Originally posted March 24, 2025

We observed contrasting approaches to instrument sizing in urological surgery recently. While Dr. Figueiredo is working to miniaturise instruments for HoLEP, Dr. Gozzi is pursuing the opposite direction. As the inventor of the transobturator male incontinence sling, he is now making instruments larger to facilitate suprapubic resection of the prostate in big chunks.

Specifically, he is utilizing a 42 F resectoscope for this purpose. This discussion covered various methods for managing prostate volume during surgery.

Originally posted March 23, 2025

We have recently published the OPTIMUM trial results in JAMA. The study compares microultrasound versus MRI for prostate cancer diagnosis. We worked with our colleague Moisés Rodriguez Socarrás and collaborated with ExactImaging on this trial to evaluate diagnostic protocols. We demonstrated non-inferiority of the microultrasound technique for diagnostic accuracy compared to standard MRI imaging. This work was conducted in collaboration with ICUA. The trial confirms the role of microultrasound as an alternative to MRI for prostate cancer diagnosis in urology.

Originally posted March 22, 2025

I participated in the EAU live surgery program performing an En bloc HoLEP. The live surgeries were organized by LYX Foundation and Viamed Salud. I was impressed by their work. Giuseppe Maiolino was an excellent host. The session allowed for the demonstration of the technique. The organization ensured smooth execution of the cases. I thank the LYX Foundation and Viamed Salud teams for everything. The event was held as a live surgery broadcast. The technical details were covered during the presentation.

Originally posted March 20, 2025

I conducted an En bloc HoLEP session with colleagues from Argentina, Colombia, and Bolivia. We discussed the technical aspects of the procedure during the live case. The international group participated in the training and observed the dissection closely. The session allowed for direct teaching on the specific steps of the enucleation. We focused on maintaining the apical dissection and sphincter preservation during the laser work. The Quanta System laser was used for the enucleation. The procedures lasted less than 60 minutes. The colleagues from the three South American countries reviewed the outcomes together. I recorded the video for future reference.

Rafael Sánchez Salas has joined ICUAurologia as an international consultant. He will visit Madrid regularly to perform focal and non-focal treatment of prostate cancer. We are utilizing Sonablate technology from Angiodynamics for these interventions. The collaboration focuses on ultrasound-guided ablation techniques for targeted therapy using specific devices.

This arrangement allows for expanded capacity in Madrid. The schedule is set for recurring visits. I will be present for the procedures. This expands available treatment options in Madrid. We will track the outcomes of these specific interventions.

I attended the EAU congress this year. It has been quite a ride to see the EAU develop over the years. Frans Debruyne and all the other urologists spent their time and efforts building such a strong and valuable association. I attended the sessions. The meeting concluded with a celebration of the association's growth. I have attended the EAU for many years. I am part of the association. The association continues to organize international events for urologists around the world and includes members from various countries.

Originally posted February 27, 2025

I spent two days at Clínica CEMTRO and ICUA performing En bloc HoLEPs. I was joined by new friends from Brazil who are interested in laser prostate surgery. We focused on the technique using the Quanta System laser. The cases included standard and complex anatomical enucleations.

We worked together during the sessions to refine the approach for larger prostates. The team at the clinic supported the procedures throughout the two days. This visit allowed for a shared experience in laser enucleation techniques. We discussed specific steps regarding apical dissection and mucosal preservation. The collaboration continued through the live surgical cases, a definitely interesting session!

Originally posted February 2, 2025

This time, I performed a surgical session at Hill Clinic. I met new colleagues from Belgium and Brazil. We focused on the HoLEP procedure using the en bloc technique. The results show the method is getting faster and more efficient for large prostates. Several cases were completed during the visit. The laser settings were optimized for each patient. I will post the surgical videos on my YouTube channel soon. It was a valuable exchange of experience with international colleagues. The team collaborated well, as always. I observed significant improvements in operative time. Operating on many cases in a short time makes you a faster surgeon!

Originally posted December 18, 2024

I will perform a live surgery during the next European Association of Urology Annual Congress in Madrid. The procedure will be an En bloc HoLEP with the use of a virtual basket and Magneto technology.

Originally posted December 16, 2024

I conducted an En-bloc HoLEP training session at Hill Clinic in Sofia. We welcomed colleagues from Kuwait, Italy, and Spain. The session utilized the high power 150 w Magneto laser system, now available at the facility. We demonstrated the enucleation technique using the Quanta System technology. The training included practical exercises for the participants to practice the steps. We discussed the laser settings and procedural workflow for high efficiency. The equipment supports rapid tissue removal during the procedure. We reviewed the technique with the international group. The system is available in Bulgaria for HoLEP cases.

