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Our Most Advanced Energy System Yet: PLASMA+

The underlying high-frequency technology of PLASMA has been used for over 17 years and offers proven therapy for patients with benign prostatic hyperplasia (BPH) and non-muscle-invasive bladder cancer (NMIBC).. Now, with the third-generation bipolar technology, we have integrated the latest knowledge, experience and innovation.

The system sets new standards in terms of performance, treatment options, safety, cost and time efficiency.

Introducing Our New Electrosurgical Generator

The ESG-410 generator comes with a wide range of smart features that aim to improve the way BPH and NMIBC can be treated.

Wide Range of Electrodes

Olympus provides a full variety of innovative electrodes for different prostate sizes and patient profiles, thus enabling surgeons to perform exactly the operation techniques that achieve the best clinical results for each patient. PLASMA+ therefore responds to the trend of more personalised treatments.

OES Pro Resectoscope

The OES Pro resectoscope in combination with the constantly extended assortment of PLASMA electrodes and the high-frequency generator allows customisable, safe and effective treatment of benign prostatic hyperplasia (BPH) and non-muscle-invasive-bladder cancer (NMIBC).

Explore PLASMA+ Live

Are you interested in experiencing the PLASMA+ system? Request more information or a live demonstration and an Olympus consultant will contact you.

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The + in Performance

The latest technology, larger capacitors and faster cycles enable the high system performance and stable and continuous PLASMA ignition compared to comparative units.

  • Maximising vaporisation volume with Plasma OvalButton electrode. 33,34
  • Maximising resection volume with large loop electrode. 35
  • Maximising precision and control in TUR-BT by instant ignition before touching tissue. 33

Superior PLASMA Stability

Comparative units have often been unable to deliver reliable and continuous PLASMA stability under all conditions.

Now the PLASMA+ system, powered by the novel ESG-410 generator, offers stable and fast PLASMA ignition for all electrode types — even in free saline.

Reliably Powering Larger Electrodes

Especially when utilising larger electrodes, the ESG-410 generator delivers up to 50% higher PLASMA stability 33 versus comparative units, allowing for smoother procedural workflows and potentially reduced procedure times.

The + in Variety

From BPH to NMIBC — One System for Individual PLASMA Treatment

Combined with the intelligent ESG-410 power control unit, Olympus provides an extended portfolio of electrodes to expand your treatment possibilities.

With resection loops in different sizes and angles, needle and band electrodes, oval and round vaporisation buttons and a special enucleation loop, the Olympus PLASMA+ system provides a wide range of solutions for BPH and NMIBC treatment.

PLASMA Procedures for BPH and NMIBC

PLASMA BPH Resection

Transurethral resection remains the most common treatment for BPH. For PLASMA resections, bipolar high-frequency current is used to create the PLASMA corona that vaporises prostatic or vesical tissue.

Benefits

  • Strong safety profile compared to monopolar resection (valid for all PLASMA procedures).5
  • High tissue ablation rate.22,23,24
  • More precise cutting and coagulation compared to monopolar resection.25
  • Short learning curve.26
  • Enables preservation of sexual function, including antegrade ejaculation, via the ejaculation-preserving resection technique.27
  • High-quality pathological samples.

Recommended Resection Electrodes

Apart from applying various technical approaches (Nesbit, Barnes, etc.), resections can be done using a wide variety of color-coded electrodes. The Olympus PLASMA+ portfolio features different loop sizes and widths, thus providing surgeons with a solution for different patient profiles.

  • Medium loop electrodes are the standard and used in most transurethral resections (TUR).
  • Large loop electrodes enable faster and smoother operation with higher tissue ablation rates, especially for large prostates.
  • The band electrode provides continuos hemostasis already while cutting and even higher stability, also for enucleation.

PLASMA Vaporisation

PLASMA vaporisation provides a safe, easy-to-use solution for TUR tissue-management procedural needs in which energised gas smoothly vaporizes the tissue.

The interaction between the electrode and the high-frequency generator combined with the easy-to-learn "hovering technique" enables effective, fast and virtually bloodless ablation.

