Originally posted June 22, 2014

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.

Originally posted June 20, 2014

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.

Originally posted June 16, 2014

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.

Originally posted June 16, 2014

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.

Originally posted June 12, 2014

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.

Originally posted June 11, 2014

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!!!

Originally posted June 5, 2014

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.

Originally posted June 3, 2014

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!

Originally posted May 31, 2014

As every month for the last five years, I travelled to Sofia to participate at a surgical session where we performed Green laser enucleation of the prostate in patients with benign prostatic hyperplasia at Hill Clinic.

This time we did not have international visitors and was a more quite session. We did 10 operations and one of the patients had a huge prostate gland.

We were able to extract almost 200 grams of prostatic tissue from this patient (you have to deduct the 55 grams the plastic tissue basket weights).

All went very well and I returned happy to Madrid, although feeling a little bit of the "spring asthenia", e.g. wanting the summer to arrive to be able to rest!

Originally posted May 28, 2014

Again we received visitors to our operating room at Clínica CEMTRO. This time we were visited by Prof. Estevao Lima (Hospital de Braga), Dr. Rui Borges (Hospital de Boavista), Dr. Luis Osorio (Centro Hospitalar de Porto) and Dr. Frederico Branco (Centro Hospitalar de Porto/Prelada).

They were interested in the new treatment techniques for Benign Prostatic Hyperplasia (BPH) with the GreenLight laser and they witnessed two cases, one in which I performed an En-bloc enucleation of the prostate and another case in which I performed an anatomic vaporization. The both went very well and I could ascertain how they enjoyed watching it. Then they had to rush to the airport to return to Portugal.

Originally posted May 27, 2014

Again I travelled to Modena, Italy, to the Hesperia Hospital, to perform several operations in patients suffering from Benign Prostatic Hyperplasia with the GreenLight laser.

The session went very well and I could demonstrate the different techniques we use with this laser to the italian urologists who attended the session. All the cases went very well.

Dr. Ferrari always spoils us with an amazing parmesan cheese and vinegar from Modena from his own family's production, so delicious!

Originally posted May 23, 2014

This time I went to the University Hospital of Coimbra, Portugal, with Dr. Capitán, from the Hospital Fundación Alcorcón of Madrid. We had been invited to participate in a course on the treatment of BPH (Benign Prostatic Hyperplasia) with the GreenLight laser.

My role was to perform two live surgical procedures that were transmitted to the meeting room at the Hospital. I performed an anatomic vaporization that went very well, and a GreenLEP procedure of a very large gland, that was difficult and laborious, but ended very well.

My colleague Dr. Capitán presented the results of the GOLIATH study that demonstrates that GreenLight vaporization has similar results to classic TURP (Transurethral resection of the prostate) with shorter hospitalization, catheterization time and complications. Also presented some publications on cost-effectiveness that showed that GreenLight is cheaper for the public health system than conventional surgery.

And finally Dr. Alfredo Mota, head of the department of Urology of the University Hospital of Coimbra did his final remarks, very impressed for what he had seen that day, seeing is believing!!!

Originally posted May 21, 2014

This time we received the visit of Dr. Javier Vicente Prados (Granada), Guillermo Olaizola (Clinica Zorrozaure, Bilbao), Fernando Díez Caballero (Clínica Universitaria de Navarra) and Pedro Lanzat (Hospital del Tajo). We were also honored by the visit of Dr. David Rendón, former colleague at ICUA, who came to update himself with the new techniques.

I performed four operations at Clínica CEMTRO and we had a good chance to comment the new techniques step by step (anatomic vaporization, vapo-enucleation and en bloc enucleation) in depth. We had a great time.

It is always a pleasure to receive visits from colleagues who share the same passion for what we do!

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