From the First HoLEP Surgery in Muğla to the Present with Assoc. Prof. Dr. Serdar Yalçın

From the First HoLEP Surgery in Muğla to the Present with Assoc. Prof. Dr. Serdar Yalçın: HoLEP, ThuLEP, ThuFLEP and the Omega Technique in Bodrum

The first HoLEP surgery in Muğla was performed on September 27, 2021, by Assoc. Prof. Dr. Serdar Yalçın at Acıbadem Bodrum Hospital.

This procedure represented an important milestone in the modern laser surgical treatment of benign prostatic hyperplasia (BPH) in Bodrum and Muğla. However, behind this first operation was a long-standing experience in anatomical endoscopic enucleation of the prostate, which began in Ankara in 2015 and developed through thousands of surgical cases, educational activities, and scientific studies.

Assoc. Prof. Dr. Serdar Yalçın joined Acıbadem Bodrum Hospital on September 8, 2021, and only 19 days later, on September 27, 2021, performed the first HoLEP surgery in Muğla.

Since 2021, hundreds of HoLEP, ThuLEP, and ThuFLEP procedures have been performed at Acıbadem Bodrum Hospital. This experience encompasses a broad clinical spectrum, including elderly patients, patients with very large prostates, patients with significant comorbidities, and complex cases involving anticoagulant or antiplatelet therapy.

Today, anatomical endoscopic prostate enucleation techniques including HoLEP, ThuLEP, ThuFLEP, and the HoLEP Omega technique are performed at Acıbadem Bodrum Hospital. Patients are evaluated not only from Bodrum and Muğla but also from different regions of Türkiye and from abroad.

The First HoLEP Surgery in Muğla: September 27, 2021

The first HoLEP surgery in Muğla was performed on September 27, 2021, by Assoc. Prof. Dr. Serdar Yalçın at Acıbadem Bodrum Hospital.

Dr. Yalçın had started working at Acıbadem Bodrum Hospital on September 8, 2021.

His experience in HoLEP and anatomical prostate enucleation, developed in Ankara since 2015 through involvement in more than 2,000 surgical cases, was thereby brought to Bodrum / Muğla.

Only 19 days after beginning his practice in Bodrum, the first HoLEP procedure in Muğla was performed, marking the beginning of a new era in anatomical endoscopic prostate enucleation and advanced laser prostate surgery in the region.

What Is HoLEP?

HoLEP (Holmium Laser Enucleation of the Prostate) is a modern endoscopic surgical technique used in the treatment of benign prostatic hyperplasia.

During HoLEP, the obstructing prostate tissue is separated and enucleated by following the natural anatomical plane of the prostate. The procedure is performed endoscopically through the natural urinary tract and does not require a skin incision to access the prostate.

HoLEP represents anatomical endoscopic enucleation performed using holmium laser energy.

Similar anatomical surgical principles can also be applied using different laser technologies. These include ThuLEP (Thulium Laser Enucleation of the Prostate) and ThuFLEP (Thulium Fiber Laser Enucleation of the Prostate).

Therefore, modern laser prostate surgery depends not only on the type of laser used but also on accurate understanding of prostate anatomy, identification of the appropriate enucleation plane, preservation of the urinary sphincter anatomy, and the surgeon’s experience in anatomical enucleation.

Assoc. Prof. Dr. Serdar Yalçın’s HoLEP Experience: From 2015 to the Present

Assoc. Prof. Dr. Serdar Yalçın’s experience in HoLEP and anatomical endoscopic enucleation of the prostate began in Ankara in 2015.

During the period when HoLEP was becoming actively established and developed in Türkiye, he participated in the work of teams at the Gülhane Military Medical Academy (GATA), Acıbadem Ankara Hospital, and Liv Hospital Ankara.

Between 2015 and 2021, he participated in approximately 1,000 HoLEP and anatomical endoscopic enucleation cases at Gülhane Military Medical Academy.

During the same period, he was involved in approximately 1,000 additional surgical cases through his work at Acıbadem Ankara Hospital and Liv Hospital Ankara.

By the time he moved to Bodrum in 2021, he had therefore accumulated experience through participation in more than 2,000 HoLEP and anatomical endoscopic prostate enucleation cases.

