Originally posted April 5, 2025

This was the second day of the Robotic HoLEP course held at Hill Clinic. Dr. Georgiev performed a robotic HoLEP case during the session. The procedure concluded successfully.

I acknowledge the support from Andromeda Surg, Quanta System, Richard Wolf GmbH, Hill Clinic and ICUA for the equipment and organization. The technical execution during the live case was precise.

The focus remained on robotic enucleation techniques throughout the session. We observed the surgical steps in real-time. This training continues to advance the standard of care for BPH patients. The participants observed the excellent ongoing progress with this concept.

Originally posted April 4, 2025

I successfully completed the first Robotic HoLEP case in Europe at Hill Clinic today. This procedure follows the initial cases performed worldwide in Chile. The surgery utilized the Quanta System laser and Richard Wolf GmbH instruments. I collaborated with the Andromeda Surgical team during the operation. The procedure was completed without intraoperative complications. The team worked together efficiently. We are documenting the technical aspects for the ongoing clinical trial. The operation was performed under general anesthesia. This marks the first European application of this specific robotic configuration.

Originally posted March 29, 2025

This time I conducted a training session at Hill Clinic focused on En-bloc HoLEP. I worked with urologists from Bolivia, Brazil, Mexico and Philippines. We covered the specific steps of the technique using the Holmium laser. I demonstrated the procedure on the laser system. The group participated actively in the observation of cases. We exchanged experiences regarding the surgery and patient selection. The session concluded successfully with a review of the cases. I shared insights on the technical aspects of the surgery. The participants showed good engagement throughout the day. We discussed all  the nuances of the enucleation process.

Originally posted March 27, 2025

I hosted visitors to our operating room from Australia, Perú, and India this week. They came to observe the en-bloc HoLEP procedure. We demonstrated the technique live, focusing on apical dissection and mucosal preservation. The group reviewed the instrumentation required for the Quanta System laser during the surgeries. They watched multiple cases and discussed the specific challenges of the en-bloc approach. We covered the technical details of the resection plane and the subsequent morcellation. The session was dedicated to observation-based training on the method we use daily.

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.