Saturday, June 30, 2007

"Joaquin Albarrán" Prize

Today I heard I got the third prize to the best video presented at the Spanish Urological Association Annual Meeting. My video presented the new Greenlight HPS laser. The prize consists in some money and a nice medal (below). I have uploaded the video to be able to post it here, sorry, it is in Spanish.

Monday, June 25, 2007

Jedda, Saudi Arabia, part II

This morning I went to the hospital. There were three patients programmed, the first one was operated by Dr. Al Tayyib, who looked like an expert surgeon after only three cases. The second patient had a big gland, with 115 grams, and I did it.

Right from the start of surgery, he started bleeding a little bit, nothing serious or risky for the patient, but enough to impair visibility and I inserted a suprapubic laparoscopic trocar and connected it to a draining tube, to improve the irrigation and be able to finish the operation satisfactorily.div>
I was happy that the urologists watching the operation had a chance to see how a difficult case is solved and finished with success. Then I was presented a much more complex case, an 85 year old old man, who was suffering from dementia, and had a high surgical risk, being diabetic, having cardiac problems... He was catheterised as he could not void spontaneously and the family asked if we could do something for him. After discussing his case with the anaesthetists, we decided to operate him under spinal.
I positioned him in the sitting position to allow him to tolerate the operation better. He tolerated the operation really well. All surgeons present in theatre were impressed to see that these patients can be operated. Due to their high surgical risk They were before condemned to life time catheterisation!!.
We finished at 9:30 and after greeting the patient's family, I joined the scientific session organised after my visit. There were many urologists from Jedda. I did my best to transmit them my experience and what how has this treatment influenced my patient's lifes. Then there was a debate and then we went out for dinner. There was a lot of interest in learning all aspects of this technique, and we all had a goog time.
I am leaving Jedda, fascinated by its architecture, full of palaces and wonderful mosques. I am also fascinated by their people, the wonderful team of the hospital where we have been operating.
That same night, I took the plane to return at 3:00 am. I went to bed and slept like a log. I was exhausted.

Saturday, June 23, 2007

Jedda, Saudi Arabia

This friday I flew to Casablanca, where I stopped to connect to Jedda, Saudi Arabia. Again I have been invited to help a Saudi Hospital to start operating with the new Greenlight HPS laser. I reached late at night and we went to the hospital, a very impressive private center with a wonderful architecture and state of the art medical technology.

There were two surgeries scheduled, and both were performed by Dr. Abdulmalik Al Tayyib with my supervision. He did not need any help, as he is a great surgeon. He visited us in Madrid for a whole week and he could see lots of operations. He is a wonderful person and a very respected urologist in Saudi Arabia.

These fast trips do not allow for much tourism, but as we left the hospital we went to see Jedda by car. It is a very beautiful city, much more relaxed than Riyadh, very nice. Then we went to have some fish for dinner sitting by the sea...

Tomorrow we have more surgeries scheduled, I will give a talk in the evening and then I will depart back to Madrid late at night.

Thursday, June 21, 2007

Visitor from Portugal

This thursday we received a visitor from Portugal who is going to start using the Greenlight PV unit in a hospital near Lisbon. As always, it is a pleasure to receive visitors and to have a chance to talk about the surgical technique and tips and tricks, and to share how this treatment has profoundly change the way we handle our BPH patients...

Sunday, June 17, 2007

Surgical Session in the Island of Gran Canaria

This saturday I took an early flight to the Island of Gran Canaria, where my colleague Dr. Juarez, had prepared four patients to operate in the Hospital Santa Catalina, with the new HPS laser. It has been one of these days where everyting is smooth and easy, all patients went really well and we had a great time together. Normally after a Greenlight operation the urine is clear, but in these patients it was cristal clear...

Then we went out for dinner, and we had a chance to talk and it seems we will keep on collaborating from now on. Dr. Juarez has learned how to do it and he is very skillful and performs a very good Greenlight prostatectomy, but he wants to offer the best possible care to his patients, so he wants me there with him, specially for the most complex cases. I am happy to go there, although I will try to get some additional day and take my family with me, so we can all enjoy our beautiful canary Islands...

Live surgery at the Escandinavian Urology Congress in Aahrus, Denmark

This thursday I traveled to Denmark to participate in the Congress of the Scandinavian Urological Association (NUF 2007). I was invited to perform a Greenlight HPS laser prostatectomy in a patient with Benign Prostatic Hyperplasia (BPH). The operation was broadcasted live from the prestigious Skejby Hospital to a conference room with 130 urologists from Norway, Finland, Sweden and Denmark. The congress welcomed 400 urologists and 400 scandinavian nurses, all of them blond and with beautiful blue eyes... (no comments...;-)

The hospital is impressive, it only has two floors, but it is massive. Nurses travel in small motorbikes around the hospital. It is really something different.

When I arrived to Billund Airport, I was picked up and driven to the hotel where the congress was taking place. Another impressive place, with beautiful architecture. I felt as if I was inside the Death Star from Star Wars.... (see photo).

Then we went out to a dinner organised by the congress at the "Old city" in Aahrus. A wonderful place with old fashioned Danish houses populated by actors... really beautiful.

There I had the chance to see two old friends, Ola Bratt, an expert in prostate cancer from Sweden and Henning Olsen, a pediatric urologist working at Skejby Hospital. I was really happy to see them. We shared many experiences while we all worked at the European Society of Residents in Urology 10 years ago...

