HoLEP en-bloc with MOSES technology

The En-bloc MoLEP with early apical release technique has many advantages over the traditional 3 lobe HoLEP technique. Those provided by the Moses technology are better cutting and excellent hemostasis, ideal for this approach.

Steps in the procedure

Clinical Background

• 1. Initially, the mucosa is scored circumferentially to demarcate the external sphincter and prostate apex

• 2. The fibers attaching the sphincter to the apex are cut from 3 to 9 o'clock

• 3. Mechanical localization of the plane at the apex bilaterally is then carried out

• 4. The connection of these planes is achieved by cutting the veru frenulum

• 5. Dissection of the posterior plane is then performed defining a clear line of attack

• 6. Attention is then paid to the anterior apex: the white line is deepened by 5 mm, cutting into the prostatic apex, and that allows for a safe anterior apical liberation following the anatomic plane

• 7. After the sphincter is fully released, the line of attack is followed circumferentially until the bladder neck is reached, incised also circumferentially

• 8. The adenoma is then flipped into the bladder for later morcellation

Technique Description