Originally posted May 30, 2013

Again I went to the Hospital de Torrejón in Madrid with my nurse Vanesa to help the urology team captained by Dr. Luis Llanes, head of the department of urology and his colleagues with their learning process with Holmium laser enucleation.

We did two cases that went really well. It is a complex technique and the learning curve is long, but with very good results.

Originally posted May 29, 2013

Today we had a surgical session at Clínica CEMTRO and we received the visit of two urologists from France, very interested in the surgery of benign prostatic hyperplasia with the GreenLight laser, Dr. Vincent Misrai, from Toulouse and Dr. Sebastian Vincendeau, from Rennes.

I performed three operations and I could show them he GreenLEP procedure (GreenLight Laser Enucleation of the Prostate), one anatomical vaporization and one vapo-enucleation (enucleation of the middle lobe). They enjoyed the experience:

And these were the comments they wrote at the visitor book.

Originally posted May 24, 2013

Again I went to Sofia to operate at the Hill Clinic. I had to participate in a two day surgical session.

I am always happy to hear from my bulgarian colleagues that the patients from the previous session are doing well after their operations.

I am very happy with the evolution of the GreenLEP (GreenLight Enucleation of the Prostate) technique. During the last three years I have introduced small variations, changes in the steps I followed to detach the adenomatous tissue from the surgical capsule, that allow us to perform it more safely.

Originally posted May 22, 2013

The 21st I travelled at night to Milano, to depart to the Hospital in Lovere early in the morning. Lovere is a small city by a beautiful lake and surrounded by mountains. The hospitals attends patients from all the region.

There I met Dr. Rainieri and Dr. Paganelli, who had prepared three patients to operate with the GreenLight XPS laser. The views from the hospital are beautiful.

The session went very well, and Dr. Paganelli could do his first steps with GreenLight under my supervision. He had been working with the simulator the previous day, and I really think it is a wonderful tool for learning.

We had a nice session and enjoyed it, everything went very well.

Then I departed to Milano, to catch a flight to Bulgaria.

Originally posted May 17, 2013

I arrived in Borgosesia on Thursday afternoon to participate as invited professor at a course in minimally invasive urology.

The hospital is located between mountains, in a really wonderful place.

First I gave a 20 minute talk covering the different generations of GreenLight lasers and the advances in surgical technique, and I presented the anatomic vaporization, the vapo-enucleation and the GreenLEP (GreenLight enucleation of the prostate) procedure. Then we performed a simulator session that was used by all attendees at the course.

The simulator is a wonderful training tool, that reduces greatly the surgeon's learning curve and obviously benefits patients who have to be operated by a surgeon in training.

Then we went to dinner to a typical restaurant, to enjoy the "cucina piamontesa". I had no choice but to leave apart my recently started diet ;-)

The next day there were surgical sessions where the attendees could participate. I performed two interventions. A vapo-enucleation of a large prostate and a GreenLEP procedure in a patient who had two previous biopsies with inconclusive signs of prostate cancer. The GreenLEP procedure allows for the retrieval of the adenomatous tissue for histological analysis.

Both operations went pretty well, and as always I could see the surprise of my colleagues when they see the versatility of this laser and the beauty of these techniques. I had a lot of fun, enjoyed to see new techniques, as the single port radical prostatectomy performed by Dr. Vincenzo Ferrara, and I made new friends. Then I drove back to Malpensa to return to Madrid to rest for the weekend after three intense work days in Italy.

Originally posted May 16, 2013

Again I arrived at the Hospital at Ponte San Pietro to assist Dr. Oscar Fenice with his training in GreenLight XPS 180 watt laser prostatectomy for BPH.

In this occasion we operated three patients, two with relatively voluminous prostates and one with a smaller gland. Dr. Fenice had been training hard with the computerized simulator designed to teach this procedure and I was impressed to see the qualitative leap in his surgical skill in comparison with the first session we performed recently. Dr. Angelo Gritti, head of the department, was very impressed with the possibility to visualize the prostatic capsule in such a clean and clear way, despite the big size of the prostates.

When we finished the session, at lunchtime, I took a rented car and drove up north to Borgosesia. I had to participate in a training course in minimally invasive surgery. Unfortunately it was raining and I do not know why the roads in Italy are always so busy, but I enjoyed the changes in geography driving up north and the beauty of the fields and the mountains in the region.

The followind day Dr. Fenice contacted me very happy to tell me that all patients had passed water without a catheter and were leaving the hospital.

Originally posted May 15, 2013

This time I travelled to Ancona via Roma, in Italy. Frome there I reached the Civil Hospital of Porto Recanati to perform a surgical demonstration of the GreenLight XPS 180 watt laser for the treatment of benign prostatic hyperplasia.