Benefits

  • Ideal for smaller to medium-sized prostates.
  • Fewer sevre complications and readmissions compared to transurethral resections of the prostate (TURP). 6,7
  • Shorter hospital stays compared to TURP with potential for day-case surgery. 20
  • Continuos hemostasis — demonstrated use in patients on anticoagulants. 21
  • Unobstructed view throughout the operation; neither tissue nor laser impulses impair vision.

Recommended Vaporization Electrodes
Our PLASMA vaporisation solutions offer an easy-to-learn, reliable and more cost-efficient solution for BPH.

  • PlasmaButton (round).
  • With its optimised shape, the new Plasma-OvalButton allows 21% faster vaporisation. 34

PLASMA Enucleation

This revolutionary technique uses the natural anatomy by “peeling” prostate tissue out of the capsule. Once the right layers have been located, each prostate lobe is peeled off in one piece. For complete enucleation the lobes are pushed into the bladder, where they are fragmented by a morcellator.

In the case of incomplete enucleation the removed lobes are still connected with the capsule through an adenoma bridge and are then resected with a PLASMA loop. For the treatment of large prostates, transurethral enucleation with bipolar (TUEB) provides an alternative to laser enucleation.

Benefits

  • Treatment of any prostate gland size with excellent tissue preservation for pathological examination.
  • Complete excision of obstruction adenoma down to the prostate capsule, if needed.
  • Minimum intraoperative blood loss. 28,29
  • Better long-term outcomes, and shorter convalescence compared to resection. 28

Recommended Electrode

The special design of the enucleation loop allows state-of-the-art enucleation, cutting and coagulation — an alternative to laser enucleation.

  • The black runner (spatula) is used to gently peel off the prostate lobes.
  • The wire loop can be used to locate layers and coagulate any bleedings.

PLASMA NMIBC Resection

Performing conventional or en bloc resection of NMIBC using PLASMA+ in combination with Narrow Band Imaging (NBI) enables the surgeon to offer the optimal therapy for the patient.

Benefits

  • More precise cutting and coagulation compared to monopolar resection. 25
  • Ignition in free saline potentially leading to more control. 33
  • Can be associated with an equal resection performance compared to M-TURBT. 30,31
  • May be more efficient in peri- and post-operative phase due to fewer complications. 32

Recommended Resection Electrodes

Apart from applying different resection techniques for bladder cancer resection, a variety of color-coded electrodes can be used. The Olympus portfolio features electrodes for the treatment of various bladder tumor types, providing surgeons with a solution for different patient profiles.

  • Needle electrode — particularly suitable for en bloc resection.
  • Loop electrode — in different sizes adapting to the tumor size.
  • Angled loop electrode — to better reach the anterior bladder wall.

The + in Usability

Plug & treat: Automatic mode selection for existing and future Olympus devices at universal sockets.

Streamlined workflow with customisable settings and fewer interruptions due to fewer non-safety-relevant pop-ups.

Ease of use with large 8.4" high-quality LCD touch panel.

Wireless foot switch option for higher degree of freedom during use.

The + in Safety & Efficiency

Bipolar TUR/PLASMA not only has a high level of evidence and grade of recommendation today but offers additional benefits with regard to safety and efficiency. The safety benefits of PLASMA may translate into cost savings while maintaining or even increasing the quality of the health care services. 14

Equivalent Efficacy with Improved Safety Profile

Bipolar technology achieves short-, mid- and long-term results comparable to those of monopolar transurethral resection of the prostate (m-TURP) 5,14 . However, the PLASMA system has a more favorable perioperative safety profile, especially regarding TUR syndrome occurrence, frequency of blood transfusions and the clot retention rate. 17

Enhancing Patient Outcomes and Comfort

The strong safety profile of the PLASMA system also results in a reduced average length of hospital stay, shorter catheterisation times, and fewer postoperative readmissions. 14,17

Lowering Overall Cost of Care

Cost modeling´ shows that equipment costs are offset by savings from reduced average length of hospital stay and fewer complications, leading to overall cost savings with PLASMA vs M-TUR for the hospital and health system. 14

Related Products and Technologies

ESG-410 Electrosurgical Generator

The ESG-410 high frequency generator provides you with reliable resection performance as well as access to surgical tissue management technology.

PLASMA Electrodes

Olympus provides a full varaiety of premium-quality and innovative electrodes for PLASMA treatment in Urology, thus enabling surgeons to perform exactly the procedures and operation techniques that achieve the best clinical results for each patient.

