Originally posted October 22, 2013

This tuesday I flew to Gran Canaria to operate a patient with Dr. Juarez del Dago. We are friends from a long time ago and regularly either I go to Gran Canaria or he comes to Madrid to operate together. This time we operated a patient with a big prostate, we performed a GreenLEP (GreenLight Enucleation of the prostate together that went very well).

Then I returned to Madrid that same day.

Originally posted October 16, 2013

Today we had a surgical session scheduled at Clinica CEMTRO and we received the visit of two urologists. One of them Australian (originally from Sri-Lanka), Dr. Ruban Thani-Gasalam, who is finishing a two year fellowship at the Hospital Sant Josef in Paris, with our friend and excellent laparoscopist Hervé Baumert. We also received the visit of a Spanish urologist, Dr. Abel Mateos, from Gijón, Asturias, who had a lot of interest in seeing us work and is considering starting to do laser prostatectomy.

I performed two cases of GreenLight Enucleation in two patients who suffered Benign prostatic hyperplasia. One of them was a patient submitted previously to a TURP, but he had too much residual BPH tissue that caused hematuria and problems with micturition. Both cases went really well and we had a wonderful afternoon together.

I love to see the reaction of urologists watching this technique, they are impressed by seeing the anatomy of the prostate in a way they never did before, by the simplicity of this "en bloc" technique and by the quality of the dissection and preservation of the sphincter. We also commented the importance of the improved morcellation with the Piranha system and the new Vmax blades that cut down the surgical time. The second case was completed in just 35 minutes!

Originally posted October 6, 2013

This time I was invited to perform a GreenLight anatomic vaporization of the prostate at the Congress of the Italian Urological Society, at the Azienda Ospitaliera S. Orsola-Malpighi, in Bologna.

From this hospital, all surgical operations in the live surgery program were transmitted via satellite to the congress center in Riccione, a seaside italian city one hour away from Bologna by car.

They selected a patient with a small prostate with a lot of prostatic calcifications that usually form in the periphery of the adenomatous tissue, that make the procedure a little more complicated.

Despite this, everything went very well, and I could show how to access the prostatic capsule to guarantee a full vaporization of the BPH tissue. In Riccione there were many urologists in the plenary room of the congress watching the procedure. I would have liked to be able to demonstrate this technique in a bigger prostate, as it is more informative, but I did my best to make the most of this case.

In the surgical room next to mine, I met my colleague and ex-older resident from my residence at the Hospital de la Princesa, Dr. Manuel Fernández Arjona, who was also demonstrating the UROLIFT system for the treatment of BPH. I really enjoyed seeing him after such a long time and we had a chance to catch up while we waited to start our procedures. Then we returned to Madrid, as we both have to work tomorrow!

Originally posted October 2, 2013

Tomorrow morning I will participate in a live webinar (or web seminar) on Benign Prostatic Hyperplasia in collaboration with Post55. If you have interest in learning on BPH, please join us live registering first in this web site with interesting contents for men over 55.

Te recordamos que para asistir a la videoconferencia del Doctor D. Fernando Gómez Sanchasobre "Nuevos Avances en el tratamiento prostático" tienes que estar inscrito en Post55. Si no tienes aún usuario puedes darte de alta haciendo clic aquí. Unos minutos antes del comienzo de la sesión llegará un enlace a tu correo electrónico para que puedas acceder a la misma. ¡¡Te esperamos!!
Socios colaboradores:
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Originally posted September 28, 2013

After Modena y flew to Sofia, Bulgaria, as I do every month, to operate at the Hill Clinic. Again they had prepared a surgical weekend.

This time we received the visit of two prestigious french urologists, who came to learn the GreenLEP technique (GreenLight Enucleation of the prostate) for the treatment of Benign prostate hyperplasia.

Dr. Vincent Misrai, from Institute Pasteur in Toulouse and Dr. Jean Baptist Roche, from Clinique Saint Agustin, Bordeaux. They are both charming and they have a genuine interest for urology and despite their extensive experience, they want to keep learning. It is always refreshing to treat people like this.

I performed 10 operations in two days that they witnessed with much interest. We had a great time and I think it was a very unique learning experience. They went home very happy and with new ideas on the advanced use of GreenLight laser to treat BPH.

Hill Clinic is the center is the most experienced center in the world in this kind of surgery and my advice to any urologist wanting to learn this technique is to come and visit us during one of this sessions.

Originally posted September 26, 2013

Again I went to Modena, this time driving from Ponte San Pietro, to operate at Ospedale Hesperia with dr. Ferrari. He had organized another training session for italian urologists as it is becoming custom now.

This time we did two surgeries that went very well and we received the visit of Dr. Mauricio Candidi, from Tivoli, Danilo Patti, from Rome and Fabiano Palmieri, from Ravena.

We had a good time together and I finished early, and that allowed me to rest in Modena. I have to travel early to Bulgaria tomorrow and I have a lot of work this weekend...

Originally posted September 25, 2013

Again I visited the Hospital at Ponte San Pietro, near Milano, to work with Dr. Fenice. He has offered me to come to operate regularly the most difficult cases of BPH with the GreenLight laser and from now on it will be an ongoing collaboration.