This period was not limited to operating room experience. He was also actively involved in educational activities aimed at expanding HoLEP expertise among urologists in Türkiye.

HoLEP Training: Instructor in More Than 15 Educational Programs

Between 2015 and 2021, numerous educational programs and scientific meetings were organized to support the development and dissemination of HoLEP and anatomical endoscopic enucleation techniques among urologists.

Assoc. Prof. Dr. Serdar Yalçın served as an instructor in more than 15 HoLEP training programs, particularly those organized at Acıbadem Ankara Hospital and Liv Hospital Ankara.

These programs were attended by hundreds of urologists from different regions of Türkiye.

As a result, his experience extended beyond high-volume surgical exposure to include the teaching of anatomical enucleation principles and the training of other urologists in HoLEP.

September 8, 2021: Bringing HoLEP Experience to Bodrum

Assoc. Prof. Dr. Serdar Yalçın began working at Acıbadem Bodrum Hospital on September 8, 2021.

The anatomical prostate enucleation experience accumulated in Ankara since 2015, through involvement in more than 2,000 cases, was thereby brought to Bodrum / Muğla.

Only 19 days later, on September 27, 2021, the first HoLEP surgery in Muğla was performed by Assoc. Prof. Dr. Serdar Yalçın at Acıbadem Bodrum Hospital.

This procedure marked the beginning of a new period in HoLEP and advanced laser prostate surgery in Bodrum and Muğla.

Hundreds of HoLEP, ThuLEP and ThuFLEP Procedures in Bodrum Since 2021

Following the first HoLEP surgery in Muğla, anatomical endoscopic prostate enucleation procedures continued at Acıbadem Bodrum Hospital.

Over the approximately five-year period from 2021 to the present, hundreds of HoLEP, ThuLEP, and ThuFLEP procedures have been performed.

The experience includes not only standard BPH cases but also patients with characteristics that may make surgical planning more complex, including advanced age, very large prostate volume, significant cardiovascular disease, multiple comorbidities, and the use of anticoagulant or antiplatelet medications.

The HoLEP experience in Bodrum / Muğla has therefore developed not only in terms of surgical volume but also in terms of the complexity and diversity of cases treated.

HoLEP in Elderly Patients: Surgical Experience Up to 97 Years of Age

Advanced age alone does not necessarily mean that prostate surgery cannot be performed.

Within the HoLEP experience at Acıbadem Bodrum Hospital, anatomical endoscopic prostate enucleation has been performed in patients up to 97 years of age.

In elderly patients, the decision to proceed with surgery should not be based solely on chronological age. Overall performance status, cardiovascular and pulmonary conditions, medications, anesthetic risk, severity of urinary symptoms, prostate size, and anatomical characteristics should all be evaluated together.

Each elderly patient should therefore be assessed individually, and the surgical decision should be personalized.

HoLEP for Very Large Prostates: Surgical Experience Up to 485 Grams

One of the important applications of HoLEP and anatomical endoscopic enucleation is the treatment of large and very large prostates.

In Assoc. Prof. Dr. Serdar Yalçın’s personal surgical experience, anatomical endoscopic enucleation has been performed in patients with prostate sizes reaching 485 grams.

As prostate size increases, the technical complexity of surgery, operative planning, enucleation, and removal of the enucleated tissue may require greater surgical experience.

For this reason, the surgical approach for a patient with a large or very large prostate should not be determined by prostate volume alone. Prostate anatomy, bladder function, comorbidities, medications, previous surgical procedures, and the patient’s overall health should be considered together.

Experience with prostates reaching up to 485 grams illustrates the broad spectrum of anatomical endoscopic prostate surgery performed in Bodrum / Muğla.

HoLEP in Patients Taking Blood Thinners

A significant proportion of patients requiring surgery for benign prostatic enlargement are older adults. Cardiovascular conditions such as coronary artery disease, cardiac arrhythmias, pacemakers, previous cardiac interventions, and other cardiovascular diseases are therefore frequently encountered in patients being considered for prostate surgery.

Some of these patients receive anticoagulant or antiplatelet therapy, commonly referred to as “blood thinners.”

In certain patients, discontinuation of these medications may carry a significant cardiovascular or thromboembolic risk.

