Originally posted March 29, 2014

Again I travelled to the Ammerland Klinik in Westerstede, Germany, to participate in a symposium on minimally invasive surgery in urology. My role was to perform a live transmission of a Green Laser Eucleation of the Prostate, that was broadcasted from the hospital to the hotel where the symposium was celebrated.

They chose a patient with a prostate over 140 cc, a difficult case, to allow me to demonstrate live the advantages of this technique even in complex cases.

The case went wonderfully well, I could demonstrate the technique steps and its advantages, the excellent visualization, the absence of bleeding, the perfect anatomical dissection and the speed, as we could finish in less than 90 minutes of surgery. I was accompanied by my friend Dr. Schmidt, and I enjoyed the assistance of personnel from Richard Wolf, the company that manufactures the best surgical instruments to carry out this procedure and the best morcellator in the world, the Piranha system with the single use fast blades Vmax.

This was the weight of the tissue retrieval basket, that we will send for histological analysis. A big prostate gland indeed!

Then I went to the hotel where the symposium took place, and there I gave a talk on the evolution of surgery with the GreenLight laser.

Then I returned to Madrid to enjoy the rest of the weekend, after having worked hard for 15 days.

Originally posted March 28, 2014

Again I travelled to Sofia to operate at a two-day surgical session at Hill Clinic. This time we received the visit of two German Urologists, Dr. Klaus Brunken and Dr. Ulrich Witzsch. Also I was very happy to receive the visit of my good friend Dr. Benjamin Choi, from New York.

We shared a very intense surgical weekend, with 12 surgical operations in which I showed them the technique of prostatic enucleation with the Greenligh laser. It is always interesting to share these experiences with other expert colleagues, as their comments are very interesting and make me learn a lot!

Originally posted March 26, 2014

Today we had an intense surgical day at Clínica CEMTRO. We performed five surgical operations and we received the visit of the French urologists Dr. López and Dr. Riviere, from the Hospital Saint Augustin in Bordeaux,  Dr. Mandron, from Toulouse, my friend Dr. Paulo Ferreira de Matos Guimaraes, from Lisboa, Dr. Antonio Guilherme Oliveira, from Figueira da Foz and lastly the Spanish urologists Dr. Marcos Cepeda from Hospital Rio Hortega in Valladolid and Dr. Manu Díaz, from the Hospital General de Catalunya.

We perfomed anatomic vaporization, vapo-enucleation and GreenLight enucleation. A very intense and interesting session with many visitors to the operating theatre!

Originally posted March 21, 2014

This time I went to Italy to visit the Ospedale Santa María degli Angeli in Pordenone, Italy, where I was invited to participate at a course on advance techniques for the treatment of BPH with the GreenLight laser.

There I operated with Dr. Lorenzo Ruggera, who was already visiting us in Madrid, and other urologists invited to the course. We performed three operations demonstrating the anatomic vaporization and vapor-enucleation technique. All went very well and then I departed to Sofia, via Munich, for a surgical weekend.

Originally posted March 7, 2014

Again I flew to Modena, Italy, to operate with Dr. Giovanni Ferrari at the Hesperia Hospital.

Giovanni had prepared a surgical session with four patients, and we received the visit of five italian urologists who came to see procedures. I performed two GreenLEP (Green Laser enucleation of the prostate) procedures in two patients with big prostates (bigger than 100 cc) and two hybrid procedures of vapo-enucleation.

These procedures guarantee the total removal of BPH (benign prostatic hyperplasia) tissue and allow to obtain a fantastic and durable result in patients with this condition. I think all urologists who come to witness it are convinced that it is a new approach for the treatment of BPH that is interesting and convincing!

The Piranha morcellator from Richard Wolf is a wonderful instrument, it allows to extract prostatic tissue from the bladder at a 10-20 gram per minute pace. Using it one can morcellate a 100 gram prostate in 5-10 minutes. This has shortened the procedures very much, and I think it is a factor that will contribute to push the adoption of laser endoscopic enucleation worldwide.

Originally posted February 28, 2014

Again I flew to Sofia to visit Hill Clinic to operate as I have been doing every month for the last four years. This time we received the visit of Dr. D'Arrigo, from the Ospedale Cannizzaro di Catania, Italy, who came to witness the Green Laser Prostatic Enucleation procedures we carry out here.

It was a very intense session with 16 operations of Green Laser enucleation of the prostate. Everything went very well and every day I am more convinced that this is an impressive procedure. All the urologists in the world should learn it and show it to their patients!

Originally posted February 22, 2014

Again we received the visit of Dr. Gastón at Clinica CEMTRO. He came with us to perform laparoscopic procedures, as he has been doing for the last 6 years. This time he did not limit himself to perform oncologic procedures, as radical cystectomies or prostatectomies, but he also performed a laparoscopic colposacropexy, a procedure designed for the treatment of pelvic prolapse in women.

His knowledge of pelvic anatomy is incredible. Again we enjoyed having him with us in Madrid. In the photo with Dr. Estefanía Romero, from the ICUA team, performing this operation.

