Live surgery in Italy at Ospedale Umberto I, Nocera Inferiore, near Napoli

Again I was invited to participate at a meeting in Italy, where live surgeries were performed from the hospital's surgical rooms to the main meeting hall. I flew to Rome very early and a driver took me all the way to the Hospital Umberto I in Nocera Inferiore, near Napoli.

First I gave a talk on the comparison of TURP (Transurethral resection of the prostate) and the GreenLight Laser treatment of BPH.

Then I went to the operating room and I performed an anatomic vaporization that was retransmitted to the main hall. Everything went very well and then I returned to Rome to fly back to Madrid very late!

Surgeries in Lisbon, Portugal

From Barcelona I travelled to Lisbon to visit the Hospital Beatriz Angelo, where I was invited to participate in a surgical session.

Sadly, the organization of the session was terrible, and despite being there at 8.30 in the morning we did not start operating the first patient until 11 am, and then we could not operate the next until 4 pm... surgeries went very well, we performed an anatomic vaporization in a patient with a mid sized prostate and an en bloc enucleation in another patient with a bigger gland. The hospital is impressive with fantastic installations, but very bureaucratic.

I spent a very boring day there, waiting, and with the sensation of losing my time. My plane was delayed and I arrived at home at midnight. I do not think I will ever go back to that hospital.

Surgeries at Hospital de Martorell, near Barcelona

This time I was invited to visit the Hospital de Martorell, near Barcelona, where I performed three operations to demonstrate the versatility of the GreenLight laser in the treatment of BPH.

There we had time to talk extensively about the best way to start a program of surgery with the GreenLight laser. I explained that the learning process must be approached seriously, paying attention to the details and choosing the patients with small prostates, easier to operate, for the first cases.

In oder to learn to operate with the GreenLight laser one must have the attitude of the wise man " see the difficult things as easy, and the easy as difficult" I told them. Many people think it is an easy surgery, but the truth is it is not so much. It requires a thorough training and progressive and structured learning.

Visitors at our operating room

Again we had another surgical session and again we received visitors. This time we hosted Dr. Sergio Zubillaga and Dr. Mario Dominguez from the Hospital de Valdecilla in Santander, Dr. Alberto Budía from Hospital de la Fé in Valencia and Dr. Luis Castellanos from the Hospital de Avilés.

As usual, we first discussed laser physics and how to manipulate the laser fiber correctly to achieve an optimal vaporization.

Then I performed four operations to show the different surgical techniques with the GreenLight laser. It was an interesting and fun session and everything went very well.

Again this time they wrote some comments in the visitors book.

Visitors to our operating room

Today we received visitors in our operating room at Clínica CEMTRO. We received the visit from Dr. Carlos Reig, from the Hospital de Manises, Dr. Beamud, from the Hospital Universitario Dr. Peset from Valencia, Dr. Guevara, from Hospital San José from Vitoria and Dr. Fernández of the Clínica Viamed Los Manzanos, from La Rioja.

I performed four operations with the GreenLight Laser for the treatment of Benign Prostatic Hyperplasia during the day and we had a great time commenting the new surgical techniques. They left these very kind comments in our visitors book (in Spanish).

Surgical session in Sofia with visitors from Germany and Portugal

This time I took the chance to being in Sofia for the World Congress of Video urology and I stayed to participating at a clinical teaching session at the Hill Clinic.

In this occasion we received the visit of three german urologists, Dr. Wiedemann and Dr. Schiefelbein, and two portuguese urologists, Dr. Antonio Rui Sousa Campos and Dr. Catarina Gameiro. In the photo, with the urologists who work at Hill and the representatives from AMS who were joining them.

We performed 9 operations and we had a good chance to comment broadly the details of the different surgical options for the treatment of BPH (Benign Prostatic Hyperplasia) with the Green Laser. We had a great time and the operations were very interesting.

Participation in the World Congress of Video-Urology in Sofia, Bulgaria

This time I travelled to Bulgaria to participate in the World Congress of Videourology. I was invited to speak about the news on the treatment of BPH (Benign Prostatic Hyperplasia) with the Green Laser.

I also participated as a panelist in two other sessions, one on surgical simulation in urology and another video session on surgical techniques for BPH.

I took the opportunity to present the description and videos of the surgical techniques that I recently published in the World Journal of Urology.

It is always a pleasure to share with other international colleagues in these congress. This month I took the opportunity to stay in Sofia and operate at the Hill Clinic, as usual.

International meeting of GreenLight laser experts in Madrid

This week we received the visit at Clinica CEMTRO of a select group of international experts in the treatment of benign prostatic hyperplasia (BPH) with the GreenLight laser.

The objective of the meeting was to present them the new techniques that I recently published at the  World Journal of Urology and to try to reach a consensus with all of them on their application, on how to train other urologists and to kick off an international multi center study to validate them internationally. 

