Wednesday, November 30, 2011

Visit of Prof. Amici, from Rome

Today we received the visit of Prof. Amici, from the Ospedale Fatebenefratelli Isola Tiberina in Rome, Italy. I did two operations to show the anatomic vaporization concept, very interesting cases. The first patient had a 75 cc gram prostate with a big median lobe. I did a mixed technique, vaporizing lateral lobes and enucleating the median lobe into the bladder, and later morcellated it. The second patient had a smaller gland, about 40 cc, I did an anatomic vaporization down to capsule in 35 minutes.

I could demonstrate with intraoperative transrectal ultrasound how it is perfectly possible to perform a radical vaporization of the adenoma, with no bleeding, in a simple and fast way. I think he was convinced that this laser GreenLight XPS allows to perform a fantastic job with minimum morbidity. I think I will go to his hospital soon to help him perform his first cases.

Saturday, November 26, 2011

Surgeries in Buenos Aires, Argentina

This weekend I went to Buenos Aires, where I was invited by my friends Edgardo Becher, Marcelo Borghi and Victor Chernobilsky, from the prestigious Centro de Urología de Buenos Aires.

The Centro de Urología is an ambulatory surgical center where they have already operated more than one thousand patients with the GreenLight Laser. The objective of my visit was to help them start with the GreenLEP (GreenLight Enucleation of the Prostate) technique, so that they can offer this to their patients, specially those with bigger prostates.

Dr. Borgi, happy after finalizing an enucleation procedure
It is a great pleasure to work with expert surgeons, they had no problems to grasp the technique, we only had to polish small but important details to do this kind of operation, that is technically more demanding than simple vaporization.

I had a great time with them, they are wonderful urologists and remarkable human beings, now even more friends.

Friday, November 18, 2011

Surgeries with Dr. Muchster

Today I flew to Rottenburg, Germany, to visit Dr. Muschter.

They asked me to visit him in his hospital in Rottenburg to evaluate him as a surgeon, to ensure that he can do a good job with the GreenLight laser, so he can be admitted for a randomized clinical trial, the "Goliath Study". This is a requisite in these randomized trials, that aim to demonstrate the true differences between treatments.

This trial is going to compare the results of conventional surgery with transurethral resection of the prostate (TURP) with those of Photoselective Vaporization of the Prostate (PVP) with the GreenLight Laser.

Prof. Muschter is one of the most active urologists in the laser field in the history of urology. I had a chat with him that was pure gold for me, I learnt a great deal from him and his vast experience with all kinds of lasers for many years.

Of course, he is a master surgeon as well. He also showed me his installations, that are impressive due to their functionality and equipment. It was a very nice day.

Then I came back to Madrid to rest during the weekend, after several weeks non-stop working!

Wednesday, November 16, 2011

Visitors from Italy, Canary Islands and Peru

Today we had programmed operations at Clínica CEMTRO and we received the visit of many urologists from Italy, Las Palmas de Gran Canaria, and of my friend, Dr. Jorge Saldaña, from Perú, who is touring across Spain and has taken the opportunity to pay a visit to see some operations.

Waiting for the patient to get ready
We operated three patients, two vaporizations and one enucleation, that went really well. Among the visiting urologists was Dr. Naspro, who has published extensively on laser prostatectomy and is an internationally known laser surgeon. He found very interesting the concept of anatomic vaporization, down to the capsule, and the new possibilities of GreenLight enucleation with a side firing fiber.

With Dr. Jorge Saldaña
Then we went to the flamenco show, as always, and we had a lot of fun!

Sunday, November 13, 2011

Surgeries in Sofia, Bulgaria

Following with my collaboration with the Hill Clinic in Sofia, in this occasion we had two very busy days.

On Saturday I arrived a little later than planned from Athens, and we started to operate a little bit late. We had six operations scheduled for the day. On sunday we operated five more patients. We did ten GreenLEPs (GreenLight enucleations) and one vaporization, and all of them were fine. One of the patients had a 230 g prostate, and all the other patients had prostates over 100 g.

To me, operating in Hill is always very interesting, the cases they select for me are the more complex, bigger prostate glands. Operating complex case after complex case in this way is an excellent opportunity for me to keep learning small details, trying technical variations that allow me to mature and perfect even more the GreenLEP technique.

We received a visit from a local urology professor from Sofia and I showed him the GreenLEP technique. He left us very impressed with what he saw, being able to treat these patients with big prostates with such a minimally invasive way, such elegant procedure is always very surprising.

The fastest procedure took 40 minutes, we can do this procedure faster, safer and more satisfactorily. It was an intense weekend, but very interesting and productive. It is always a pleasure to go to Sofia.