There I met Dr. Enrico Caraceni, from Ospedale Generale di Zona a Civitanova Marche, Gabriele Mammana head of the department of urology of the Ospedale di Macerata and Doctor Emilio Sacco from Ospedale Policlinico Universitario Agostino Gemelli di Roma, who came to witness the three operations of the day.

It was interesting that we operated a young patient and we performed an ejaculation preserving technique, a relatively new technique that is offering very good results, and allows to improve urinary symptoms respecting the ejaculatory function of the patient.

The session went very well and that same evening I flew to Milan, as I had to operate at the Hospital in Porto Recanati.

Originally posted May 9, 2013

Again I travelled to Modena in Italy to operate at the Ospedale Hesperia with Dr. Giovanni Ferrari. This time I operated four patients with benign prostatic hyperplasia with the GreenLight XPS 180 watt laser.

This time we enjoyed the visit of Dr. Mario Fiorello from Policlinico Ospedaliero di Camposampiero, Padova, Dr. Motjaba Rahmati, from Ospedale ULSS no. 4 at Schio, Vincenza, Dr. Stefano Trovarelli and Dr. Fabio Mattei from the Casa di Cura Rugani, at Siena and Dr. Paolo Guido Dell'Orto, from Policlinico di Milano.

The course went very well, despite having to treat very complex cases, we did vaporizations and enucleations and had a great time. All cases went very well.

Originally posted May 7, 2013

This time I could not join the AUA Annual Meeting, but there our Australian colleagues in this study presented our multicentric experience with the GreenLight XPS laser for the treatment of patients with Benign Prostatic Hyperplasia.

Also, at this congress, Prof. Alexander Bachmann presented the results of the important study "Goliath"that compares GreenLight XPS 180 watt laser vaporization of the prostate with conventional transurethral resection of the prostate (TURP) for the treatment of BPH. Despite the TURP arm obtaining excellent results, probably the best ever published in a study, GreenLight vaporization showed to be equally efficacious with less postoperative complications, catheterisation time and hospitalization. It is a very rigorous study, methodologically sound, that finally demonstrates the superiority of GreenLight for BPH over conventional TURP.

Originally posted May 6, 2013

As it has happened almost monthly for the last 5 years, Dr. Richard Gaston joined us in Madrid at  Clínica CEMTRO to perform surgeries.

We operated several patients with a diagnosis of prostate cancer in which we performed a laparoscopic radical prostatectomy, with the collaboration of Dr. Estefanía Romero, from our team, the specialist in laparoscopy at ICUA. Dr. Romero was trained in Bordeaux with Dr. Gaston and performs all laparoscopic procedures in our center.

It is always a pleasure to receive the visit of Dr. Gaston in our center. He is a great expert and now a friend. Keeping this link with him on a regular base allows our patients to access the best world expert in the field, without needing to travel to Bordeaux in France where he works. For us it is a true privilege to collaborate with him and to keep on learning from him.

Originally posted April 30, 2013

Today I was invited to the National Spanish TV, to participate in the program "La Mañana de la 1" with the famous presenter Mariló Montero.

This time we spoke about prostate and about surgery of Benign Prostatic Hyperplasia. I explained conventional surgery and the advantages of surgery with the GreenLight laser, and also presented the new technique of GreenLight Enucleation of the prostate that I developed.

We discussed the role of surgical simulators for training of urologists in this technique and the importance of learning with virtual models prior to starting to operate on patients. I had a great time, as always.

Saber vivir - Problemas de orina y próstata.

• Saber vivir - Problemas de orina y próstata.

Originally posted April 25, 2013

This wednesday I travelled to Amsterdam to meet with Dr. Gordon H. Muir, from King's College Hospital, London, UK.  Prof. Alexander Bachmann, from Basel University Hospital, Switzerland.  Dr. Riddick, from Scotland. Prof. Georges Fournier, from the University Hospital in Brest, France and Dr. Brunken, from Germany.

All of them are experts in BPH surgery with the GreenLight laser and they engage actively in the training of other urologists, like me.

Mr. Muir, Prof. Fournier and Prof. Bachmann, in a break at our meeting.

We met to discuss the advances in the technique of GreenLight laser vaporization of the prostate and on how should the training be to optimize GreenLight laser use in ambulatory clinics, e.g. without hospitalisation.

We had a fruitful discussion and we hope to publish a couple of papers, one with recommendations on training and one on advanced surgical technique, that we hope to publish soon.

Dr. Riddick left on a shirt and Dr. Brunken by the picture on the wall

Originally posted April 23, 2013

Today we received the visit of the French Urologist Denis Chautard, who has an interest in laser surgery of BPH.

He witnessed two cases we performed today, an anatomic vaporization of the prostate and a GreenLEP procedure.