Originally posted December 16, 2024

I conducted an En Bloc HoLEP training session at Hill Clinic in Sofia. New colleagues joined from Kuwait, Italy, and Spain for this practical course. I demonstrated the procedure using the high power 150 w Magneto system from Quanta System. We now have this equipment operational in Sofia, enabling advanced local training capabilities. The session focused on the technical application of the technique with the specific laser settings. 

Originally posted December 13, 2024

Visitors from Costa Rica and Greece visited our operating room recently for training purposes. We performed five HoLEP procedures during their stay. The team observed the entire surgical workflow from start to finish.

We discussed the technical aspects of En bloc versus classic enucleation in detail during the breaks. The surgeries were conducted using the Quanta System laser platform. The visiting urologists reviewed the procedural steps and patient outcomes. This exchange allowed for direct comparison of the techniques used in our department.

Originally posted December 13, 2024

We had visitors from Costa Rica and Greece in our operating room. We performed five HoLEP procedures during their stay. The team discussed all aspects of en bloc versus classic enucleation techniques. We utilized the Quanta System laser for the cases. The surgeons observed the live procedures. We reviewed the differences in approach between the two enucleation methods. The discussion focused on tissue removal and apical dissection details relevant to the HoLEP technique. We also addressed specific questions regarding the laser settings and energy delivery during the cases. The visit concluded with a review of the patient outcomes from these procedures.

Originally posted December 1, 2024

Concluding this month’s En bloc HoLEP course at Hill Clinic Sofia with new and old friends from Mexico, Chile, and Spain. The course was conducted using Quanta System technology.

Originally posted December 1, 2024

I concluded this month’s En bloc HoLEP course at Hill Clinic Sofia. Participants included colleagues from Mexico, Chile, and Spain. The training focused on the technical execution of the procedure utilising the Quanta System laser.

I outlined the specific steps for en bloc resection and highlighted the critical technical points. The modules were completed according to the schedule. The collaboration between the instructors and the visiting urologists enabled detailed feedback on surgical steps. It was very nice to have close friends in this session!

Originally posted November 21, 2024

I performed a live surgical case today at the T&T congress in Torino. The setup included a simple instrument tray designed for efficiency during the procedure. I utilized my preferred instruments from Richard Wolf GmbH throughout the operation. The equipment facilitated the dissection steps required for the demonstration.

I recorded the session for the surgical community. The live case showcased the specific technique details without unnecessary complexity. Attendees observed the instrument handling directly. This aligns with my focus on simplifying the learning curve for HoLEP procedures. The venue in Torino hosted this educational segment well. The audience engagement was high throughout the session.

Originally posted November 21, 2024

Today, I am preparing for live surgery demonstrations in two adjacent operating rooms. I will be working alongside Dr. Sergio Proietti. These demonstrations will showcase our surgical techniques and provide valuable learning opportunities for attendees.

Originally posted November 21, 2024

I returned to Torino for the T&T meeting organized by Cesare Scoffone. The program included interesting discussions regarding current urological techniques. We reviewed recent case studies and debated specific procedural nuances. Following the group discussion, I participated in a live surgical case demonstration. 

Originally posted November 15, 2024

I have uploaded a video of a Da Vinci robotic radical prostatectomy. The procedure was performed by Dr. Richard Gastón, assisted by Dr. Moises Socarras. It took place during the Introductory Course on Robotic Surgery, organized by the San Rafael Urology Group in collaboration with ICUA-Clínica.

The video shows the complete surgical technique. The Da Vinci surgical system was used during the procedure. The collaboration between institutions made it possible to hold the course. The material is available for technical review in our youbute channel.

Dr. Socarras' assistance was essential to the development of the procedure. The organizing group facilitated the teaching environment. The video is available for consultation.

Originally posted November 9, 2024

We concluded the robotic surgery training course. Dr. Gaston coordinated the sessions with the participants. We covered technical modules on robotic assisted procedures. The team completed all practical sessions. I reviewed the outcomes with the students. Dr. Gaston managed the coordination. The program included practical training and discussions. We focused on standard robotic techniques used in our department. The participants demonstrated proficiency in the basic skills. We will pause for a short break before scheduling the next training session.