prostate depending on the size of the prostate , risk category of the patient and bleeding tendency and other bleeding disorders . Lasers used in prostates are Holmium , KTP and thulium lasers . Following are the problems and indications .
  • Large prostates > 60 gms ; HoLEP (holmium laser enucleation of the prostate)
  • Prostate of extralarge size (>100-200->350 gms); HoLEP : holmium laser enucleation of the prostate
  • High Cardiac risk patient on antiplatelets(blood thinners ) : KTP – high power XPS for large prostates
  • High risk with small prostates: PVP (photoselective vapourisation of the prostate

Laser applications in others

Laser can be used to treat bladder cancer like TCC and small papilloma’s of low grade pathology. Urethral strictures are also commonly treated using holmium laser especially in high risk and elderly patients as a pallitave measure.
*Success rates: Indicates the intraoperative recovery for prostate surgeries and Stone free rates for RIRS.
*RIRS : retrograde intrarenal surgery: for kidney stones.
*HoLEP : Holmium laser enucleation of the prostate: for treating BPH