We received the visit of: (left to right in the photo) Dr. Shahin Tabatabaei (Harvard, Boston, USA), Prof. Oliver Reich (Munchen, Germany), Dr. Claus Brunken (Hamburg, Germany), Dr. Edward Collins (San Francisco, USA) and to my left Prof. Henry Woo (Sydney, Australia), Prof. Andrea Tubaro (Rome, Italy), Dr. Vincent Misrai (Institut Pasteur, Toulousse, France), Mr. Gordon Muir (King's College Hospital, London, UK) and Prof. Alexander Bachmann (Basel, Switzerland).

Firstly I performed three surgical operations, demonstrating each of the techniques that I have described for the treatment of BPH with the Green Laser. Clínica CEMTRO is fully equipped to transmit live surgical procedures to the main auditorium and although some of my colleagues preferred to come and witness the procedures in the operating room, the rest of the attendees watched them from there. All the operations went very well and all the patients were discharged the following day.

We also did a press round in which we told everything about these new techniques and the transcendence and impact that the Green Laser has had in the treatment of BPH worldwide.

Then we met for two days to set the basis of the clinical studies we are going to carry out jointly to validate internationally the excellent results we have achieved during the last four years with these new surgical techniques at ICUA and Clínica CEMTRO.

It was a very interesting meeting, and I am sure that the clinical study we have started will have a great impact worldwide. It was a pleasure to receive the visit of my colleagues and international friends and to feel fully supported by Clinica CEMTRO for its organization and development.

Publication of my new paper on surgical technique with the GreenLight laser for BPH in the World Journal of Urology

At last my paper on new surgical techniques with the GreenLight laser for the treatment of BPH has been published at the World Journal of Urology. It can be downloaded for free as I decided to publish it with "open access" which means that everybody can see it without cost.

I am happy and proud to have described these techniques and to be able to share them with my colleagues around the world. It has been a five-year work of continuous learning and improvement and much effort, but finally there it is. It would not have been possible without the help of my nurse, Vanesa Cuadros and my team in Madrid, nor without having worked at Hill Clinic in Sofia, Bulgaria, for the last five years. I am deeply grateful to all of them.

We developed some drawings for this publication, describing three surgical techniques, from simpler to more complex, that allow the surgeon to improve his results and to learn step by step until he can perform the En Bloc enucleation technique.

This is the graphical description of the anatomic vaporization.

This is the graphical description of the vapo-enucleation or median lobe enucleation.

 This is the graphical description of the En bloc enucleation.

And these are images of prostatic transrectal ultrasound (before and after the operation) that demonstrates the excellent removal of adenomatous tissue obtained with these techniques.

I hope my colleagues find it useful and that these surgical techniques will help them obtain better results with their patients.

Surgical session in Salt, Gerona, Spain

This time I travelled to Barcelona in the evening, and I found that there were no taxis due to a strike!! So I took the bus and metro to reach the hotel and managed to rest a little. The next morning, early, I was picked up to go to the public hospital in Salt, Gerona, where I met Dr. Andrés Ponce and Dr. Roger Boix who had invited me to demonstrate the surgical treatment of BPH with the GreenLight laser and I operated three patients they had selected for the session.

All the operations went very well and I could demonstrate the anatomic vaporization as well as the middle lobe enucleation techniques. It was a very dynamic session and I enjoyed a lot.

Then I returned early to Madrid, and I managed to enjoy the rest of the day and get some rest.

Surgical session with Dr. Gaston

Again we welcomed Dr. Richard Gaston to Clínica CEMTRO, he works at Clinique Saint Augustin, in Bordeaux, as he has been doing for the last 7 years.

He is a master in laparoscopic surgery for prostate cancer and it is always a pleasure to have him with us. We also received the visit of Dr. David Rendón, who will soon part definitively to Colombia. Dr. Rendón worked with us at ICUA and he is not only an outstanding urological surgeon, but a remarkable human being. We will miss you!!!

Talk in Valencia, Spain

Today I took the high speed train to give a talk in a symposium on GreenLight laser treatment of BPH (Benign Prostatic Hyperplasia).

I spoke of my techniques and of how to deal with patients with large sized prostates. Then I returned to madrid in the blazingly fast AVE (Alta Velocidad Española) train.

Live surgery at the "Challenges in Endourology" Congress, from Hospital Tenon in Paris

I was honoured to be invited to perform a live surgical transmission to the congress Challenges in Endourology from Hopital Tenon, in Paris, France.

This session consisted of five surgeries, an electrosurgical enucleation, a TURP (Transurethral resection of the prostate) a Thulium laser enucleation, a Holmium laser enucleation and I was in charge of presenting the En Bloc Green Laser enucleation of the prostate, a technique that I have developed over the last few years.

All videos from the surgeries will soon be available at the websites of Challenges in Endourology and   SIU Academy.

The truth is that everything went really well. I had enough time to show the technique, and I was asked many questions. I was very happy and proud to have had the chance of presenting my technique in such an important forum.

When I was returning to the airport I received the call of Enrique Pérez Castro, a very important Spanish Urologist, internationally known for being the inventor of the ureteroscope, who was participating at the congress and witnessed the session. He was very kind and congratulated me for the session. I really liked to receive his call. I went back to madrid very happy!