Session: MP13: Benign Prostatic Hyperplasia: Surgical Therapy & New Technology I
MP13-12: A comparison of the efficiency and safety profile between two morcellators for laser enucleation of the prostate: Piranha versus Cyber Blade devices
Introduction: Different types of morcellator by different companies are available on the market with different features. However, the type of morcellator which provides the best performance has not been found yet and evidence on the comparison between these tools is still scarce. We performed a comparison between the Wolf® Piranha™ and the Quanta System® Cyber Blade™ instruments for the Thulium laser enucleation of the prostate (ThuLEP). Methods: 205 patients suffering from lower urinary tract symptoms due to benign prostatic hyperplasia underwent ThuLEP using the Cyber TM laser generator between 2020 and 2022. All surgeries were performed by the same operator. Morcellation was performed with the Piranha morcellator in 100 cases (Group A, 48.8%) and the Cyber Blade morcellator in 105 cases (Group B, 51.2%). Morcellation time and efficiency were recorded relating instrument performance to prostate volume. Complication rate and device malfunctions were reported to assess safety of these instruments. Results: Groups were comparable according to preoperative features. Mean prostate volume (PV) was 82.5 ml and 91.9 ml (p=0.21) in Group A and B respectively. Mean morcellation time was 9.7 min and 10.1 min in Group A and B respectively when PV was = 100 ml, with no statistically significant difference (p=0.34). On the contrary, mean morcellation time was significantly lower in the Cyber Blade group vs the Piranha group when PV was > 100 ml (12.7 min vs 10.1 min, p=0.04). Similarly, morcellation efficiency was comparable when PV was = 100 ml (8.5 g/min vs 9.1 g/min, p=0.08), while it was significantly higher in the Cyber Blade group when PV was > 100 ml (7.0 g/min vs 9.3 g/min, p=0.04). Bladder injury occurred in 3 cases (3.0%) in Group A and 2 cases (1.9%) in Group B. Both morcellators had comparable complication rate (p=0.12). No mechanical problems occurred. Conclusions: Performance was similar in terms of morcellation time and efficacy between Piranha and Cyber Blade tools when PV was = 100 ml, while it was significantly higher with the Cyber Blade morcellator when PV was > 100 ml. Both instruments are safe and reliable according to the risk of bladder injury and the occurrence of mechanical problems. SOURCE OF Funding: None
