Surgeries in Lima, Perú

I departed to Lima early monday morning. I had planned to leave on Sunday, but the Air Comet flight was delayed. It was a very special trip, as the pilot was my brother Enrique. He invited me to see the take off from the cockpit. I learned a lot about planes and I was impressed to see how it is full of technology and how they follow strict protocols and constant verification in contact with air controllers from nearby airports. It was a great experience and I felt very proud to see my little brother piloting an aeroplane with such mastery.

He is passionate about planes since he was little and he fought hard to become a pilot. He is a champion!! I admire him deeply, he did a perfect landing!

Once in Lima, I went to the Marriot Hotel and then we drove to the Hospital El Golf, where we did two operations with Dr. Elvis Sueldo and Dr. César Quincot. Both were uneventful and they had a good chanobserved advanced techniques techniquestechnique.

After we finished the operations, we went to the headquarters of the Peruvian Urological Association, where I gave a talk on photoselective vaporization of the prostate with the Greenlight HPS laser in front of a numerous group of Peruvian Urologists, who were very interested in the technology.

Then we had a tipical dinner, a "piqueo criollo" with local refreshments. In Perú they dring Inca-Cola, a very nice soda that sells much more than Coke over here.

The following morning started early, we went back to the Hospital El Golf to do a third case and then we went to another Hospital, Santa Teresa, where we did two operations with Dr. Jorge Saldaña. He is a young urologist with an impressive spirit.

He really believes in pushing technology forward and has decided, like me, to write a blog to narrate his experiences.

Everything was uneventful without problems, although one of the prostates was very big and took a while to complete.

Then we went out for dinner to celebrate the success of the surgical sessions and I try the famous Peruvian Ceviche, with Pisco Sour, a local drink that Peruvians claim they make better than the Chilenians. They I went to sleep, as the time change is quite tough and I had to fly to Ecuador. I left Perú happy after the experience and grateful to these three wonderful urologists!!

Spanish Urological Association Annual Meeting

Today I drove to Valencia in the morning to participate in the Spanish Urological Association Annual Meeting, where I was invited to participate in a symposium on Greenlight laser treatment of benign prostatic hyperplasia.


I had to give a talk on surgical technique, but some days prior to the symposium we decided it would be even more interesting if I covered the differences among different lasers used in urology for the treatment of BPH.

A very interesting session, as other centers presented very solid data supporting the use of this laser in public hospitals in Spain.

Then I went to have luch by the Malvarrosa beach, a wonderful paella. After that I drove back to Madrid, there was a horrible traffic jam, so I got home rather late. Tomorrow I wake up early because I depart to Lima, for a week of surgery in different hospitals in Perú and Ecuador.

Greenlight Turkish Users Meeting

This friday I flew to Istanbul in Turkey to lecture in front of a group of users of Greenlight in Turkey. The traffic was incredibly packed and slow, but I managed to reach a dinner by the bosphorus. The following day we celebrated the meeting. There we talked about surgical technique, how to optimize clinical results, tips and tricks and precautions to take...

En la foto con algunos participantes

Prof. Ali Riza Kural moderated the session. Apart from being a prestigious urologist, he is also an immense artist. I met him in a previous congress in Istanbul, and I became his fan number 1, he sings wonderfully. I scanned the CD cover, and I have found this video in Youbute with him singing, an exotic delight.

After the session there was a very nice dinner and then we jumped in a boat to navigate through the bosphorus. My camera and my limited knowledge of photography did not allow me to obtain better pictures but it was a magic night...The full moon, the illuminated bridge, the thousand musics coming from the palaces, the mosks.... a true wonderful experience I will never forget.

Portuguese Urological Association Congress

I came to Lisbon invited by the Portuguese Urological Association to participate in their yearly congress. I had to lecture in a round table on Benign Prostatic Hyperplasia.
There are new developments in medical treatment (combination with anticolinergic drugs, PDE5 inhibitors, new alpha blockers...) as well as in the classic TURP (bipolar devices, plasma vaporization) and specially in the laser world (Holmium, Tulium, Greenlight and Diodes). My role was to try to clarify the current role of these lasers and their application.


I always enjoy a lot coming to Portugal, and I have a chance to see my friends. I chatted with Dr. Reis Santos, from whom I always learn a lot. Tonight I go back to Madrid, tomorrow I must fly to Istanbul.