OES Pro Resectoscope

The OES Pro Resectoscope allows easy, effective, and safe resection in saline of benign prostatic hyperplasia and NMIBC.

NBI and PLASMA for Bladder Cancer Management

NBI is clinically proven to provide better clinical outcomes for NMIBC diagnosis and treatment.

Our New Patient Website Informs Your Patients about the Treatment of Benign Prostatic Hyperplasia (BPH)

In the patients website www.bph-plasma.eu Olympus is offering support when patients' questions occur. Among other things, patients will find more detailed information about the development of benign prostatic hyperplasia (BPH), PLASMA technology and the transurethral resection of the prostate (TURP) procedure.

Visit the Patient Website

Natural Occurrences of PLASMA

PLASMA is common to our world and appears in different variations in nature. It is especially prevalent in atmospheric and outer space phenomena such as the sun and initiates polar lights as well.

Downloads

References

  1. 1.Effects of bipolar and monopolar transurethral resection of the prostate on urinary and erectile function: a prospective randomized comparative study. Akman T, et al. BJU Int 2013;111:129–36.
  2. 2.A European multicenter randomized noninferiority trial comparing 180 W GreenLight XPS laser vaporization and transurethral resection of the prostate for the treatment of benign prostatic obstruction: 12-month results of the GOLIATH study. Bachmann A et al. J Urol. 2015 Feb;193(2):570-8.
  3. 3.Bipolar transurethral resection in saline vs traditional monopolar resection of the prostate: results of a randomized trial with a 2-year follow-up. Chen Q et al. BJU Int 2010;106:1339–43.
  4. 4.Bipolar transurethral resection in saline system versus traditional monopolar resection system in treating large-volume benign prostatic hyperplasia. Chen Q et al. Urol Int 2009;83:55–9.
  5. 5.EAU Guidelines on Management of Non-Neurogenic Male Lower Urinary Tract Symptoms (LUTS), incl. Benign Prostatic Obstruction (BPO). Gravas S et al.
  6. 6.Complications and clinical outcome 18 months after bipolar and monopolar transurethral resection of the prostate. Fagerström T et al. J Endourol. 2011 Jun; 25(6):1043-9.
  7. 7.Bipolar PLASMA vaporization vs monopolar and bipolar TURP–a prospective, randomized, long-term comparison. Geavlete B et al. Urology 2011;78: 930–935.
  8. 8.A prospective randomized study comparing monopolar and bipolar transurethral resection of prostate using transurethral resection in saline (TURIS) system. Ho HS et al. Eur Urol 2007;52:517–22.
  9. 9.Incidence of urethral stricture after bipolar transurethral resection of the prostate using TURis: results from a randomised trial. Komura K et al. BJU Int 2015;115:644–52.
  10. 10.Endoscopic enucleation versus open prostatectomy for treating large benign prostatic hyperplasia: a metaanalysis of randomized controlled trials. Li M et al. PLoS One 2015 Mar 31;10(3):e0121265. eCollection 2015.
  11. 11.Bipolar Resection in Saline – An Alternative Surgical Treatment for Bladder Outlet Obstruction? Michielsen DPJ et al. in: European Urology 178 (2007) November: 2035-2039.
  12. 12.Bipolar transurethral resection in saline: the solution to avoid hyponatraemia and transurethral resection syndrome. Michielsen DC et al. Scand J Urol Nephrol 2010;44: 228–35.
  13. 13.Urethral strictures and bipolar transurethral resection in saline of the prostate: fact or fiction? Michielsen DP et al. J Endourol 2010;24:1333–7.
  14. 14.The PLASMA system for transurethral resection and  haemostasis of the prostate. National Institute for Health and Care Excellence. NICE medical technology guidance MTG23. January 2021.
  15. 15.GreenLight XPS for treating benign prostatic hyperplasia. National Institute for Health and Care Excellence. NICE medical technology guidance MTG29. June 2016.
  16. 16.Transurethral Bipolar Enucleation of the Prostate Is an Effective Treatment Option for Men With Urinary Retention. Tracey JM et al. Urology. 2016 Jan;87:166-71. doi: 10.1016/j.urology.2015.10.011. Epub 2015 Oct 21.