This time I did two GreenLEP procedures (GreenLight enucleation of the prostate), that went very well. During the operation the blood loss is minimal, and this is how the urinary catheter looked like after the operation. A tube conducts saline solution to the bladder, and the other tube brings it out, but there is no blood at all. Great!

The following day Dr. Fenice told me that the patients were doing well and were going home. From now on, the Hospital at Ponte San Pietro will be another regular place of work for me. I am very happy.

Originally posted September 24, 2013

During my previous trip to Bulgaria I was interviewed for the most prestigious TV program on health in Bulgaria. Today I got it and I include it here.



The goal of the interview, to clarify things after Angelina Jolie was submitted to a bilateral mastectomy for carrying a defective form of the BRCA1 gene.

Right after that happened, the London Based urologist Roger Kirby told the press that after sequencing the BRCA2 gene in a man with a non aggressive form of prostate cancer, he found a mutation in the gene. This mutation decided him to recommend radical surgery for his prostate tumor that normally would not be treated. This was very polemic and hence, the interview.

I tried to clarify that some people carry a mutated form of these genes that does carry out the normal function of suppression of tumor growth. Men who carry these defective forms of the gene have a higher risk of prostate cancer and usually also more aggressive, but it is not justified to carry out preventive surgery in all carriers. It is more logical to watch them closely and if the tumor arises treat them aggressively.

Originally posted September 22, 2013

I woke very early to catch a flight to Rome at 6.00 am. I was picked up at the airport to drive to L'aquila to participate at the UROLEAGUE Congress from the Association of Italian Urologists (AURO) that took place at the Hospital San Salvatore, chaired by Prof. Di Clemente.

The surgical schedule was very interesting, with the participation of great italian urologists. I was the only foreign urologist invited to operate.

With Prof. Di Clemente

I had to do two procedures one after the first, an anatomic vaporization with GreenLight laser of a trilobulated 80 cc adenoma, and a GreenLEP procedure (GreenLight Enucleation of the Prostate) in a prostate bigger than 100 cc.

Both cases went very well, and were retransmitted to the congress venue, in a nearby hotel. Dr. Mutto moderated the session and he relayed questions from the floor during the operation. Both were successful.

During the operations I noticed my mobile vibrating in my pocket, and later I found out that it was a message from one of my colleagues that was cheering me during the live procedure! Interesting times we live in...

Originally posted September 17, 2013

Today we received in our surgical theatre at Clínica CEMTRO the visit of Dr. Thomas Dean, urologist from Sydney, Australia.

He was very interested to see a GreenLEP procedure (GreenLight Enucleation of the Prostate). I performed a case,  a patient with a prostate bigger than 100 cc, that went very well.

The enucleation itself took 40 minutes and the morcellation took other 15. A very beautiful case. I think he went away happy and impressed by the technique. If I can, I will take him to the Flamenco show tomorrow ;-)

In the meantime, in the surgical theatre just beside mine, Dr. Guillén was retransmitting a Master Class to more than 300 hospitals in all the world using the Google Glass. He performed a chondrocyte transplant using his cable free endoscope and using surgical instruments developed at Clínica CEMTRO.

Originally posted September 12, 2013

This time I visited the prestigious Clinique Saint Agustin in Bordeaux, France

This clinic is the most important center in Europe in laparoscopic urology. There they perform 5000 laparoscopic procedures and more than 1000 robotic surgeries per year. Dr. Gaston, Dr. Piechaud and their colleagues are very well known worldwide for their specialization in laparoscopy and specially in robotic radical prostatectomy.

Dr. Richard Gaston ready to start a robotic laparoscopic prostatectomy with one of the two robots available at St. Agustin

Dr. Gastón has collaborated with us for the last 7 years and comes to operate every month to Clínica CEMTRO, we are very good friends.

The reason for this invitation was that the urologists at Saint Agustin wanted to learn to perform Holmium laser enucleation of the prostate in patients with big prostates, e.g. high volume benign prostatic hyperplasia.

They prepared five patients that we operated in two days, and I had the occasion to demonstrate the details of this technique. All patients had big glands, some also had big and multiple bladder calculi (stones) that we could fragment seamlessly with this Holmium laser. We also tried the Storz morcellator, that has improved recently and the Piranha system with the Vmax blades, my favourite morcellator.

All surgeries went very well and patients recovered extremely fast. My french colleagues were very happy to see this and I think they were convinced that it is perfectly possible to treat big prostate adenomas with laser enucleation. Also they could ascertain its superiority to the laparoscopic approach they were using up to now, as patients can be discharged the next day as opposed to three days after the laparoscopic operation.

With Dr. Piechaud during the surgical session

I really enjoyed collaborating with these great urologists, true living legends of urology, and help to light their enthusiasm for laser prostatectomy. It was a great honor to help them and I returned to Madrid very happy after this session.

Originally posted September 4, 2013

Again we had Dr. Gaston with us to operate at Clinica CEMTRO.