Visitor from Kuwait

This week we received the visit of Dr. Ivan Ormanov, a bulgarian urologist that has worked for many years in Hospital Al-Rashid, from Kuwait. We shared two surgical sessions where we operated some patients with benign prostatic hyperplasia using the Greenlight HPS laser.


In this picture, we were having coffee in the cafeteria at the hospital, and we were chatting about surgical technique. Dr. Ormanov proposed me to visit him in Kuwait and maybe start an ongoing collaboration with his prestigious hospital as a visitor surgeon.

AUA Annual Meeting, Chicago

I spent last week in Chicago, at the American Urological Association Annual Meeting. I attended the scientific sessions and some interesting courses. The congress was full of news, there are so many simultaneous sessions that it is impossible to see all. It is always a good oportunity to meet old friends and also many invitations and opportunities arise. Soon I will go to Ecuador, Perú, Shanghai, Germany, etc...


From Chicago I flew to San José, to visit the American Medical System's research center, with some of my IGLU (International Greenlight Users Group) colleagues. We are going to promote new clinical studies and new interesting initiatives.

And then, lastly, I took a flight to Seattle, where my sister lives. It had been a while since I last saw her. I spent the weekend with her and this morning I arrived at Madrid, and now I am back to the normal work life!!

Visitor from Bulgaria

We operated this thursday and friday and we received the visit of Dr. Iliya Kalchev, from Sofía, Bulgaria. The first greenlight laser user in his country.

He visited to get familiarised with the technique and we could show him four operations with the greenlight laser and a stone fragmentation with the Holmium laser.



We also enjoyed dinner together in Casa Patas with flamenco dancing... very nice. It is always a pleasure to receive visitors.

Surgeries in the Fundación Jiménez Díaz

This tuesday I visited the Fundación Jiménez Díaz, invited by the new head of department, Dra. Carmen González Enguita, to assist them with their first Greenlight HPS cases.



I first operated a patient with a moderate to big prostate, and then Dr. González Enguita operated a patient with a smaller sized prostate with great ease and mastery. I must be a great teacher!! ;-)

A very pleasant morning and a great honour to step in the surgical rooms of a Hospital with such an important urological tradition.

European Association of Urology - Best video 2008 award

I spent the weekend in Stockholm, Sweden, where the twenty fourth congress of the European Association of Urology was taking place. I had the honour to receive the award to the best video published in European Urology Video Journay in the year 2008.

The video included the recommendations of the IGLU (International Greenlight Laser Users) group on how to perform a Greenlight HPS laser prostatectomy. An important recognition of our work and our efforts to help in the training of new surgeons adopting the greenlight laser for the minimally invasive treatment of BPH (Benign Prostatic Hyperplasia).

The video was projected in the main hall of the congress.

New video series

We are producing a series of comprehensive videos on urologic diseases. This is the first one we have finished, where Dr. Enrique de la Peña, the pediatric urologist working at the ICUA, explains vesicoureteral reflux, and how it is diagnosed and treated. Fot the time being, only in Spanish, sorry.



We hope to help patients improve their understanding of urological disease processes. I will post the videos here as we publish them.

Experts meeting in Barcelona

I flew again to Barcelona to participate in the first meeting of urology experts. A small meeting organised by Olympus, a manufacturer of high quality surgical devices. A very interesting initiative, that gathered a small group of Spanish opinion leaders and experts to comment the current state of minimally invasive surgery. My partner at the Institute of Advanced Urological Surgery, Dr. Castillón, was also invited as an expert in laparoscopy.

I contributed with a talk on Greenlight laser and there I met again Dr. Placer, who presented his experience with the Holmium laser. The treatment of BPH is rapidly changing and the future is very promising. Companies as OLYMPUS have a fundamental role in the advancement of medicine and surgery, because they constantly improve and refine their products, and the interaction with us, the surgeons, is very important. We are operating every day and we generate new needs and ideas. A fantastic initiative from Olympus!

Surgeries at the Hospital Vall d'Hebrón in Barcelona

Today I spent the morning at the prestigious hospital Vall d'Hebron in Barcelona. The urology department directed by Dr. Morote Robles is one of the leading hospitals in the country. They are setting up a laser unit and they wanted to evaluate the greenlight HPS system.

