绿激光选择性前列腺汽化术.ppt

绿激光汽化术优点 手术操作简便。直出光可汽化也可切割，速度快，亦可取病理。 出血极少，术野清晰。 对周围组织损失小，产生瘢痕挛缩几率小，并发症少。 术后创面水肿轻微，缩短带管时间，“日间手术”。 生理盐水冲洗，无TUR综合征风险，无电场，无闭孔神经反射，体内有金属物者也可手术。 尤适合高龄，危重患者。 抗凝治疗患者也可手术。 * SPEAKER NOTES Use player buttons to control videos (Click on slide background, before advancing to next slide) 初始功率为100W * SPEAKER NOTES If case is 60 min then remove catheter when anesthetic is worn off Foley insertion. The speaker should speak about his own practice and elaborate on how it‘s motivated. In general it should be noted that: The decision about whether to insert a foley should depend on the completeness of the tissue removal. Tissue left in place may continue to obstruct or slightly swell post-op if excessive coagulation was induced. Other factors are; clarity of the urine, status of bladder function, type of anesthesia used and the physician‘s comfort level with PVP. Typically, continuous bladder irrigation is not necessary. * SPEAKER NOTES Postoperatively some antibiotics should be given. Non-steroidal anti-inflammatory drugs and mild analgesics are optional. The patient should not engage in strenuous activities or sex for 2 weeks post-op. Typically patients can return to normal activities in about 2 or 3 days. * SPEAKER NOTES The important thing with this slide is how you deliver the message. Don’t scare new user but present as possible adverse events. * SPEAKER NOTES Who is likely to have a fibrous glands? TUNA, microwave, long standing 5 ARI, radiation * SPEAKER NOTES Set realistic expectation Not all large glands take the same amount of time 1 - 3 grams per minute depending on vascularity and size * SPEAKER NOTES GreenLight has proven safe on patients with anti-coagulation therapy, however, it is preferred that anti-coagulation therapy be discontinued prior to procedure, if possible. 初始功率为100W * SPEAKER NOTES: AMS strongly recommends assessing volume of gland size as measured by ultrasound TRUS provides most accurate measurement * SPEAKER NOTES: AMS strongly reco