Both cases went really well, and I think Dr. Chautard was impressed with the techniques he saw today. We have prepared a visitors book and he wrote a comment after his visit that I reproduce below. French language is not my strongest talent, but I think it is a positive comment ;-)

Originally posted April 22, 2013

This weekend I operated again at the Hill Clinic in Sofia, Bulgaria. The weather is getting better and we had a beautiful sun.

This time we had a four day session where I performed 19 prostatectomies. Every time I am more convinced that the GreenLEP procedure is here to stay. We have refined the technique so much that surgeries take place placidly and safely and we can operate prostates any size.

One of the patients had a lot of stones in the bladder and had a huge gland. First we fragmented the stones with Holmium laser and then we performed the enucleation, that went really well. We could extract nearly 150 grams of prostatic tissue that we sent to the pathologist.

A very interesting session that I enjoyed thoroughly. I recommend to all urologists who are interested to learn this procedure to join us at the Hill Clinic to see the operations with us. It is the operation of the future, today!!!

Originally posted April 18, 2013

This month I travelled to Modena, Italy, in virtue of the collaboration agreement that my institution, the ICUA (Institute of advanced urological surgery) has with Dr. Giovanni Ferrari to come to Italy to operate on a regular basis at the Hospital Hesperia.

In this occasion I did four operations, two anatomic vaporizations, a vapo-enucleation with middle lobe enucleation, and a GreenLEP procedure, followed by morcellation of the adenoma.

We received the visit this time of Dr. Franco Montefiore Director of the urology department at Ospedale San Giacomo de Novi Ligure, Dr. Danilo Zani from Instituto Clínico Città de Brescia, Dr. Alberto del Nero of the Clínica Urológica San Paolo de Milán and Dr. Enrico Conti, Head of the urology department at the Ospedale San Lázaro de Alba accompanied by Dr. Fasolis.

With all of them I appear in these photos, Dr. Ferrari wears a white coat. It was a very interesting session and I  had a great time. That night I slept in Italy and departed early in the morning to Bulgaria.

Originally posted April 13, 2013

After a long trip with a stop in Istanbul, I arrived in Antalya to participate in the congress of the Turkish Association of Endourology.

My role was to participate in a round table with other experts in the surgical treatment of BPH.

I had a terrible cold, but managed to attend the session, which was celebrated in Turkish language, with simultaneous translation.

An interesting session, in which we covered all alternatives for the surgical treatment of BPH. I really hallucinated when I saw that there are still urologists who defend open prostatectomy as the ideal option! I enjoyed Dr. Ali Erol's very balanced comments.

It is always nice to visit Turkey.

Originally posted April 4, 2013

I landed in Torino at night, raining (what a long winter) and then I was picked up by a driver who took me to Ponte San Pietro.

The following morning I arrived at the Ospedale di Ponte San Pietro.

There, Oscar Fenice had programmed three patients to perform a surgical training session in which I had to help him with his first cases.

Everything went really well and we finished early, this laser is fast, and I could return a little earlier than expected to Madrid.

This saturday I was going to go to Croatia to perform a live surgical procedure in an Endourology congress, but I was informed that the surgical session was cancelled due to organizational problems. The truth is I was not sad to get a free weekend!

Originally posted March 24, 2013

I arrived early at Sofia from Istanbul, and I went directly to the Hill Clinic to start the surgical session. We had 14 patients to operate from Friday to Sunday.

My colleagues at Hill showed me this press article where they referenced our team at the Hill Clinic. The truth is that we work really well there with very high quality standards. Everything is efficient and patients do really well. This is certainly due to the great team we have formed there.

The operations went really well, the GreenLEP technique has improved over the years in our hands and it is now a fast operation (we take from 40 to 75 minutes, depending on prostatic sizes) and the new Vmax blades from the Wolf Piranha morcellator allow us to cut down the morcellation time and the total surgical time.

I am really happy with this operation and the Hill Clinic is no doubt the center in the world with more experience in this technique. I love to work there.

Then I returned to Madrid on Sunday, tired but happy as the easter holiday is starting.

Originally posted March 21, 2013

I spent the day today at the wonderful L'aquila, in Italy, surrounded by white mountains.

In the hospital they had prepared four cases to demonstrate all the technical variants of GreenLight XPS 180 watt laser. I performed an anatomic vaporization, a vapo-enucleation, an en-bloc enucleation and another vapo-enucleation.

A very intense morning, with Dr. Luigi Clemente, and other urologists that joined the session from other Italian Hospitals. I had a great time.

From L'aquila I drove to the airport at Fiumicino, to fly to Istanbul. I slept at the airport Hotel and departed in the morning to Sofia, to operate during the weekend in Bulgaria.