  17. 17.Economic value of the TURis system for treatment of benign prostatic hyperplasia in England and Wales: systematic review, meta-analysis and cost-consequence model. Treharne C et al. EU Focus, March 2016
  18. 18.Bipolar PLASMA enucleation of the prostate vs open prostatectomy in large benign prostatic hyperplasia cases - a medium term, prospective, randomized comparison. Geavlete B et al. BJU Int. 2013 May;111(5):793-803.
  19. 19.“Button type” bipolar Plasma vaporisation of the prostate compared with standard transurethral resection: a systematic review and meta-analysis of short-term outcome studies. Wroclawski ML et al. BJU Int. 177 (2016): 662–668.
  20. 20.Transurethral resection (TUR) in saline PLASMA vaporization of the prostate vs standard TUR of the prostate: “the better choice” in benign prostatic hyperplasia? Geavlete B et al. BJUI 106 (2010): 1695–1699.
  21. 21.Surgical management of BPH in patients on oral anticoagulation: transurethral bipolar PLASMA vaporization in saline versus transurethral monopolar resection of the prostate. Delongchamps NB et al. Canadian Journal of Urology 18 (2011): 6007–6012.
  22. 22.A prospective, randomized clinical trial comparing plasmakinetic resection of the prostate with holmium laser enucleation of the prostate based on a 2-year followup. Chen YB et al. J Urol. 2013 Jan;189(1):217–22.
  23. 23.Holmium laser enucleation versus bipolar resection of the prostate: a prospective randomized study. Which to choose? Fayad AS et al. J Endourol. 2011 Aug;25(8):1347–52.
  24. 24.Comparison of outpatient versus inpatient transurethral prostate resection for benign prostatic hyperplasia: Comparative, prospective bi-centre study. Kim JH et al. Can Urol Assoc J. 2014 Jan–Feb;8(1–2):E30-5.
  25. 25.Histologic Effects of the GYRUS Resection System Versus Standard Electrocautery Resection in the Treatment of Bladder Tumors. Moy ML et al. J Endourol 15 (suppl 1): A63, 2001.
  26. 26.Management of large prostatic adenoma: Lasers versus bipolar transurethral resection of prostate. Gupta NP et al. Indian J Urol (2013) Jul;29(3): 225–35.
  27. 27.Ejaculation-preserving transurethral resection of prostate and bladder neck: short- and long-term results of a new innovative resection technique. Alloussi SH et al. J Endourol. 2014 Jan;28(1):84–9.
  28. 28.Electrosurgical enucleation versus bipolar transurethral resection for prostates larger than 70 ml: a prospective, randomized trial with 5-year followup. Zhu L et al. J Urol. 2013 Apr;189(4):1427–31.
  29. 29.A study comparing plasmakinetic enucleation with bipolar plasmakinetic resection of the prostate for benign prostatic hyperplasia. Liao N, Yu J. J Endourol. 2012 Jul;26(7):884–8.
  30. 30.Safety and Efficacy of Bipolar versus Monopolar Transurethral Resection of Bladder Tumor: A Systematic Review and Meta-Analysis. Sharma, G., Sharma, A. P., Mavuduru, R. S., Bora, G. S., Devana, S. K., Singh, S. K., Mandal, A. K., World J. Urol. 2020; Apr 21: 1-11.
  31. 31.Does Bipolar Energy Provide Any Advantage over Monopolar Surgery in Transurethral Resection of Non-Muscle Invasive Bladder Tumors? A Systematic Review and Meta-Analysis. Tzelves, L., Mourmouris, P., Skolarikos, A., World J. Urol. 2020 Jun; 26: 1-13.
  32. 32.Comparison of perioperative outcomes including severe bladder injury between monopolar and bipolar transurethral resection of bladder tumors: a population based comparison. Sugihara, T., Yasunaga, H., Horiguchi et al. J Urol. 2014 Nov;192(5): 1355-9.
  33. 33.Data on file. Bench test comparing plasma stability of ESG-410 with competitive generator.
  34. 34.Data on file. Bench test comparing plasma stability of ESG-410 with competitive generator.
  35. 35.Compared to existing Olympus vaporization electrode.Olympus internal lab testing; data on file.
  36. 36.Data on file. Resection volume versus medium loop.