Friday, November 11, 2011

San Luigi Hospital, Torino

From Belgrade I flew to Torino, Italy, where I had to visit Hospital San Luigi, to perform a demonstration of the GreenLight XPS 180 watt laser in action. I did two operations with the urologists of San Luigi. The Italian hospitals are very well equipped and in this one there is a lot of robotic laparoscopic procedures being carried out.

We had a problem with the visibility during the operation as we tried to use a three chip endoscopic camera. These are not ideal for GreenLight surgery, as the image gets too saturated.

Then we used a high definition camera that was amazingly good. I showed them the anatomic vaporization technique by with the prostatic capsule is localized to allow for a complete removal of the adenoma.

Then I left to Milan, where I tried to catch a flight to Sofia. Unfortunately I was late and I lost the flight, and I had to find an alternative option, fly to Athens, sleep there and then fly to Sofia early in the morning.

Thursday, November 10, 2011

Surgeries in Belgrade, Serbia

I went to Belgrade, Serbia, to help in the presentation of the new GreenLight XPS 180 watt laser at the Dean's building of the University of Serbia.

The distributor company of Americal Medical Systems in Serbia, Medicon, donated a laser to the Clinical Center of Serbia, the most relevant urology department in the country, to allow the Serbian people to access to this treatment at the national health service.

I presented the technology and its advantages and then I performed two live procedures, that were transmitted to the room, full of local dignitaries, as the Serbian Minister of Health, or the ambassador of the United States in Serbia.

The session was very successful. I enjoyed thoroughly helping to introduce this marvelous technology in a country like this.

I also had a very nice moment when one of the patients I operated in my previous visit to Belgrade, a famous serbian actor who had a huge prostate gland, on whom I performed a GreenLight enucleation, a very difficult case, came to see me. He very kindly described how well he was feeling and how happy he was, he brought one of his movies for me and we spoke about his life in cinema, and commented on Emir Kusturiça, who directed him in multiple occasions, and who I love as a director.

Soon I will return to Serbia to train the urologists who are going to start using this laser.

Tuesday, November 08, 2011

Participation in "La Mañana" - Spanish National TV

Today I participated in the National TV program "La Mañana.

This time we speak about urinary tract infections. It is always nice to go to the TV and contribute to expand the public knowledge on urological disease.

Friday, November 04, 2011

Surgeries in University Hospital Infanta Leonor, in Madrid

Today I visited Hospital Infanta Leonor, in Madrid. I did three operations with the GreenLight XPS 180 watt laser in the morning session. I really liked this new hospital. It is a very modern and beautifully designed hospital.

The interest for GreenLight laser has reached public hospitals in Spain, where the low risk and short hospital stay that this laser allow for the treatment of patients with benign prostatic hyperplasia is becoming interesting.

Tuesday, November 01, 2011

Surgeries in Quito, Ecuador

I could reach Quito after a long trip. My plane from Avianca broke down while trying to take off, and the flight was cancelled, so I had to wait one day to travel. I was going to operate with Dr. Ricardo Yépez and Dr. Saskia Suarez, at Hospital Carlos Andrade Marín.

Con el Dr. Ricardo Yépez antes de entrar en el Hospital
I was very impressed by quality of the technical equipment available in the surgical rooms in this hospital. It seems the government is investing heavily in infrastructure and has pushed healthcare forward significantly.

The objective of this visit was twofold, the first objective was to help my colleagues to start with GreenLight Enucleation of the prostate. We operated two days and we went through step by step surgical technique and we could deepen in details and improve several important technical aspects.

Prostate enucleation is a complex technique and to be able to perform it properly it is important to have specific surgical instruments, an impeccable anesthetic technique, a properly trained surgical team and to pay great attention to detail. The clinical results are excellent and many of the patients we operated, not specially easy cases, went home the same day of the operation.

The second objective was to support Dr. Yépez and Dr. Suarez with the planification of the first international congress of the GRILUR (Grupo Iberoamericano de Láser en Urología) that will take place in this hospital in July 26th-29th, 2012, with special focus in the minimally invasive treatment of benign prostatic hyperplasia (BPH) as well as of urinary stones. It will be an important congress, with live surgeries and the participation of international experts. We had a good chance to comment on the current status of the organization of the meeting that aims to gather those spanish and american urologists interested in the use of lasers for the treatment of urinary tract diseases.

We also had a chance to travel to the east where we visited amazing places and I was able to enjoy my friend's hospitality.

Then I returned to Madrid. A long trip, but definitely worth it!