Training in San Sebastian

This friday I travelled to San Sebastian. I took a plane with my wife and daughters, accompanied by Dr. Al Tayyib, from Saudi Arabia, to participate in a training session on HPS laser prostatectomy at the Clinica del Pilar, that has decided to invest in top technology for the treatment of benign prostatic hyperplasia. I had to train two local prestigious urologists.

We had some problems just after arriving to San Sebastian. Iberia lost my luggage, and my cystoscope was inside my suitcase, and I needed it to operate that same afternoon. Thanks to the rapid reaction of the Olympus representative in the Vasc Country we could borrow a new continuous flow Olympus cystoscope. This new instrument has an 8 F channel that allows a better irrigation and it performs much better than the previous Olympus cystoscope. It provided us with a fantastic visibility during surgery, so I would recommend it to other users.

I did two cases, the first one was a huge prostate, bigger than 120 grams, that was completely uneventful. Then we did a second case that was also interesting. Dr. Al Tayyib, who was extremely satisfied to have had a chance to see the HPS in action with small, medium and large prostates during his week in Spain with us, rushed to the airport as he had to return to Saudi Arabia. I stayed in San Sebastian to spend the weekend with my wife and daughters.

Although it is one of the most beautiful cities in Spain, we were not very comfortable in San Sebastian, as the rain did not stop pouring over us and also because we could not change our clothes as much as we would have liked. If you lose your luggage with Iberia, you are in trouble. You call the lost luggage information number and they do away with you with a simple recording. I was lucky because Ana María, my PA, went to Madrid Airport on Sunday, and asked a friend working at the airport to help her review case by case until she found it. If I did not have the best PA in the world, I think I would have never recovered our lugagge and cystoscope!

Visitor from Saudi Arabia in Madrid

Today I did three PVPs with the new high power 120 watt HPS laser in the company of Dr. Al Tayyib, from Jedda, Saudi Arabia. We enjoyed very much because the cases were very interesting, prostatic sizes were bigger than those we did on tuesday. We had a wonderful session together where we could share a lot of information on the technique. I prefer to have this one-to-one sessions because it is much easier for me to share my experience and for the visitor to ask every possible question. One of the cases was extremely interesting, because the patient had very limited mobility of his right hip, and I had to perform the operation with very limited movements of the cystoscope, but the result was fantastic... we both thought it would have been impossible to operate him with the traditional TURP.

Dr. Al Tayyib, as all Saudi doctors I have met, has a fantastic urological knowledge and it was a great pleasure to share this session with him. Soon his Urology department at Jedda will start using this technology and I will travel again to Saudi Arabia to give them a hand.

Multinational visitors to theatre in Madrid

Today I had a theatre training session in Madrid with a lot of visitors. We received 6 visitors from Sweden, four from Switzerland and one from Saudi Arabia. I first did a talk in a nearby hotel on the basic principles of Greenlight HPS 120 laser treatment of BPH, and then we went to the hospital, where I did two operations with this laser.


Then I had lunch with the Swedish visitors who left Madrid very impressed by the technique and then I went to have dinner with the Swedish visitors to a famous flamenco restaurant in Madrid, El Corral de la Morería, so we had time enough to enjoy the operations in theatre and then a fantastic dinner and a great dance show. Our visitor from Saudi Arabia stayed in Madrid to participate in further surgical sessions this week.
I did not take photos in theatre this time, but one of our visitors did and promised to send them to me, so I hope she does and I can update this post sometime...

European Association of Urology Congress in Berlin

I have just arrived from Berlin, where I have participated in the 22nd Annual Congress of teh European Association of Urology. This is the impressive building where it took place.

I try to go every year to the EAU congress because it is an excellent congress. Not only it allows to update your knowledge, but also to get to know new drugs in the market, new medical or surgical devices, but also it is a great opportunity to meet friends from other countries. In this respect, I have had a very intense activity meeting with other world experts in Photoselective Vaporization of the Prostate, we have very interesting projects in common that I will cover in future posts in this blog. There were many abstracts related to PVP coming from many different countries, and all of them were extremely positive.

This year I chaired the European School of Urology course on Multimedia applied to urology, with Dr. Aurel Messas, from France. The EAU offers webcasts of all ESU Courses online, and my presentations are available online. I guess the quality of the webcast will not be perfect, because I was using a lot of flash videos that will not play on the webcast. A pity.

Another very interesting aspect of this congress has been the launch of www.urosource.com, a website sponsored by the EAU that offers news, key papers and other content, but the most amazing is the possibility to access the surgical video bank of the EAU. There I found, for example, a video on a new urethroplasty technique that I submitted to the congress two years ago.

From Bilbao to Venice

On Friday morning I did a short talk on the new Greenlight HPS at the congress in Bilbao. Thanks to the impressive technological organization of the meeting we could transmit to the audience the status of the patient I had operated the previous day. He was doing well, and we showed a live transmission of his ultrasound compared to the previous day. His prostatic volume went down from 70 cc to 25 cc, the median lobe had been vaporized completely. The flow rate had gone up from 5 mL/s to 18 mL/s in just one day. He was after discharged and I went to the airport.


I took a flight to Venice, Italy, invited by the pharmaceutical company Astellas to a training session on how to improve medical presentation skills. It was beautiful to take the boat-taxi from the airport to the hotel...


This was a very interesting initiative from Astellas, I had a very nice working day in the company of some friends, Dr. Castillón, Dr. Sanz from Marbella and Dr. García Montes, from Mallorca. The lady in the photo is Chira Ariño, from Astellas, a fantastic woman and professional.


Dr. García Montes is the chap with the looks of a flamenco dancer in the middle of the photo, and he is one of my most loved friends. We shared a lot of time together when we both worked at the Institute of Urology in London. He is now an expert on artificial sphincters.

Then I travelled back to Madrid on Sunday, I needed to rest a little in the company of my family.

Live surgery in Bilbao

Yesterday started the I Symposium Internacional de Cirugía Robótica y Nuevas Tecnologías en Urología, organised by the prestigious urologists group Urología Clínica, from Bilbao. This congress, mainly devoted to robotic surgery, also has a session on lasers for benign prostatic hyperplasia. The panel of experts invited is espectacular, with urologists as Cathelineau, Gastón, Lugnani, Murat, Piechaud, Wilson. I was invited to participate performing a live surgery in a patient with BPH with the new Greenlight HPS (High Performance System) laser in the Virgen Blanca Hospital in Bilbao, while the attendees were in the conference hall at the Museo Marítimo de Bilbao, in a beautiful part of the city. The hospital was equipped with a system to retransmit video and audio to the congress hall.

The patient I operated had a 70 gram prostate with a humungus median lobe, a slightly difficult case, with the intention to show the audience a real life case, rather than a selected and easy BPH case, so they could evaluate the real ability of this laser to deal with real life prostates...
During surgery, Dr. Carlos Hernández, the moderator of the session, asked me questions about the technique, the surgical strategy and the features of the new HPS system.

Surgery was smooth and beautiful, there was no problem at all. I delivered 525.000 joules in 80 minutes. Some colleagues commented they were impressed not to see a single drop of blood. Today I will do a presentation in the congress hall and then I have to split because I have to fly to Venice, where I will attend another medical meeting this weekend.