The 80 watt Greenlight PV - KTP laser is very popular, but apparently they use very little amounts of energy (80-90.000 joules) in each prostate, and thus, they do a minimal channel prostatectomy. I am convinced this can only work in the short term. Patients improve after sugery, but I am afraid they have a higher risk of needing a reoperation in the future.
The live surgery went really well. The case was ideal for a surgical demonstration, a 45 gram prostate. The audience saw how I used 275.000 joules to perform the operation and how the operation resembled a complete TURP. I showed them my tips and tricks and they all saw the fantastic end result. During the operation, I answered questions from the audience... I think we all had a good time. The feedback after the session was very positive, I think many urologists changed a few concepts in their minds, and saw a different operation to what they were used to...
Then we did a second case, without the cameras, because they had prepared two cases just in case one of the patients got ill and could not be operated that day. Both cases were unevenful. It has been a great experience, and a great honour to operate in one of the best hospitals in Europe.
After the session, I rushed to the airport as I had to reach Madrid on Friday. I had to travel to Gran Canaria on Saturday, I had an appointment with my friends there...

Tuesday, June 12, 2007

Symposium on HIFU for prostate Cancer

Yesterday we celebrated a symposium on HIFU (High Intensity Focused Ultrasound) in hotel Hesperia Finisterre, in La Coruña, during the Annual meeting of the Spanish Urological Association. The panelists were Dr. Sebastian Rogenhofer, from Regensburg, Germany (in the center of the image), Dr. Ander Astobieta, from Bilbado and me.

I presented the scientific basis of the treatment of prostate cancer with HIFU (High Intensity Focused Ultrasound) and I also explained the training system for new users. Dr. Astobieta, from Bilbao, summarized the spanish experience and Dr. Rogenhofer commented on the results in his Hospital in Regensburg, Germany after 11 years using this technology.

Sunday, June 10, 2007

Spanish Urological Association Annual Meeting in La Coruña

Yesterday I flew to La Coruña, in Galicia, the North-West region of Spain situated on top of portugal. I have come to the Annual meeting of the Spanish Urological Association to present two papers, the only two papers on Greenlight HPS laser treatment of BPH in this congress.

The congress center is situated in the "Paseo Marítimo", one of the most beautiful areas of La Coruña, facing the sea.

The first paper is a video presentation on the new Greenlight HPS laser, that I have presented only a couple of hours ago, with very good reception from my colleagues. It seems it is very didactic. My colleagues specially liked a short video of a transrectal ultrasound monitorization of the procedure, an idea I took from Dr. Gil Vernet, for the production of this video.

Tomorrow I will present a poster detailing my initial experience with this new laser.

Then, at 7.00 pm I will give a conference on the basic science behind HIFU (High Intensity Focused Ultrasound) for the treatment of prostate cancer.

It is nice to come to the National Congress, in part because it is always celebrated before the summer, and I relate it with the proximity of the summer holidays... and I realise it has been a tough year and that I really want August to come soon, so I can rest. But it can only be a brief thought, because there is still much to do.... Denmark, Ireland, Saudi Arabia, maybe the Canary Islands, London, and all before the end of the month...

Wednesday, June 06, 2007

A new paper

After the international experts meeting we held last year in Madrid, the consensus we reached on how to perform the PVP procedure will be published soon in Prostate Cancer and Prostatic Diseases. We have received the proof for review and this is how it looks like.

This year we will meet again in Madrid in July. We will try to reach a similar consensus with the new Greenlight HPS laser. As this laser is more powerful, the surgical technique is different and it becomes necessary to produce new surgical and training recommendations. I will host 9-10 top international experts for three days and we will perform surgeries, meet to discuss the technical points and recommendations and also we will publish our conclusions.

Tuesday, June 05, 2007

Terrible heat in Seville

Today I have operated in Seville. The objective was to demonstrate the PVP (Photoselective vaporization of the prostate) technique to various urologists from the Hospital Esperanza de Triana, in Seville, Spain. I took the high-speed train yesterday night, so we could start early in the morning. I have operated four patients and it has been a very interesting session, as two of them were reoperated several years after having had a TURP (Transurethral resection of the prostate). They will be able to compare both patient's experiences: having a TURP and having a Greenlight laser PVP - it would be interesting to know what they think and which they prefer...

After finishing the second operation I gave a brief talk on the basics of Greenlight laser surgery and the new features of this new high powered HPS laser. Then we went back to sugery.
It is seriously hot in Seville, today we had 36º Celsius... aaaggh. All my colleagues were very impressed by the technique and wanting to start offering it to their patients.

Sunday, June 03, 2007

Surgery in Valencia

This Saturday I travelled to Valencia to operate a high risk surgical patient with a 120 gram prostate that was causing him serious problems. We used the old 80 watt KTP laser, that is slower than the new high power (120 watt) HPS laser, but the operation was a success. Valencia is celebrating the America's Cup, and you can tell it is a big event... I was able to reach Madrid on time for lunch - a late lunch at 3.30 pm, as we like to have it over here on Saturday and Sunday...

Friday, June 01, 2007

Article in European Urology Today

Today I have received the official newspaper of the European Urological Association. They have published an article I wrote in conjunction with Mr. Gordon Muir, from Kings College Hospital, London, with our personal view on the new high powered Greenligth HPS laser. This newspaper is sent to all members of teh European Association of Urology.