Within the clinical experience at Acıbadem Bodrum Hospital, selected patients in whom interruption of antithrombotic therapy is considered inappropriate or potentially high-risk are also evaluated for surgical treatment through a multidisciplinary approach.

The decision regarding surgery and medication management is individualized according to the type of medication, bleeding and thromboembolic risks, cardiovascular status, and characteristics of the planned procedure. When necessary, this assessment is performed jointly by urology, anesthesiology, and cardiology specialists.

Therefore, the use of blood-thinning medication or the presence of significant cardiovascular disease does not automatically mean that HoLEP cannot be performed. An individualized risk-benefit assessment is essential.

Complex Patients Previously Considered “Not Suitable for Surgery”

During the approximately five-year period in Bodrum, patients have also presented after having been considered high-risk for surgery at other centers because of advanced age, significant cardiovascular disease, blood-thinning medications, pacemakers, or multiple comorbidities.

The objective in these cases is not to recommend surgery unconditionally to every patient.

Instead, the approach is to understand precisely why the patient has been considered high-risk and, when appropriate, develop an individualized treatment strategy in collaboration with the relevant medical specialties.

Through this multidisciplinary approach, selected complex patients have been evaluated and, when considered appropriate, treated surgically at Acıbadem Bodrum Hospital without requiring referral to another center.

HoLEP Omega: A Surgical Technique Development Process Beginning in 2015

Assoc. Prof. Dr. Serdar Yalçın’s work in anatomical endoscopic enucleation was not limited to applying existing HoLEP techniques.

During the high-volume HoLEP experience beginning in 2015, work was undertaken to make anatomical prostate enucleation more systematic, with particular attention to apical anatomy and surgical principles aimed at preserving the urinary sphincter.

Over time, this process contributed to the development of the surgical approach known as HoLEP Omega / Omega Sign.

Assoc. Prof. Dr. Serdar Yalçın is among the principal authors involved in the development, clinical application, and scientific publication process of the Omega technique.

What Is the HoLEP Omega Technique?

HoLEP Omega is an anatomical endoscopic prostate enucleation approach that places particular emphasis on the anatomy of the prostatic apex and urinary sphincter.

The fundamental principles of the technique include early apical release, careful identification of anatomical structures surrounding the sphincter, and controlled enucleation of the prostate tissue within the anatomical plane.

The objective of the Omega approach is not merely to remove obstructing prostate tissue. It employs a systematic dissection strategy designed to preserve functionally important anatomical structures as much as possible during surgery.

The technique evolved from the high-volume clinical experience, anatomical observations, surgical technique development, and scientific research that began after 2015 and was subsequently introduced into the academic literature through scientific publications.

Assoc. Prof. Dr. Serdar Yalçın’s Role in the Scientific Development of the Omega Technique

The development of the Omega technique was not based on a single operation or a short period of observation.

The experience accumulated through a high number of anatomical endoscopic enucleation procedures from 2015 onward enabled detailed evaluation of the prostatic apex, sphincter anatomy, and different enucleation planes.

Assoc. Prof. Dr. Serdar Yalçın actively participated in the development of the HoLEP Omega approach, establishment of its surgical principles, clinical applications, and preparation of scientific publications, and is among the authors of the principal scientific studies describing the technique.

Today, this academic and surgical experience accumulated over many years is applied to HoLEP, ThuLEP, ThuFLEP, and other anatomical prostate enucleation procedures performed in Bodrum / Muğla.

What Is the Difference Between HoLEP, ThuLEP and ThuFLEP?

Patients frequently ask, “Which is better: HoLEP, ThuLEP, or ThuFLEP?”

Although these techniques use different laser technologies, their fundamental surgical principle is based on endoscopic enucleation of the prostate adenoma along its anatomical plane.

HoLEP uses holmium laser energy.

ThuLEP uses thulium laser technology.

ThuFLEP uses thulium fiber laser technology for anatomical prostate enucleation.

The choice of energy source and enucleation approach should take into consideration the patient’s prostate anatomy and size, clinical characteristics, available technology, and the surgeon’s experience.

For this reason, in modern laser prostate surgery, experience in anatomical enucleation is as important as the name or type of laser technology being used.