Dr. Gaston is an international expert in urooncology and laparoscopy who works at Clinique Saint Augstin in Bordeaux. He has been collaborating with us in Madrid for seven years.

In the surgical session, he was assisted by Monique, her nurse from Bordeaux and Dr. Estefania Romero, our expert laparoscopist at ICUA.

This time we tried the VIKING system for 3D laparoscopic high definition visualization.

Dr. Gaston invited me to visit their department in Bordeaux next week to help them with their fist cases of laser prostatectomy.

Originally posted August 30, 2013

My holidays are over, time to get back to work!

This season has started very well, we did a surgical session at Hill Clinic, in Sofia, Bulgaria.

This time we operated for two days, and all operations went very well. The GreenLEP procedure (GreenLight Enucleation of the Prostate) is a wonderful operation, very fast and safe. Every time I do it I am more convinced that this is much superior to conventional surgery in every sense. I am so proud that I conceived this technique and perfected it to the point it is today.

I love to see the smiles of operated patients and to be able to offer them the best possible results with this technique.

Originally posted August 21, 2013

I went to Gran Canaria to participate in the section "Saber Vivir" (know how to live) from the program La Mañana de la 1 of Spanish National TV.

We spoke about a lot of things, in this wonderful morning TV program on health, including bladder ageing, and bladder problems in women and men.

Saber vivir - Consejos urológicos para el verano 21/08/13

Saber vivir - Consejos urológicos para el verano 21/08/13

Originally posted July 26, 2013

Again I went to Sofia to operate at Hill Clinic,  this is my last trip before I take my summer holidays.

This time we had a lot of work and we did 23 prostatectomies in several days.

I am very fortunate to be able to collaborate with Hill Clinic. I feel we help a lot of patients. It is typical there to operate old patients with big prostatic glands that carry a urinary catheter, with a lot of co-morbidities (cardiac, diabetic patients) that make them high risk surgical candidates.

Everything went very well, the laser enucleation technique is no doubt the gold standard for the treatment of BPH. It is impressive to see the patients the next day, as if we had not operated them. I love to see how we can operate a high number of patients with a minimal complication rate. In this session, for example, no patient had any significant intra or postoperative complication. The surgical time is getting shorter, we did some of the procedures in less than 30 minutes.

We operated patients with small, medium and big prostatic sizes (we extracted 160 grams of tissue from one of the patients with a huge gland). We left a lot of work for the pathologist, literally kilos of prostate tissue.

Then I returned to Madrid. I work monday and tuesday and then I will take my summer holidays. Despite my love for my work I feel like resting a little bit!

Originally posted July 16, 2013

Today we received the visit of two representatives from the laser manufacturing company Lumenis, who came to watch surgeries and to exchange knowledge and ideas.

I performed several operations with Holmium laser that went really well.

Moshe Shtengel, Director of Global Marketing of Lumenis, left a comment in our visitors book.

Originally posted July 11, 2013

Yesterday I went to the hospital in Udine, Italy, to help Dr. Simone Crivellaro in a surgical session. The objective was to help him with his first case of GreenLEP (GreenLight Enucleation of the Prostate). Dr. Crivellaro had already been at Hill Clinic in Bulgaria to witness some procedures some months ago.

We performed two operations in two patients with very large prostates, of 120 grams. Maybe they were not the best patients to learn with, as big prostates are technically more demanding.

I performed the first case, we obtained 115 grams of prostatic tissue, and then Dr. Crivellaro started the second case and I finished it. We also obtained a big volume of tissue, 110 grams of prostatic adenoma, in this case.

The session was very interesting. I believe this technique can be taught when the surgeon already has experience with vaporization. Dr. Crivellaro told me he has operated already 300 patients with vaporization. Now he will have to develop his experience with GreenLEP.

Originally posted July 2, 2013

Today we received the visit of Dr. Richard Gaston who came to operate with us at Clínica CEMTRO.

We performed two laparoscopic radical prostatectomies in patients with prostate cancer. We had Dr. Juarez, from Gran Canaria, joining us for the session as we were operating one of his patients.

Everything went very well, Dr. Gaston is a true master of the technique and he feels at home operating with us after seven years of collaboration, also our colleague Estefanía Romero was trained in laparoscopy at his center, so they work in perfect synchrony.

Again he commented his interest of welcoming me in September at Clinique Saint Agustin in Bordeaux to help them start with their experience with their brand new Holmium laser for the treatment of BPH and I will help them with pleasure.

Originally posted June 30, 2013

Today I woke up early and took the high speed train to reach Zaragoza in time to reach the  Hospital Viamed Montecanal to demonstrate the use of the GreenLight XPS laser to Dr. Jorge Rioja and his uncle, Dr. Carlos Rioja, as they have recently adopted this technology.

They had programmed three surgical cases. I demonstrated the anatomic vaporization technique, the vapo-enucleation technique and the GreenLight Enucleation of the prostate (GreenLEP).

All cases went really well and I really enjoyed the company of my friends, sharing tips and tricks in this  very nice new hospital in Zaragoza.