Saturday, October 28, 2006

Experts meeting in London

This friday I travelled to London to meet Mr. Gordon Muir and Prof. Alex Bachmann (in the Photo) to finish the article on technical recommendations on PVP (Photoselective vaporization of the prostate) with the 80 Watt Greenlight PV laser. This article also includes recommendations on how to train urologists to perform this operation correctly. We started this article during our experts summit in Madrid in July. We have used the opportunity to start a second paper on the complications observed with this technique (of course less important than those observed with the classic transurethral resection of the prostate) and how to avoid them. Christine Mckillop, a professional medical writer specialised in Urology is helping us to maintain order and focus, as it is not always easy to reach the consensus among five international experts... She is always taking notes and drawings, and as the time was short, we decided to keep on working during our lunch....

Friday, October 27, 2006

Trip to Lyon, France, HIFU for Prostate Cancer

This thursday I took a plane to Lyon, to visit Dr. Murat and Dr. Gelet, both world experts in the treatment of localised prostate cancer with HIFU (High Intensity Focused Ultrasound). I went to theatre to witness two HIFU cases, one for a primary prostate cancer (recently diagnosed), and the second one was a patient who was treated with radiotherapy and this treatment failed, and recurred to HIFU as a salvage treatment.
Next tuesday we will perform our first case in Madrid, we will have the first permanent HIFU device installed in Spain and we will offer this treatment option to our patients, and the possibility of getting trained to those urologists who want to learn. It is an impressive technology, that allows prostate cancer to be treated with minimal discomfort and with a lower risk of complications or secuelae.

This video shows how the technique is performed.

Thursday, October 26, 2006

Surgeries in Castellón

This morning I woke up early to travel to Valencia. From there I took a car to go to Castellón, where I was invited to mentor a group of urologists. I did three PVPs in the morning session. The National Health Service in Castellón is starting to use PVP. After I finished, I went back to Valencia and from there back to Madrid and from there I took a plane to Lyon, France. Tomorrow I will wake up early again to participate in a course on HIFU (High Intensity Focused Ultrasound) for prostate cancer.

Saturday, October 21, 2006

Masterclass with Prof. Gastón

This saturday we had the privilege of hosting Dr. Gastón in Madrid. In this ocassion he came with the legendary Monique, his nurse, that is able to assist him and do the instrumentation as a scrub nurse at the same time. They have operated together for 20 years and they are maybe the best example of surgical excellence in urology. Watching them operate is like watching a ballet as they perform an impecable operation. He did three radical prostatectomies while we watched. I picked them up at the airport at 9 am and at 5.30 pm he had finished and had time to relax in the way back to the airport and Bordeaux.

Wednesday, October 18, 2006

Invitation to Egypt

Yesterday I received an invitation to participate in the Annual Course of the Egyptian Urological Association. This is one of the most prestigious congresses celebrated in the African continent. Egyptian Urology has produced a number of world class surgeons and urology gurus... I will lecture on Greenlight Photoselective Vaporization of the prostate. A nice challenge and a wonderful trip!

International Course at Fundació Puigvert

This morning I had to wake up early to take a plane to Barcelona, to participate at the Annual International Course organised by the prestigious Fundació Puigvert. My role was to moderate a live surgical session where Dr. Montlleó performed a Photoselective Vaporization of the Prostate with the 80 Watt KTP laser. After the training sessions I conducted at Puigvert, and after having operated 15 patients, she was able to perform a wonderful operation. We took the opportunity and we discussed in depth the advantages of this technique over conventional surgery in the treatment of BPH.

This has been an impressive course, world class surgeons were invited and the best technical resources were available. The conference room was totally silent, because there were two simultaneous operations being retransmitted and the attendees had the option of chosing what surgery and comments to listen. Also, to appreciate the surgeon's point of view in robotic operations, all attendees wore 3D goggles. An espectacular course!!!

Thursday, October 12, 2006

Trip to Valencia to operate a colleague

Yesterday I went to Valencia to operate a colleague. A urologist and friend of mine who I mentored on the technique of Photoselective Vaporization of the Prostate. He has had a chance to experience the results of this operation in his own patients, and he asked me to fly to Valencia to operate him, and I did with pleasure. He has phoned today to tell me that he spent the night home after the operation, and that he is voiding well, will totally clear urine... It is a great honour to be asked by a colleague and friend to operate him.

Monday, October 09, 2006

Greenlight HPS

This video shows an endoscopic prostatectomy in a patient with a 60 gram prostate with the new 120 watt HPS grenlight laser. This laser has the same wavelenght than the 80 watt Greenlight KTP laser (532 nm), but is much more powerful. It vaporizes tissue at a higher rate and thus operative time is reduced. The Greenlight KTP laser is a wonderful tool, this new laser will be specially useful to treat bigger prostates.
This is a TRUS image of the prostate preoperatively.

And this is the postoperative aspect of the prostate. There is a huge central cavity showing that all BPH tissue has been removed.

Saturday, October 07, 2006

European School of Urology Course in Albufeira, Portugal

This morning I participated at the ESU Course on minimally invasive treatments in urology, that took place during the Annual Congress of the Portuguese Urological Association. This has been my first contribution as a faculty member of the European School of Urology.

My task was to discuss the current status of minimally invasive treatments of benign prostatic hyperplasia. I have analized these options, as well as their pros and cons (TUMT, TUNA, ILC, intraprostatic Botox, TEAP, WIT, HoLap, HoLep, and so on). I also discussed in detail my experience with the Greenlight laser, and showed my experience with the new HPS laser. The meeting has been really interesting and many urologists showed up for the course. After our lectures, we had a relatively long and lively discussion.

The chairman of the session, Prof. Morgia, from Italy, in the left hand side of the photo below, spoke about the minimally invasive treatment of prostate cancer, including cryosurgery, High Intensity Focused Ultrasound (HIFU) and brachytherapy. Prof. Dimitri Pushkar, from Moscow, in the center of the photograph, spoke about urinary incontinence, he has a vast experience in lower urinary tract reconstruction in the female. He has operated more than 2000 urinary fistulas (!).

After the session, I only had time to enjoy lunch by the sea with my good friend Dr. Reis Santos, from Lisbon, and I had to rush to the airport, on my way back to Madrid.