Incission at 12 o'clock P. Schatteman

In this video, we present  the OLV technique of Holmium Laser Enucleation of Prostate.
It is a modification of the original technique as described by Kuntz et al..

After the middle lobe enucleation, we proceed with the 12 o'clock incision and detachment of the prostate between 10 and 2 o'clock from the bladder neck. This prevents a "clapper effect" of the adenoma at the end of the procedure. The "clapper effect" is the situation where the adenoma is completely enucleated with some remaining attachments at the 12 o'clock position. It can be hard to cut these last fibers because of lack of tension on these attachments with a completely freed adenoma.