Wednesday, December 13, 2017

ExactVu system, micro-ultrasound of the prostate for prostate cancer diagnosis

Last December 2017 we tried for the first time the ExactVu system of high resolution microultrasound of the prostate for the diagnosis of prostate cancer.

It is a sophisticated high resolution ultrasound (conventional transducers for transrectal ultrasound imaging have 7 MHz, but this has a 29 MHz probe), that improves radically our ability to detect subtle anatomical details in the prostate.

After studying carefully what this technology can add to the diagnosis of prostate cancer, we have decided to adopt it at ICUA-Clinica CEMTRO, to make it available for our patients.

We believe it can be a very nice companion to 3 Tesla Multiparametric MRI and that it can be of great help in paitents who do not tolerate MRI or in which MRI is non conclusive. In some of the cases we performed we could see lesions that the MRI had not even seen and on biopsy there was a tumor lesion.

It is a costly technology, but we believe it will help us detect prostate cancer even earlier in men and thanks to that, improve the chances of cure in our patients.

Many other high level centers are also adopting this technology, and the data published to date is extremely positive.

A very interesting tech that can be better known at the website of exact imaging.

Monday, December 11, 2017

First cases of Prostate Aquablation in Spain

This december we had the opportunity to try for the first time in Spain the Aquablation system, from
Procept Biorobotics for the treatment of BPH.

It is a robotic system that uses a very powerful water jet to deobstruct the prostatic urethra, and it does that in just 5 minutes. The patient is awake, tipically under spinal anaesthesia.

It needs some preparation, but it is surprising to see how fast one can treat prostates of all sizes in such a reduced time.

The main advantage of this system is that 90% of men treated preserve the ability to ejaculate normally.

This is why this technology is very interesting, as many men that need to face an operation for BPH would like to preserve ejaculation, that is tipically affected by other surgical techniques.

More info in spanish here, or watch our video below.

Friday, December 08, 2017

Focal treatment for localized prostate cancer

I Spent this weekend in Paris participating in the ESU-ESUT-ESUI course on Focal therapy for localised prostate cancer.

It is interesting to see how this concept is gaining ground around the world, and evidence to support its use is acumulating. It was interesting to explore this option of management for very selected patients. The information obtained from MRI-Ultrasound fusion biopsies is allowing us to better select the patients who will benefit from this approach.

A very interesting course in Paris!

Wednesday, November 29, 2017

Visitors to our operating room

As it is common every month, we had visitors in our surgical room. This time, various colleagues from spain came to witness a surgical session, where I could show them the advanced techniques for the treatment of benign prostate hyperplasia with the GreenLight laser. I showed them anatomic vaporization and GreenLEP and how to transtion from vaporization towards enucleation.

The reactions of visitors coming to our surgical room are always the same, they leave convinced of the versatility of this laser and the robustness of theste techniques, as they are very safe and efficacious. It is always a pleasure to receive visitors and make new friends.

Friday, November 24, 2017

ESU-ESUT Masterclass on Lasers in Urology

This weekend I travelled to Barcelona to participate in the ESU-ESUT masterclass on lasers in urology.

I was invited to give a couple of lectures, participate in a round table and to perform a live surgical procedure that was broadcasted to the main auditorium of Fundació Puigvert.

Everything went very well and I could present my techniques of anatomic vaporization and GreenLEP (Green Laser Enucleation of the Prostate), and a very interesting discussion followed. Despite I am trying to travel less offten to be able to devote myself to my patients at Clinica CEMTRO in Madrid, it is always a pleasure to see my friends and to participate in the training of other urologists in the minimally invasive treatment of prostatic diseases.

Wednesday, November 15, 2017

Visitors to our operating room

As usual, today we received the visit of Urologists from the United Arab Emirates and Saudi Arabia, who were interested to watch advanced techniques on the treatment of BPH with the GreenLight Laser.

I could show both an anatomic vaporization and two enucleations (GreenLEP). I think they were surprised as there are still many urologists that are unaware of the extreme versatility of this laser ot treat prostates of all sizes.

Thursday, November 02, 2017

New video of a radical nephrectomy in a patient with renal cell carcinoma and caval tumor thrombus

We have edited this video of a recent surgery we performed at ICUA - Clinica CEMTRO in Madrid.

The Da Vinci Xi robot has improved the contitions to perform this kind of complex surgery that used to entail big open operations with a high risk of surgical complications.

It is in Spanish, I will see if I can produce an English version of this soon.

Experts meeting in London

This time I went to London to join a meeting with other international experts in surgery for BPH to discuss advanced techniques for the treatment of BPH, that at last are going to be promoted internationally in collaboration with Boston Scientific, the manufacturer of the GreenLight laser.

I had to present on my techniques of anatomic vaporization and GreenLEP (Green Laser enucleation of the prostate).

I am also working in the preparation of a manual describing step by step how to perform these techniques, that will be distributed to all GreenLight Users worldwide.

Despite the fact that these techniques that I described have gained wide support by urologists in various countries, as Italy, France and USA, up to now Boston Scientific had not supported them officially, but the good results obtained in studies published in Italy and France and the enthusiasm they generate in their users and patients finally have made it happen!