Originally posted February 12, 2014

This time we had two days of surgeries at Clinica CEMTRO with 4 patients programmed for surgery on tuesday and 3 on wednesday. We received the visit of Stefanie Thiele, Michael Gebauer and Luz Velázquez from AMS (American Medical Systems). This company manufactures the GreenLight laser we normally use.

They came to witness the Green Laser Enucleation of the Prostate Technique for the treatment of BPH that we performed throughout the two days.

On wednesday we also received the visit of Dr. José Ramón Pérez Carral, from the Fundación Hospital Alcorcón and Dr. Leticia López Martín, from the Fundación Jiménez Díaz, who also came interested to see this technique.

It was an intense session, with many surgeries, that went very well.

Originally posted February 7, 2014

Again I travelled to Gran Canaria to help Dr. Juarez with a patient who had a big prostate gland due to BPH (Benign Prostate Hyperplasia). We performed a Green Laser Enucleation of the prostate and everything went very well.

Dr. Juarez is the organizer of the XX Canarian Meeting on Andrology and Sexual Medicine and he invited me to participate speaking on the impact of surgical treatment of BPH for the sexual function of the male.

Originally posted January 31, 2014

This time I travelled to the Hill Clinic in Sofia, Bulgaria, to operate 9 patients in two days.

We had two international very prestigious guests, Dr. Henry Woo, Professor of Urology of the University of Sydney and Dr. Rainer Schmidt, from Germany, who already came to Madrid to visit us some years ago.

They are both international experts of Green Laser treatment of BPH (Benign Prostate Hyperplasia) and they both train urologists in their respective countries. They have both published extensively in international peer-reviewed urology journals. They came to Bulgaria to see for the first time the Green Laser En Bloc Enucleation technique that I developed during the last four years.

The operations went very well and they were impressed with the speed, safety and elegance of the technique. The truth is that it is a beauty and I think it will be more and more considered and important in the urological world.

Hill Clinic organized a press round due to its nomination as a European Center of Excellence in the treatment of BPH with the GreenLight laser. In the photo, Dr. Woo and myself with all the cameras in the back who came from the 5 Bulgarian TV channels to interview us.

Dr. Woo is editor of CME (Continuous Medical Education) of the British Journal of Urology (BJU International) and is always commenting things with Twitter. This time he made this comment of the session.

We had a great time and I was delighted to be able to show the result of very tough work during the last 4 years to my colleagues and I am proud to see that they appreciate it and consider it relevant. Both went home happy and willing to offer this technique to their patients.

Originally posted January 25, 2014

Today I performed a live surgical demonstration of a Green Laser En Bloc Enucleation followed by endoscopic morcellation (fragmentation and extraction) of the tissue (this is the technique I developed) at the Hospital Complex in Oporto,

The operation was retransmitted to the congress meeting room and it was recorded to be used as a webcast at the SIU (Société Internationale d'Urologie) website. I suppose they will publish it online soon.

I was constantly communicating with the meeting room and they asked me about the technical aspects of the operation. Everything went very well and then Dr. Luis Osorio, the organizer of the meeting, commented that the patient recovered very well.

This operation generates a lot of interest, as it is simple, safe and tremendously efficacious. The patient had a 60 cc prostate with a big middle lobe, and I could finish the operation in 30 minutes.

I could also demonstrate the morcellation with the Piranha morcellator from Richard Wolf, and the new Vmax blades, that are very fast.

Originally posted January 18, 2014

As part of the close and constant collaboration we have at ICUA with the Gabinete de Urología y Andrología of Las Palmas de Gran Canaria, I travelled to the island to help Dr. Juarez del Dago to operate a patient with a huge prostate with the GreenLEP technique (Green Laser Enucleation of the Prostate).

I am more and more convinced of the advantages of this approach for the endoscopic treatment of BPH. The GreenLight laser offers an unparalleled reliable coagulation of prostatic tissue that avoids bleeding during and after surgery. It allowed us to solve the big problem this patient had elegantly and smoothly.

Everything went very well, and Dr. Juarez told me the postoperative recovery was excellent. It is always a pleasure to travel to Gran Canaria, although the weather was a bit fresh this time.

If there is any international reader of this blog who needs laser surgery for his BPH condition, a nice plan would be to contact Dr. Juarez, travel with the family to Gran Canaria for a Holiday and have us operate him over there!

Originally posted January 8, 2014

This is the new technique of "En Bloc" GreenLEP (Green Laser Enucleation of the Prostate) that I have developed over the last 4 years.

It is a very safe procedure and extremely efficacious. Normally we operate patients in the afternoon and they return home the morning after without a urinary catheter. I hope it is useful for urologists wanting to adopt enucleation with this laser type.

Originally posted December 14, 2013

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

This time we performed 13 procedures in 2 days, and everything went very well. The GreenLEP procedure is so refined and mature that it is very fast, very safe and the results are extremely good and predictable.

