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.

Ureteroscopy and Holmium laser

I have just posted this video in Youtube, it has been edited by Dr. Luis Llanes. He is an expert in endourology and the minimally invasive treatment of ureteral and kidney stones.

Dr. Luis Llanes is the director of our urinary lithiasis unit at the Institute of Advanced Urological Surgery in Madrid, a true endourological artist. Sorry the video is in Spanish. Holmium-YAG lasers allow to fragment urinary stones with safety and allow patients to recover very fast and go back to their normal life.

Surgeries in Barcelona

This Monday I went to Barcelona, to the Fiatc Clinic, with Dr. Fakiani. He is interested in learning to perform the greenlight HPS laser prostatectomy. We did two cases and then I rushed to return to Madrid...

Surgeries in Gran Canaria

This Sunday I flew to Gran Canaria, to operate with Dr. Francisco Juarez del Dago. We have been operating together for two years now. What sarted as a collaboration to help him kick off and support him with his greenlight laser prostatectomy learning curve is now a fantastic friendship.



I am really proud to see him operate, transformed into a true master of the technique...

Participation in Spanish TV

Today I went to Spanish national TV, invited to speak about urinary infections and urinary incontinence. The programme "Saber Vivir", is the most important health related TV show in Spain. I had a great time, it was interesting and fun.

The video is online following this Link.

Surgeries in Montevideo

I spent this weekend in Montevideo, to help the Urologists of the British Hospital, Dr. Daniel Porto and Dr. Javier Zeballos to kick off with his Greenlight HPS 120 watt laser surgical unit. This is the first center in Uruguay to adopt this technique for the treatment of benign prostatic hyperplasia.

The trip was a little bit boring as my flight from Madrid to Buenos Aires was delayed 10 hours, but once there I had some time to tour Buenos Aires. Then I took a flight to Montevideo and after resting for the night we started the surgical sessions which were successful!!!


The following day my colleages took me out and showed me the highlights of Montevideo and then I returned to Madrid via Sao Paulo. Quite a long trip...¡But it is always nice to make new friends!

Visitor from Venezuela

This week we received the visit of Dr. Dario Soto, from Venezuela. He is a prestigious urologist from Maracaibo, who already was a pioneer in the adoption of extracorporeal shockwave lithotripsy. He is about to start operating with the Greenlight laser in Maracaibo and he came to see how we perform this operation. Between Thursday and Friday he witnessed six operations. We had time to comment all the technical aspects of this operation and we also had time to go out for dinner and enjoy some flamenco dancing at Casa Patas!! I usually do not have time to go out to see some flamenco, which I really love, so I take the opportunity of having a foreign visitor as an excuse to enjoy for a while....

Interview in "La Razón"

Today this was published in La Razón, one of the leading Spanish Newspapers.

Surgeries in Seville

Today I travelled to Seville, to help Dr. Rus to perform two laser prostatectomies in patients with big prostates. I already helped him start with his first cases, and he has been operating on his own since then, with good results. It is a good idea to have a second interaction with an expert after some initial experience, it helps polishing little technical details that can make a difference. As always, Seville is a wonderful city and a pleasure. We did a first case and then had a wonderful lunch, and then we did the second case. The high speed train connecting madrid and seville, as always, wonderful.

2nd Continuous Medical Education Course of the AEU

Today I participated in a round table at the II Continuous Medical Education Course of the Spanish Association of Urology. A fantastic initiative of the Spanish Urological Association.

With the current pace of technological acceleration, we urologists have to invest a good part of our time to keep updated on current scientific information, and courses like this are perfect to help us achieve this objective.


We commented the different minimally invasive treatment options of BPH, and I had to present on Greenlight laser treatment, we then had a very interesting discussion. It was a great honour to be invited to collaborate with the Spanish Urological Association.

Prostate MRI spectroscopy

This is a video I have recently produced to explain the usefulness of MRI spectroscopy in the evaluation of patients in whom we suspect the presence of a prostate cancer. In Spanish only, sorry!

