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Ageing populations worldwide requires more affordable minimally invasive therapy procedures. German data show an increase in both benign prostate enlargement (BPE) and carcinoma of the prostate. In 1901 the introduction of anesthesia made the Freyer operation possible, and using electricity enabled transurethral resection of prostate (TURP) in the 1920s. In 1991 Hofstetter was the first physician to laser prostate tissue by means of interstitial laser coagulation. Twenty years later 80% of the BPE operations in the USA were carried out by mostly outpatient photoselective vaporization of the prostate (PVP). In France, this method was declared a standard in December 2012. Our experience with Medilas100 and re-sterilized quartz fibers dates back to 1988 and includes the laser treatment of 4000 urothelial tumors and 2000 BPEs (as presented at nearly 60 congresses). In 1996 the 50 W, 980 nm diode laser replaced the scalpel and reduced costs to 45% of the pre-laser era. Today portable laser devices with over 100 W and using an extremely wide variety of wavelengths operate for 100,000 maintenance-free hours and facilitate cutting, sawing and drilling in tissue, teeth and bones with bare fibers. Currently a method using beam reflection indicates when the beam is entering or leaving the tumor and Raman spectroscopy is being introduced as new diagnostic method for tissue differentiation. The proton laser DRACO has been tested at the Dresden Center OncoRay. It destroys only tumor tissue without damaging the surrounding healthy tissue. It is possible to use a laser anywhere where there is an electric source – in high-tech mega-clinics as well as in Red-Cross/Half Moon disaster relief tents. All laser physicians should publish their results, so that others can follow and prove the method.

photonics and lasers in medicine

Replacing the scalpel with the laser reduces expenses in surgery – Taking the history of prostate therapy as an example: Die Geschichte der Prostata-Therapie zeigt: Der Ersatz des Skalpells durch den Laser reduziert Kosten in der Chirurgie