title: Wolf Piranha Versus Lumenis VersaCut Prostate Morcellation Devices: A Prospective Randomized Trial.
abstract: OBJECTIVE
  Holmium laser enucleation of the prostate for the management of benign prostatic hyperplasia involves the 2 steps of enucleation and morcellation. Few prostate morcellation devices are available. In this study we compare the Wolf Piranha and Lumenis® VersaCut™ prostate morcellation devices.
  
  
  METHODS
  After institutional review board approval and patient informed consent, a prospective, randomized trial was initiated for patients with symptomatic benign prostatic hyperplasia undergoing holmium laser enucleation of the prostate. All procedures were performed by a single surgeon (JEL) at Indiana University Health Methodist Hospital using the Piranha or VersaCut prostate morcellation device. Patient demographics, and preoperative, intraoperative and postoperative data for patients in the 2 treatment groups were analyzed and compared in a prospective fashion.
  
  
  RESULTS
  A total of 74 patients were enrolled and randomized for the treatment device. Both groups were comparable in terms of age, prostate specific antigen and prostate size. There was no difference in patient demographic and preoperative characteristics. The Piranha achieved a slightly higher morcellation rate at 5.6 gm per minute (range 1.4 to 18), compared to the VersaCut at 4.8 gm per minute (range 1.3 to 9.5). However, the difference was not statistically significant (p = 0.14). Cost analysis (USD per patient) favored the VersaCut ($241 vs $471, p <0.001).
  
  
  CONCLUSIONS
  Morcellation rates for the Piranha and VersaCut prostate morcellation devices are comparable, with the Piranha having a statistically significant increased cost. The Wolf Piranha also has a more complicated design, making it less user-friendly for the operating room staff and, therefore, more difficult to troubleshoot than the Lumenis VersaCut. Nevertheless, 75% of urology faculty, fellows and residents preferred the Piranha over the VersaCut, reporting that when working properly, it was more efficient in tissue removal.
authors: Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana.
authors: Marawan M
authors: MM
authors: El Tayeb
authors: Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana.
authors: Michael S
authors: MS
authors: Borofsky
authors: Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana.
authors: Jessica E
authors: JE
authors: Paonessa
authors: Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana. Electronic address: jlingeman@iuhealth.org.
authors: James E
authors: JE
authors: Lingeman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004867:Equipment Design; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011470:Prostatic Hyperplasia / Q000601:surgery*; D013523:Surgical Equipment; D020728:Transurethral Resection of Prostate / Q000295:instrumentation*; D016896:Treatment Outcome
keywords: equipment and supplies; lasers, solid-state; prostatic hyperplasia; transurethral resection of prostate