Sunday, February 15, 2015

Invitation to proctor at Massachusets General Hospital, Hardvard University, Boston, USA.

This time I had to travel far, to Boston, where there was a winter storm with terribly low temperatures, to help Dr. Shahin Tabatabaei, associate professor at MGH - Harvard University, to polish his technique of GreenLight En bloc enucleation of the prostate. He already came to visit me in Bulgaria and saw many cases and had initiated the technique on his own, but wanted to improve and learn some tips and tricks.

We spent the first day at the operating room, we did two very difficult cases of patients with large glands that took their time. The rest of the surgeries were cancelled because the city was blocked by the snow.

Both cases went very well and Dr. Tabatabaei was able to extract a huge adenoma from one of the patients.

The second day I participated in a training session for residents and urologists of the hospital with Dr. Tabatabaei.

We first gave two short talks on the principles of laser surgery and then we worked with the residents with the surgical simulators and studied the surgical instruments necessary for this technique.

The following day I gave a talk at the department Grand Rounds session to present the En Bloc Green Laser Enucleation technique. It was very interesting and we had the honor of receiving the visit of Lori Lerner, famous for her dedication to Holmium laser enucleation, who added her experience to a very intense and interesting discussion. The urologists from MGH thought this is a very interesting new avenue for the treatment of BPH and Dr. Tabatabaei is going to continue to perform it and I hope we can participate together in a multi center international study that is going to start soon.

The last day of my stay in Boston we went back to the operating room for another surgical session, that also went very well. Dr. Tabatabaei chose very complex cases and we spent the day operating.

I got this diploma as a reminder of my stay in Boston. It has been a great honor for me to share with my colleagues in Boston and to collaborate once again with my friend. Dr. Tabatabaei.

Finally I returned to Madrid, despite the weather getting worse, I managed to take off just in time to celebrate my birthday (I am now 47!).

The following day they cancelled 1800 flights in the northeast of USA, due to the intense cold.

Friday, February 06, 2015

Surgical session at Hopital Europeen Georges Pompidou in Paris, France

This time I went to this impressive hospital in Paris, to demonstrate Prof. Arnaud Mejean the new techniques of anatomic vaporization and En Bloc Enucleation of the prostate with the GreenLight laser for the treatment of BPH.

I performed three operations during the morning that went very well. Dr. Mejean showed me the department of urology, really impressive.

We had the chance to discuss the role of the GreenLight laser in the treatment of BPH and I insisted in the importance of proper training to obtain optimal results. He was very impressed with the operations, we could operate a patient with a prostate over 100 g in less than one hour.

Thursday, February 05, 2015

Surgical mentorship in Modena, Italy

Again I travelled to Modena to operate with Dr. Ferrari patients with BPH (Benign Prostatic Hyperplasia). I reached the Ospedale Hesperia by car from Bologna, it was very cold and snowed all day long.

This time I helped him with his cases of GreenLEP (En bloc Greenlight laser enucleation of the prostate). I could ascertain one more time how this technique can be taught and learnt. Dr. Ferrari performed two cases wonderfully and independently. He is a great surgeon.

From Modena I travelled to Paris that night, to participate the following day in another surgical session.

Thursday, January 29, 2015

Round table at the annual meeting of the Endourology Group of the Spanish Urological Association

I went to Bilbao to participate in the annual meeting of the Endourology Group of the Spanish Urological Association.

The round table was moderated by Dr. Rodriguez Antolín and I participated with Dr. Placer (Holmium laser) and Dr. Ruibal (laparoscopic adenomectomy), my role was to defend the role of GreenLEP (Green Laser Enucleation of the Prostate).
Con el Dr. Placer (centro) y Ruibal (derecha)
I briefly presented the development of the GreenLEP technique, how to learn it progressively, starting with anatomic vaporization and hybrid operations, and the results obtained in the last 5 years.

I tried to express my conviction that we have to abandon conventional open surgery and TURP once and for all, and that there is no sense in doing laparoscopic adenomectomy when we have safer and less invasive techniques as laser enucleation. All the departments of urology in the world should embrace laser prostatectomy, making whatever efforts are necessary to learn and to replicate the excellent results we can achieve with Green and Holmium lasers.

Wednesday, January 28, 2015

Visitors to our surgical room at Clínica CEMTRO

Today we received the visit of Dr. Francisco Bon and Dr. Alfredo Bohorquez from Hospital Dr. Peset, Dr. Narcis Camps, from the Hospital de Bellvitge, Dr. Virgilio Vaz, from Portugal, and Dr. Ramón Abascal from the Hospital General de Asturias.

We performed at Clínica CEMTRO a surgical session with 4 patients. I could demonstrate the different existing techniques for the treatment of BPH, anatomic vaporization, vapo-enucleation and the "en bloc" enucleation with the GreenLight laser.

Everything went very well, it is always a pleasure to receive the visit of other colleagues and to share with them!

Tuesday, January 27, 2015

GreenLEP tutorship in Portugal

Again I flew to Porto to reach Coimbra with Dr. Antonio Oliveira, who is determined to learn the En bloc GreenLEP (GreenLight Enucleation of the Prostate) technique.

We went to the Hospital Idealmed to perform three operations. All patients had prostates over 100 cc.

I was very happy to see the fast progress that Dr. Antonio Oliveira had, he is now independent in the performance of this operation. I helped surpass some minor difficulties in two of the cases, but he was able to complete one on his own.

I am very proud to see that this technique that took me five years to develop is now reasonably easy to teach and learn and I liked the interest and determination of Dr. Oliveira to learn properly.

The following day we went to another hospital, the Hospital at Oia, to do another case. Dr. Oliveira completed it perfectly well!

Then I returned to Madrid to rest for the weekend. I was happy thinking that this technique is going to help a lot of patients.

Thursday, January 22, 2015

Surgical session at Ospedale de Guastalla, Italy

Again I travelled to Italy. I went to Milan and slept there, and then drove to the Ospedale di Guastalla, near Parma. In this occasion I had to help Dr. Frattini with his learning curve of anatomic vaporization of the prostate. This technique I developed is becoming the standard technique for Green Laser vaporization in Italy.

Two of the patients had very large glands, over 120 cc, and I performed an En Bloc enucleation of the prostate with the Green Laser. Both went very well. Al the urology staff was there for the session. Then I endured two more hours in the car back to Milan to take a late return flight to Madrid. These sessions are nice and gratifying but it is a hard job!