Thursday, December 22, 2005

Audiovisual Course on New Technologies in Urology

Today I have received a copy of the fourth volume of the Audiovisual Course on New Technologies in Urology. A training programme sponsored by Pfizer and supported by the Spanish Urological Association. I already contributed for volume I with a video and a chapter on PVP - Photoselective Vaporization of the Prostate. In this volume IV I have published an article and a video on Cryosurgical ablation of prostate cancer. This is an interesting video, it includes images of the 4D transrectal ultrasound monitorization of the procedure, a new approach we performed at the Instituto de Cirugía Urológica Avanzada (ICUA), in Madrid.
This training course will be provided for free to all Spanish urologists. The editor is one of my colleagues at the ICUA, Dr. Ignacio Castillón. He was trained as a laparoscopist in L.A., USA. 90% of the content in this audiovisual course is related to laparoscopy.

Monday, December 19, 2005

New training session in La Coruña

This Monday, December 19th, I went to La Coruña again to participate in a Photoselective vaporization of the prostate (PVP) surgical training session. We did two operations, the morning session on a patient with a 70 gram prostate and the afternoon session on a patient with a 90 gram prostate. The day was uneventful, we had time to go a wonderful restaurant for lunch, with a view of La Coruña. Octopus is the local specialty and it is delicious. I then came back to Madrid, the following day I had to operate a friend who is a Doctor and his prostate volume was 105 cc. The operation was also uneventful and I was able to discharge him in the afternoon, after two and a half hours of PVP. The more PVPs I do, the more I like PVP, recovery is so spectacular, patients go back to their normal lifes, and results are so good!!!

Tuesday, December 13, 2005

New training session in Barcelona

Today I went to Barcelona, to participate in another surgical teaching session at TEKNON hospital, in Barcelona. We did two PVP cases, both prostates were relatively small, so the surgeries did not take much, and everything developed smoothly. One of the patients had been operated in the past, fifteen years ago, with a TUIP (Transurethral incision of the prostate), performed with a classic resectoscope. His prostate was highly irregular, but this did not pose any problem. We did not see a drop of blod in all day, both cases were highly satisfactory.

Monday, December 12, 2005

New training session in La Coruña

Today I took a plane to La Coruña, to participate in another teaching session. The case we operated today was relatively difficult. The prostatic size was not too big, but it was richly vascularised and had a tendency to bleed. As the instrument we introduce through the urethra for Photoselective Vaporization of the Prostate is rather thin, and the irrigation of water in-and- out the bladder it provides is rather slow, any amount of blood, no matter how small, obscures vision and makes the procedure more difficult. We had to use all the surgical tricks and strategies to be able to finish the procedure successfully. A teaching session with a high learning value. The image shows the Veru Montanum, the anatomic structure where ejaculatory ducts drain into the urethra. This is an important surgical landmark, because it tells the surgeon the exact localization of the external urinary sphincter, that must be respected. A little bit upwards, both lateral lobes can be seen in part, they obstruct urinary flow in the same way as tonsils obstruct the pharynx in children...

Saturday, December 10, 2005

Meeting of Spanish Greenlight users at USP Hospital San José

This saturday we celebrated the second meeting of the Spanish users of the Greenlight Laser at thel Hospital USP San José de Madrid, the institution where I work. The meeting was kindly sponsored by Davanzia, the medical company that distributes this KTP laser and other medical products in Spain. The meeting was organized with the help of USP and the Instituto de Cirugía Urológica Avanzada. We welcomed doctors working in 20 out of the 25 (soon 30) units offering this technique throughout the country. Two live surgeries were performed, one in a 100 gram prostate, by Drs. Torrecillas, Macías and myself, to show the different strategies and techniques used. This was transmitted via a videolink to the audience. In the afternoon, I performed a PVP on a patient with a 166 gram prostate. It was interesting to share the initial experience of the groups offering this relatively new technique in the country. It allowed us to share experiences and technical aspects of great interest, specially for those groups with less experience. All presentations were of high quality and I believe all participants went back home with better knowledge on the technique and convinced about the fact that PVP will gradually substitute TURP for its high efficacy and low morbidity.

Friday, December 02, 2005

Invitation to operate in Chile 4

Today we returned to the theatres of the Military Hospital in Santiago de Chile to carry out the last surgical training session. It has been a privilege to get to know this urology department where all urologists are great specialists and also fantastic human beings. We have again operated three patients and I will return to spain with the nice feeling that the urologists of this department have taken advantage of the training and are now able to carry out a PVP (Photoselective Vaporization of the Prostate) correctly and in a safe and efficacious way. Two o fthe patients we operated yesterday voided without problems, the last one had some difficulty and we decided to keep a small urinary catheter for a couple of days. The surgical result was very good, so he will do well for sure. All patients had clear urine and felt very well.

Coming to Chile has been a very enriching experience and it has been a privilege to be able to share some time with the urologists from the Military Hospital. The head of the department of urology, Dr. Fernando Coz is a fantastic urologist and a wonderful person. This morning he was able to operate one of the patients with technical perfection. After the satisfaction of having contributed to this department and their future patients, I will take some time to rest visiting the south of Chile with my wife.

Thursday, December 01, 2005

Invitation to operate in Chile 3

Today we performed three new cases of PVP (Photoselective vaporization of the prostate) at the Military Hospital at Santiago de Chile. We did two simple cases with prostatic weights of 40 and 50 grams and a more difficult one, with 79 grams, that was very successful and I was able to complete it in one hour and fifteen minutes. We visited the patients operted the previous morning, and were catheter-free and voided wonderfully, their flow rate was 12, 14 and 18 mL/s, and it will improve further day by day. The personnel working at the military hospital was very surprised to witness the results of this technique.

The Military Hospital in Santiago is very nice and it looks as a wonderful hospital, but they are building a new one and they will move there next year. The theatre's personell is really nice and efficient. The urologists working here have enjoyed this experience because they thought this technique was something different. They thought PVP was a slow and less spectacular than it really is. I have taught them all the tricks I know to perform it safely and efficaciously.

During the afternoon, I dictated the conference "PVP (Photoselective vaporization of the prostate, a new horizon in the treatment of BPH" in the auditorium at the Military Hospital. After my presentation we had a discussion that was very fruitful, with very good questions from the floor related to the technique.