Visit to Kuwait City

I have spent some days in Kuwait visiting my colleagues at the Al-Amiri Hospital. They have adopted the Greenlight HPS technology for the treatment of benign prostatic hyperplasia, and I went there to give them a hand with their first cases.


We did seven surgical procedures. First I did two operations, explaining the technique.

Then three Kuwaiti urologists from Al-Amiri Hospital performed the rest of the operations under my supervision, with great enthusiasm for this technique that allows patients to recover surprisingly fast. It was very impressive how well they did their first cases on their own.

On Monday night, we got together with other urologists from Kuwait City and Saudi Arabia, also interested to learn about the technique. I reviewed some basic science concepts, surgical technique and results, with a very interesting discussion at the end.



It has been a great experience, Kuwait is a modern and vibrant city, and all the people I met here were really nice and warm. I had a great time.

2nd Meeting on Urology for GPs and Urology Residents

Today I participated in this congress addressed to primary care physicians, organised by my colleague and friend. Dr. Juan Carlos Ruiz de la Roja. The meeting gathered more than 300 GPs and urology residents and there were 26 prestigious urologists from all over Spain as faculty.


Dr. Ruiz de la Roja, besides being a great urologist is a first class medical communicator and author of the famous book "Let's talk about your prostate (hablamos de tu prostata?)" a highly recommended read for men and women alike, available at Amazon.

Wonderful Istanbul

Last thursday I travelled to Istanbul, Turkey, to participate in the international meeting "Hands-On Live Endoscopic Surgery Conference" organised by the ESUT (European Society of Uro-Technoogy) and the Turkish Urological Association.

Istanbul is a city between Europe and Asia, crossed by the Bosphorus and a mixture of culture, influences and religions. A remarkable place. One would like to be able to dedicate more time for tourism and less to work in places such as this.


After arriving we celebrated a reception dinner, where Dr. Jens Rassweiler from Germany surprised us all and played the guitar live and Prof. Dr. Ali Riza Kural sang classic symphonic turkish songs as well as modern ones (I bought one of his records in a music shop).

Then the congress started. I first participated in a "observed advanced techniques observation" training session in which the attendees could try technology with their own hands using surgical models. We usually use bull prostates to evaluate these new surgical instruments. There was of course a Greenlight HPS laser and I was there to answer questions on laser prostatectomy.


Then I left towards the hospital, where I performed an operation that was retransmitted to the congress venue. The patient had a 65 cc prostate. The operation was uneventful, unfortunately we did not get much time left and the operation was not broadcasted entirely.



The congress followed with very interesting sessions on endourology with many live surgical procedures. I had some time to visit the Great Bazar and I entered a nearby Hammam, a Turkish bath, to enjoy the sauna and a Turkish foam massage!! An unforgettable experience that I recommend.

It was sad to have to go back, Istanbul is one of the most fascinating cities in the world.

Helsinki University Hospital

I am writing this post from Brussels. I am returning to Madrid, waiting at the airport (my flight has been delayed) after spending two days in Helsinki to participate in a symposium on Greenlight laser prostatectomy for the treatment of Benign prostatic Hyperplasia (BPH).

The programme of the meeting

The symposium took place in one of the buildings of the Helsinki University Hospital, where I first gave a lecture covering physical basis of laser prostatic treatments, and mainly recommendations on surgical technique.

Then we went to the surgical theatre, where I performed a Greenlight prostatectomy in a patient while I anwered the questions coming from the auditorium. The Auditorium was equipped with a direct link to the theatre, and urologists and nurses could witness the operations and formulate questions.


Then we ate something and then Dr. Hannu Koistinen (in the photo below) did a second operation.


A very nice scientific session. Both patients recovered very fast. I love Finland... Today I go back to my clinics and I will also see patients tomorrow. Then on thursday I depart to Istambul, Turkey.