Celebration of the fourth anniversary of Hill Clinic and 300 enucleations

Again I travelled to Sofia, Bulgaria to operate at Hill Clinic.

In this occasion we celebrated the fourth anniversary of the clinic. I started to collaborate with them three years ago and since then we perform the GreenLEP (GreenLight laser enucleation of the prostate) technique to treat the clinic's patients suffering from Benign Prostatic Hyperplasia.

To celebrate the event, Hill organised several activities and an open doors day where for the first time in Bulgaria we could show the GreenLight SIM, a computerized simulation of GreenLight laser vaporization of the prostate, a tool for urologists to train themselves before treating a real patient.

For me it has been a great experience to collaborate with Hill Clinic all these years, it has allowed me to develop this technique progressively, perfect it, introducing minute improvements as I got to understand how to make this procedure faster and safer. Interestingly, we reached 300 Enucleations the day of the 4th anniversary, we did 43 in 2010, 75 in 2011, 103 in 2012 and 79 up to now in 2013.

This weekend, as it is usual, we performed 14 operations in three days that went really well.

These are the specimens of prostatic tissue that we sent to the pathologist for histological analysis. This technique allows to extract all the adenomatous tissue independently of the prostate size and to analyze it.

Also the technique has improved a lot with the new Vmax blades of the Piranha morcellator, that allow for an extremely fast morcellation. In this extract from the intraoperative data of two of the cases we did this weekend we can see the prostatic volume as estimated by abdominal ultrasound, the weight of the tissue extracted (137 g and 73 g), the energy used, the firing time of the laser at 80 w and 40 w settings, the active morcellation time and the total morcellation time. It is impressive to be able to extract adenomatous tissue in such a short time (137 grams in 14 minutes and 26 seconds and 73 grams in four minutes and 5 seconds of real time), as it allows us to perform most cases in under one hour.

I am really convinced that any urologist who sees the work we do will agree that there is no justification nowadays to keep performing open prostatectomy.

The truth is that there I feel great, with my friends and colleagues from Buglaria. I really believe that we form an elite team of laser prostatectomy at the top level. In the photo from left to right, Dr. Botsevski, the nurse Ms. Petia, Dr. Kotsev, Mr. Lubo and Dr. Georgiev, all of them great professionals.