Wednesday, June 30, 2010

First surgery in the world with the GreenLight XPS 180 laser and the new MoXy Fiber

This week I have had the pleasure to become the first surgeon in the world to use the New GreenLight XPS 180 watt laser with the new MoXy fiber. This new laser and this new fiber are a great step forward and they improve greatly what we could achieve with the previous generation, the GreenLight HPS 120 watt laser.

The plan was to evaluate this laser in 10 European Centers during the month of July. It was going to be evaluated first in Europe, because the EU approved it for clinical use prior than the american FDA.

I had the honor of being the first user worldwide!

We performed seven operations in the Clinica CEMTRO and we received the visit of various representatives from the manufacturing company, American Medical Systems, very interested to see the laser in action! Soon I will publish a video with my comments and my opinion on the new characteristics of this impressive new laser for the treatment of Benign Prostatic Hyperplasia.

We operated seven patients in two days and we could ascertain the superiority of this laser over the previous generation. It allows to operate patients with the same safety but much faster than before, almost twice as fast as we estimated in theatre. We checked with pre and postoperative ultrasound that we had done a great job extracting the hyperplastic tissue almost completely.

It is fascinating to check day by day how the vertiginous technological acceleration is impacting fully in medicine, allowing us to treat our patients safely, faster and more comfortably. It is really wonderful to be able to witness these advances first hand.

I am also happy because I have received an invitation to participate in the advisory committee of this company to participate in the development of the next generation of this laser. My role will be to help with my ideas and opinions to keep improving the treatment of Benign Prostatic Hyperplasia.

Sunday, June 27, 2010

New surgical session in Bulgaria

Again I travelled to Sofia to operate in the famous Hill Clinic. This time we  had a very busy schedule. My friend, Dr. Luis Izquierdo, came with me as he was interested in establishing links and collaborate as well with this clinic.

We arrived on Saturday, and I went to theatre to operate two patients. On Sunday we started at 8 o'clock and we finished at 1 am the following day. We did five laser prostatectomies, a patient with prostate cancer who was treated with HIFU (The first patient in Bulgaria treated with this technique) and also a high risk patient with a huge bladder tumour. On Sunday morning we operated four GreenLight prostatectomies before I returned to Madrid.

Very hard work, but very satisfactory. I was later told that all patients did quite well after the operations.

Wednesday, June 23, 2010

Jornadas Gallegas de Urología

This time I was also invited to participate in the Jornadas Gallegas de Urología that took place in the Hospital de Conxo. I did two prostatectomies with the GreenLight HPS 120 watt laser. Both prostates had huge median lobes, but we could operate them without any trouble. They were scheduled the day prior to my participation, we recorded both so I could offer an edited version the following morning.

I showed them the new technique that I have named "Anatomic PVP", in this technique the prostate capsule is identified to ensure that the whole adenoma is vaporized, right down to the prostatic capsule. I also presented the new GreenLight XPS 180 watt laser, that has just been presented and we will use briefly.

Tuesday, June 22, 2010

New visit of Dr. Richard Gastón

Again we received the visit of Dr. Richard Gastón to perform radical prostatectomy in some patients with localized prostate cancer. The session was wonderful and we all enjoyed operating in the Clínica CEMTRO in the best possible conditions.

We have confirmed Dr. Gastón's next visit for the 31st of July.

Sunday, June 20, 2010

Surgeries in Mallorca: Hospital Son Dureta

This friday I flew to Mallorca, to demonstrate the GreenLight HPS laser in action. I went to the Hospital Son Dureta, the biggest in the Island.

They had prepared two patients with Benign Prostatic Hyperplasia (BPH) and they wanted to see the technique because they are considering acquiring a laser for their hospital. After the publication of Dr. Benejam of his experience in major ambulatory surgery in Manacor, proving that GreenLight HPS treatment of BPH is cheaper than traditional surgical treatment, public hospitals in Spain are considering this treatment more seriously.

It was a fantastic session because both cases did very well. I showed them the new technique anatomic laser prostatectomy, where the surgical capsule is clearly localized, to ensure a complete vaporization of the adenomatous tissue.

It was a specially nice session because my friend, Dr. Fernando García Montes, an international expert in reconstructive pelvic surgery, works there. He and I shared a year working at the Institute of Urology in London, where we forged a true friendship. It is so good to have FRIENDS.

Friday, June 04, 2010

AUA annual congress - AMS Launches it's new GreenLight XPS laser

I have spent this week in San Francisco, where the AUA Annual Meeting was taking place. In this congress we were presenting a poster with the excellent results of the treatment of Benign Prostatic Hyperplasia with the GreenLight HPS 120 watt laser, carried out by the IGLU (Internationa GreenLight Laser Users Group).

I also participated as faculty in a training session on advanced techniques with the GreenLight, sposored by American Medical Systems, although this time I did not take any photos... vary interesting. The new procedure GreenLEP (GreenLight Enucleation of the Prostate) attracts a lot of interest from my colleagues who use the GreenLight HPS to vaporize high volume prostates.

It has been a very exciting congress, and finally AMS launched the new GreenLight XPS laser, 180 watts, that will be available soon (more information in:

This new laser offers:
  • Higher power (higher speed) with the same safety profile - 180 watts but with a thicker laser beam, with the same surgical dose as the 120 watt laser. This thicker beam will translate into higher efficacy of vaporization and shorter surgical times. 
  • Better and more durable laser fibers, with a fiber tip irrigation system that keeps it in good shape throughout the procedure (minimal deterioration and thus, maximal efficiency), and a built in protection mechanism that makes it stop if it heats too much.
  • An improved coagulation.
I spent some time trying it with a bull's prostate and it really looks as if the vaporization efficiency has improved significantly. It is certainly a major improvement that will help us treat big size prostates.

On June 30th we will perform the first operations in the world with this new laser. The Institute of Advanced Urological Surgery has been selected with other 9 european centers to perform the first clinical study with this laser.

It is clear that the laser treatment of BPH was one of the most vibrant aspects of this congress. Many companies presented their new and improved devices, Holmium, various diode lasers, Thulium, each of them with their strenghts and weaknesses... no doubt, the classic TURP (Transurethral resection of the prostate) and open prostatectomy are seeing their last days of life...