Originally posted May 12, 2014

This time I flew to Oporto and drove from there to the Hospital Nossa Senhora da Assunção in Seia, near the Star mountains. There Dr. Antonio Oliveira had prepared two patients to operate with the Green Laser Enucleation technique.

Both cases did very well and after having lunch in Seia we drove again to the Hospital Cliria, of the Group Espirito Santo Saude, where I performed a similar operation.

All patients did very well and it was an opportunity to show my Portuguese colleagues the wonders of Green Laser enucleation and morcellation with the Piranha system from Wolf.

Originally posted April 30, 2014

Today we received at Clínica CEMTRO the visit of two urologists with a lot of experience in BPH laser surgery, Dr. Placer, from Hospital Vall d'Hebrón in Barcelona and  Dr. Sánchez Macías from the Hospital de Mollet.

We had programmed four operations but they only had time to see two of them prior to returning to Barcelona. It is always a pleasure to share time with BPH experts like them.

I showed them a hybrid technique, with median lobe enucleation and an En bloc GreenLight enucleation of the prostate. All patients went well and I only would have liked to share more time with them!

Originally posted April 29, 2014

Today we travelled to the Hospital in Heidelberg, Germany, to learn to do transperineal prostate biopsies with MRI-US fusion imaging.

I was accompanied by Dr. Estefanía Romero, from ICUA (left) and our super-nurse Vanesa.

Soon we will start to perform transperineal prostate biopsies based in the fusion of images of Multiparametric MRI with transrectal Ultrasound at  Clínica CEMTRO in Madrid.

This technique is based in that Multiparametric MRI "sees" the cancers and transrectal ultrasound rarely allows to see them. The biopsies are usually performed with ultrasound guidance and thus we do not know if we take the biopsy where the tumor is or not. With the Biopsee system we can use the data obtained in the multi parametric prostate MRI to fuse them with the real time ultrasound image we are seeing and direct the needle exactly to where the tumor is.

In the studies published with this technique, the diagnostic performance rises from 30% to 60% (it detects more cancers) and it allows to do it in the first biopsy, it allows us to differentiate tumors that deserve to be treated from those who do not, so it is really a technical wonder.

Also, performing the biopsies through the transperineal route reduces the risk of infection caused bu the biopsy from 3% (3 out of 100 patients develop acute febrile prostatitis that can be serious) to 0,4% (four infections in one thousand patients).

A very important step in the diagnosis of prostate cancer that we will start offering to our patients at ICUA this month.

Originally posted April 26, 2014

Again I went to Bulgaria to participate in a new surgical session. We operated 7 patients in two days.

This time we received important visitors, like Dr. Andrea Tubaro, from La Sapienza University in Rome, Dr. Shahin Tabatabaei, from Harvard, Boston, USA, Dr. Edward Collins, from San Francisco, USA, Dr. Peter Weib from Siegen, Germany, Dr. Tobias Mebner, from Gehrden, Germany, and we also had Sasha Röhling and Glynn Burt, from AMS, the company that manufactures the GreenLight Laser.

The interest for the new techniques that I developed is progressively greater and that is why we receive more and more visitors from all over the world. These sessions are very interesting as they also allow to talk long on BPH surgical treatment and we all learn!

Dr. Shahin Tabatabaei and "Chip" Collins are my dearest friends and form part of the IGLU group (International GreenLight Laser Users) and we also had a chance to talk and enjoy to be together. A fantastic session!

Originally posted April 24, 2014

I went to the Spanish National TV to participate in the program "Saber Vivir" (know how to live) of the matinee program on the first channel.

We spoke about bladder hyperactivity, of the new drug Betmiga for its treatment, of laser surgery for BPH and transperineal biopsy of the prostate guided by MRI-US image fusion. I had a great time.

Also my colleague and laparoscopy and pelvic floor dysfunction expert Dra. Romero, from our team at ICUA, participated.

Suelo pélvico débil y próstata agrandada

Originally posted April 23, 2014

Today we received the visit at ICUA - Clínica CEMTRO of the Drs. Ahmed Elshal and Mahmoud Laimon, from Mansoura, Egipt, Dr. Michel Jabbour, from Beirut, Lebanon and my close friend Dr. Edward Collins, from San Francisco, USA.

I performed four operations and we also had time to chat on the physics of lasers and all technical aspects between cases. I could demonstrate all technical variants of the use of the GreenLight laser for the treatment of BPH, anatomic vaporization, vapo-enucleation, and the En Bloc enucleation technique.

The session went very well, and then we went out for dinner together. Dr. Collins is joining me to Bulgaria as he is very interested in the GreenLight Enucleation technique that I have developed over the last 5 years. There we will meet other urologists and friends.

Originally posted April 15, 2014

After the European Association of Urology Annual Congress I travelled to Sofia, Bulgaria. There I went to the Hill Clinic where we had organized a full intensive day of surgeries to demonstrate the En bloc Green Laser Enucleation of the Prostate technique for the treatment of BPH to two visitors from Canada (Dr. Dean S. Elterman) and Jeff Bennet, from USA, who had also been in Stockholm for the European Congress.

I performed 7 surgeries in a full day surgical schedule that went very well. Then I returned to Madrid to take some days to rest for the Easter Holidays.

Originally posted April 12, 2014

This time I went to Stockholm to participate at the Annual Congress of the European Association of Urology, really the most important European Congress with more than 14.000 participants from all over the world.

My role was to participate in a session of the ESUT (European Society of Uro-Technology) that organized an amazing surgical program that took place at the Karolinska Hospital and were transmitted live to the audience of the congress.

These are very appreciated sessions as they allow urologists from all over the world to watch experts performing surgery in real time.

I had the great honor to be invited to perform an operation in a patient with Benign Prostatic Hyperplasia. I performed the GreenLight En Bloc Enucleation procedure that I have developed during the last 4 years.

Everything went well during the operation and I received many positive comments from some friends and colleagues, some of them through twitter.

The urologists in the auditorium could visualize both the endoscopic image (left) as the image in the operating room, and what my hands were doing during the operation.

I hope the patient will recover well and improve his quality of life. Next year during the next EAU congress they will present the results of the operation and will tell how the patient is feeling.

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!