I performed two operations in two patients and I had the opportunity to chat with Dr. Placer, one of the few experts in Holmium laser enucleation of the prostate (in the center of the photo, besides Dr. Carles Raventós, right).


There I met also Dr. Fakiani, whom I had visited recently to help him with his first cases in the Fiatc Hospital, and who told me about his successes with this laser. It has been a great honour to operate in this fantastic hospital, and I was happy to hear from Dr. Placer that both patients did very well postoperatively.

Surgical Marathon in Caracas, Venezuela

Last week I went to Caracas, where I visited five hospitals that have adopted the Greenlight HPS technology for the treatment of benign prostatic hyperplasia, to try and help them start their first cases or to improve their surgical technique and optimize clinical results. It has been a very intense week.

Monday 2nd: Hospital General del oeste, "Magallanes"

We started with this public hospital in Caracas, where there were six patients ready to be operated.

First I gave a talk to the members of the urology department directed by Dr. José Aguillón and then we went to the operating room, where we spent the whole day. We did six operations that were uneventful. The following morning I learned that all patients were OK. It as a long and tough day, but very interesting and intense, and the surgical cases were optimal for such a session.

Tuesday 3rd: Hospital Militar "Dr. Carlos Arvelo"

On Tuesday I woke up with a little bit of Jet-Lag, but a pair of coffees helped me through it. I went to the military hospital directed by Dr. Nirka Marcano.

I also gave a talk in the department initially and we did five operations througout the day, with a lot of people attending at the operating room.

Wednesday 4th: Policlínica Metropolitano

Here I met Dr. Nelson Ramírez and Dr. Jaime Czechowitz, who already had some experience with the Greenlight HPS laser for the treatment of BPH. Dr. Juan Carlos Vargas came to visit us, I met him last year in Caracas and now is the most experienced greenlight surgeon in Venezuela.

We did four operations in a very interesting and fun working session. All patients fared very well. Then we went out for dinner and I enjoyed their company thoroughly as well as the wonderful Venezuelan meat cuts...

Thursday 5th: Clínica El Ávila

At this moment in the week the jet-lag was over, and I went to visit the Clínica El Ávila, one of the most important private hospitals in Caracas. I just did a single operation this time.

Other patients who were programmed for surgery today did have some trouble to make it to the hospital and so we used the opportunity to take it easy and went out for lunch after a brief but intense morning.

Friday 6th: Hospital Domingo Luciani "El Llanito"

On Friday, at last, we finished this surgical marathon visiting Hospital Domingo Luciani. I met the head of the department of urology, Dr. Montes, and after giving a talk to the department, I was able to demonstrate the technique operating two patients.

Then I rushed to the airport, where I took my direct flight to Madrid. It has been a very intense week, I did 18 operations and met more than 30 Venezuelan urologists!!!

Surgical Course at the Hospital Clínico Universitario San Carlos

This week I participated in a prestigious course on Incontinence and Robotic Surgery and New Technologies. It took place in the hospital where I studied medicine, so it was nice to come back to the surgical theatres, but this time as the surgeon!

This is also the hospital where one of my partners at the ICUA works, Dr. Ignacio Castillón Vela, who is a wonderful urological laparoscopist. He contributed with his participation in robotic surgical procedures during the congress. In the photo below, with the blue cap, assisting Dr. Motrie with the Da Vinci Surgical System.

I was invited to participate in a live surgical demonstration of a Greenlight laser prostatectomy. The case was very well picked up and it was really nice and smooth. They told me the day after that the patient was fine!

Winds of Change - Zaragoza

Yesterday I participated in the International Course on Urology "winds of change 2009", organised by Hospitals Miguel Servet from Zaragoza (Dr. Rioja) and the University Hospital AMC from Amsterdam (Dr. de La Rossette).


The truth is that the invitation to participate in this international course was a real honour, the panel of invited experts is impressive. As always, the organization was impecable and the number of attendees impressive.


My role was to perform a greenlight HPS laser prostatectomy, which was transmitted live to the congress venue. The operation was a success and the case was very nicely selected. The patient had a big median lobe and I proved that this is no problem at all to perform this operation. Then I participated in a round table with other eminent national professors, which was extremely interesting.

Best European Video Award

Today I received an Email where the European Association of Urology communicates that the video I submitted to the European congress last year has been chosen as the best video published in 2008 in the European Urology Video Journal. I will receive the Award during the European Congress that will be celebrated next month.