Richard Wolf PIRANHA: The Morcellator for Prostate Enucleation

Why enucleation needs a morcellator

In enucleation procedures such as HoLEP or thulium enucleation, the prostatic lobes are separated from the capsule in one piece. They cannot pass through a resectoscope sheath whole, so after enucleation they lie in the bladder. A morcellator cuts the tissue into small fragments and removes it by suction, which is why it is a standard part of an enucleation tower.

Without a reliable morcellator, the benefit of enucleation is lost at the last step. Morcellation speed and safety are therefore selection criteria on par with the laser itself. For a general overview, see our prostate morcellator guide.

When comparing morcellators from different manufacturers, use neutral criteria: tissue throughput under the same irrigation conditions, blade availability, noise, how easily the morcescope is cleaned, and whether the suction pump can collect tissue for pathology. Ask each supplier for the instructions for use and for a demonstration in your own theatre.

PIRANHA system: what is in the package

Richard Wolf describes PIRANHA as a morcellation line for endoscopic enucleation of the prostate (EEP) that speeds up and refines tissue morcellation. The PIRANHA package consists of the morcescope, a suction pump set and the Vmax blade, available in disposable and reusable versions.

The morcescope has two irrigation channels and a 5 mm working channel. Its telescope fits 24 Fr and 26 Fr outer sheaths, a SNAP-ON coupling joins the parts and an automatic valve reduces water loss. The Vmax blade turns at 1500 rpm.

• Morcescope with two irrigation channels and 5 mm working channel
• Fits 24 Fr and 26 Fr outer sheaths
• SNAP-ON coupling and automatic valve
• Suction pump with separate container
• Vmax blade, disposable or reusable

Resectoscope vs morcellator: how they work together

Resectoscope vs morcellator is not a choice: they have different jobs. The resectoscope, here the SHARK, provides the sheath and access and, with a laser fiber, the enucleation. The morcellator then works through the same outer sheath after the resectoscope insert is exchanged for the morcescope.

Because PIRANHA is designed for SHARK, outer sheaths of 24 and 26 Fr are shared and the transition between steps is short. A footswitch toggles between PIRANHA mode and suction mode, which keeps the surgeon in control without a second pedal set.

Enucleation prostate using Wolf morcellator: workflow and histology

A typical workflow has three phases: enucleation with a laser or bipolar energy, morcellation of the lobes in the bladder, and a final check for bleeding. PIRANHA uses a suction pump with a separate container, so the tissue remains suitable for histology, which pathologists need to review.

The Wolf morcellator for HoLEP works with a holmium laser such as the MegaPulse 70+; the same morcellator can serve other enucleation energy sources. See holmium laser enucleation equipment for the complete tower.

Plan staff preparation as well: the scrub nurse should know the assembly order, the valve check and the pedal toggling, and the surgeon should know the suction modes and the safe blade position in the bladder. A dry assembly on the table before the first case is good practice.

What to check before buying

Check sheath compatibility with your existing resectoscopes, the availability of reusable and disposable blades, and the capacity to reprocess the morcescope. Ask who trains the team and who services the suction pump. Confirm registration requirements with MOHAP, DHA or DOH, as they change.

Beckfinity can prepare a combined offer for SHARK, PIRANHA and the laser, with installation support through our installation service. Send your case mix through the contact page.