Patients Traveling to Bodrum / Muğla for HoLEP from Other Cities and Abroad

Patients seeking evaluation for HoLEP at Acıbadem Bodrum Hospital apply not only from Bodrum and Muğla but also from İzmir, Aydın, Denizli, Istanbul, Ankara, and other cities throughout Türkiye.

In addition, international patients and patients living abroad can be evaluated for HoLEP, ThuLEP, ThuFLEP, and the Omega technique.

For patients living outside Bodrum or abroad, available medical records can initially be reviewed and, when appropriate, an online consultation can be arranged.

Prostate MRI or ultrasound findings, prostate volume, PSA levels, uroflowmetry results, post-void residual urine volume, current medications, previous surgical procedures, and existing comorbidities can be reviewed to provide an initial assessment of potential treatment options.

The definitive surgical decision is made individually after the necessary clinical assessment and investigations have been completed.

Milestones in HoLEP Experience in Bodrum / Muğla

2015
Beginning of Assoc. Prof. Dr. Serdar Yalçın’s experience in HoLEP and anatomical endoscopic prostate enucleation in Ankara.

2015–2021
Participation in approximately 1,000 cases at Gülhane Military Medical Academy and approximately 1,000 additional cases through work at Acıbadem Ankara Hospital and Liv Hospital Ankara — representing involvement in a surgical experience of more than 2,000 cases.

More than 15 HoLEP Training Programs
Serving as an instructor in educational programs attended by hundreds of urologists from different regions of Türkiye.

HoLEP Omega / Omega Technique
Active involvement in the development, clinical application, and scientific publication process of the technique and authorship of its principal scientific studies.

September 8, 2021
Beginning of clinical practice at Acıbadem Bodrum Hospital.

September 27, 2021
The first HoLEP surgery in Muğla, performed by Assoc. Prof. Dr. Serdar Yalçın at Acıbadem Bodrum Hospital.

2021–2026
Hundreds of HoLEP, ThuLEP, and ThuFLEP procedures performed in Bodrum.

97 years
The oldest patient treated within this surgical experience.

485 grams
One of the largest prostate sizes treated with anatomical endoscopic enucleation within the personal surgical series.

Where Is HoLEP Performed in Muğla?

The first HoLEP surgery in Muğla was performed on September 27, 2021, by Assoc. Prof. Dr. Serdar Yalçın at Acıbadem Bodrum Hospital.

Assoc. Prof. Dr. Serdar Yalçın has continued in Bodrum since 2021 the HoLEP and anatomical endoscopic enucleation experience that began in Ankara in 2015.

At Acıbadem Bodrum Hospital, patients with benign prostatic hyperplasia are evaluated and treated using HoLEP, ThuLEP, ThuFLEP, and the Omega technique, according to individual clinical characteristics and surgical indications.

From 2015 to the Present: HoLEP Experience from Ankara to Bodrum / Muğla

Assoc. Prof. Dr. Serdar Yalçın’s HoLEP journey began in Ankara in 2015.

Following participation in a surgical experience involving more than 2,000 cases at Gülhane Military Medical Academy, Acıbadem Ankara Hospital, and Liv Hospital Ankara; serving as an instructor in more than 15 educational programs; and contributing academically to the development and scientific publication of the Omega technique, this experience was brought to Bodrum in 2021.

Assoc. Prof. Dr. Serdar Yalçın began working at Acıbadem Bodrum Hospital on September 8, 2021, and performed the first HoLEP surgery in Muğla on September 27, 2021.

Since then, hundreds of HoLEP, ThuLEP, and ThuFLEP procedures have been performed in Bodrum. This experience encompasses a wide range of clinical scenarios, from patients up to 97 years of age to very large prostates reaching 485 grams, and from patients with significant cardiovascular comorbidities to complex patients receiving antithrombotic therapy.

Today, this experience continues at Acıbadem Bodrum Hospital, combining surgical expertise, modern laser technologies, multidisciplinary patient assessment, and the academic knowledge gained through participation in the development of the Omega technique.

Assoc. Prof. Dr. Serdar Yalçın – Urologist

HoLEP • HoLEP Omega • ThuLEP • ThuFLEP • Laser Prostate Surgery • Anatomical Endoscopic Enucleation of the Prostate

Acıbadem Bodrum Hospital – Bodrum / Muğla, Türkiye

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