We have worked so much during the last four years that things have simplified significantly. This is a photo of the sterile table where we prepare the necessary instruments. A 26 F laser cystoscope with a 30º lens, some dilators, a nephroscope or morcescope (as we use it for morcellation), the new Vmax blade for morcellation (really important) and the Piranha morcellator, from Wolf, that is not in the photo.

After performing enucleative laser surgery for the treatment of BPH, one understands how superior this technique is to vaporization or transurethral resection, and it is extremely safe!

Originally posted December 12, 2013

Again I travelled to Modena, to Hesperia Hospital, to operate with Dr. Ferrari.

This time we received the visit of three italian urologists, Dr. Timossi, Dr. Canovaro and Dr. Gianella, who witnessed the operations. I demonstrated the GreenLEP technique (GreenLight Enucleation of the Prostate) as well as the vapo-enucleation technique, as we only had patients with big prostates today.

Fortunately we could use the new Vmax blades from the Piranha morcellator, manufactured by Richard Wolf, that allows a super-fast extraction of prostatic tissue from the bladder, cutting down the surgical time!

At the end of the session I drove to Bologna Airport to travel to Sofia sleeping at Istanbul airport... a little tired, but very happy.

Originally posted December 4, 2013

Today we received the visit in our surgical room of Dr. Eduardo Reyes, urologist from Hospital DIPRECA, from Santiago de Chile, who came to witness two laser enucleations for BPH.

Dr. Reyes is going to be in Madrid in a rotation for three months, and will attend our operations during this time at Clínica CEMTRO.

Originally posted November 29, 2013

This time I went to Berlin invited to perform a live surgery that would be transmitted to the audience of the congress at Auguste-Victoria-Klinikum.

This Hospital has been the most active center in Europe in Holmium laser enucleation of the prostate, and his recently retired head of department, Dr. Kuntz, an enthusiastic advocate of laser prostatectomy for many years, very respected all over the world.

Getting ready for the operation and the TV transmission

It has been a great honor for me to have been invited to operate there. My role was to demonstrate the GreenLEP technique (Green Laser Enucleation of the Prostate), but the patient's prostate was so small that I decided to use a mixed technique, vaporizing anterior and laterally and enucleating the middle lobe. Then I showed a video of the GreenLEP technique.

During the operation I communicated with the audience in the congress

I got a tweet from one of the attendees at the congress:

Everything went very well, then I returned to Madrid to rest during the weekend, after two full weeks non stop.

Originally posted November 25, 2013

This time I went to operate to the Hill Clinic and we welcomed Dr. Ruban Thanigasalam, urologist from Australia who was already visiting us in Madrid at Clinica CEMTRO. Ruban is finishing a two year rotation in a Paris Hospital and is about to return to Australia to work.

The objective was to witness enough GreenLEP (Green Laser Enucleation of the Prostate) operations to understand this technique's complexities and we did 9 cases, a very fruitful session. There is yet another urologist convinced of the advantages of GreenLEP for the treatment of BPH.

More and more urologists express their interest to join us in Sofia to see this technique. In principle we plan to do another session on December 13-15th and another one in January 30-31st.

Originally posted November 23, 2013

This time I participated at the annual meeting of the German GreenLight Users Group.

I was invited to give a talk on my experience and ideas about the use of the GreenLight laser for the treatment of BPH and the role of the new techniques I developed, anatomic vaporization, vapo-enucleation and GreenLEP (Green Laser Enucleation of the Prostate).

These techniques are generating a great interest worldwide and more and more urologists are interested in learning them as they allow to obtain improved results in patients with bigger prostates, with minimal risk.

There were many questions at the end, many urologists find hard to believe that these techniques are easy to learn and perform, until they visit us to see them, they feel the enthusiasm and then they learn them.

Originally posted November 21, 2013

This time I went to the Ev. Krankenhaus Hospital, in Witten, Germany, to perform a surgical demonstration of GreenLEP and Anatomic Vaporization. The head of the urology department, Dr. Wiedeman was a very kind host of the session.

I performed two operations that went very well. Dr. Wiedeman has an extensive experience with the GreenLight laser and is convinced as I am that TURP (Transurethral resection of the prostate) is obsolete.

Dr. Schattka also came to see this session and when we finished the second surgery we took this photo with Dr. Wiedeman and his nurse, who helped us really well.

Then I took a flight to Berlin, as I was invited to participate in the Annual Meeting of the German GreenLight users.

Originally posted November 20, 2013

This time I flew to Hamburg and from there I drove to Westerstede, to operate at the Ammerland Klinik, the public hospital in the region, with Dr. Schattka.

At the hospital this morning, prior to starting the surgical session of laser treatment of BPH

The plan was to teach him to perform the new techniques, anatomical vaporization with capsular localization and GreenLEP, Green laser enucleation of the prostate for the treatment of Benign Prostatic Hyperplasia (BPH).

Checking the instruments gently provided by Richard Wolf for this session

I performed three operations that went very well. As always, urologists who watch these techniques are highly impressed and they are convinced that this is the way forward in surgical treatment of BPH.

Performing a GreenLEP at Ammerland Klinik

Then I drove again to Dortmund, to participate in another surgical session tomorrow morning.