Originally posted August 26, 2015

This time I travelled to Belgium to participate in an advanced three-day training course on radical prostatectomy at ORSI with Prof. Alex Mottrie.

In September I will return to complete the second part of the course for another three days.

It has been a great experience and an extremely well conceived, didactic and comprehensive course.

Prof. Mottrie is a great robotic surgeon and despite the fact that we have worked for the past 8 years with Dr. Richard Gastón, who is considered the "guru" of robotic surgery worldwide, and that we are spoiled by his geniality, it is always a pleasure to share with expert surgeons like Prof. Mottrie, compare the different points of view and the alternative surgical strategies.

It was also very nice to share with other urologists from Australia, Scotland, India, Italy and The Netherlands.

Originally posted August 10, 2015

Again I was invited to participate in the TV program Saber Vivir, this time directed by Teresa Viejo, in which we spoke on urinary tract infections in the summer time. As always it was a pleasure to participate and spread useful healthcare related concepts through Spanish TV. The program can be seen here.

Originally posted July 31, 2015

This time I went to the Hill Clinic in Sofia, Bulgaria, to film a teaching video on the Green laser en bloc enucleation technique that the surgical instrument manufacturer Richard Wolf wants to distribute worldwide.

We performed several operations and we filmed the technique step by step as well as many explanations on surgical technique.

It is a good opportunity to teach the technique I developed now 6 years ago to urologists worldwide. I am very happy with the simplicity of it as well as with the results we obtain. It is a very important advance on the surgical treatment of BPH that is going to allow many urologists to learn the technique in a simple way.

Originally posted July 30, 2015

This time I went to Milán to visit the European Institute of Oncology in Italy. There I met Prof. Ottavio de Cobelli who invited me to his operating room to witness a Da Vinci robotic radical prostatectomy in a patient with prostate cancer.

It was an interesting morning in which I could see the strategies they use systematically. It was their first day with the new Robot Da Vinci Xi and they had to use some tricks to be able to work with the alexis access port which was perfect for the 12 mm tracers, but not so good for the 8 mm robotic ports from the new Da Vinci Robot.

It was a very interesting morning. Dr. Cobelli is a great expert. These experiences let me copy the good ideas from other centers, but it also makes me realize the incredible quality level of our work with the Da Vinci Robot, inspired by Dr. Richard Gaston.

Then I went to the airport to travel to Sofia the next day, I have been invited to produce an educational video on GreenLight Enucleation of the prostate.

Originally posted July 24, 2015

As usual, Dr. Gastón came to Madrid to work with me at Clínica CEMTRO and we performed two days of radical prostatectomy cases prostatectomía radical robótica.

We are very impressed with the functional results we are obtaining in the patients we have operated during the last few months with the latest generation Da Vinci robot. The robot itself is a technological wonder, but what is really important to be able to achieve these results, a high quality urinary continence and the preservation of erectile function, is the vast experience of Dr. Gaston in robotic surgery. To me it is an immense privilege to be able to assist him every month and to learn from a master like him. In surgery it is paramount to share the experience, what has been learnt by one surgeon performing thousands of cases, to avoid mistakes, to achieve objectives. Learning from a true master is a luxury and an unparalleled opportunity.

After many years dedicated with devotion to the treatment of prostatic diseases, I feel we have managed to build up a urology department where we offer the best in the diagnosis of prostate cancer and in the treatment of BPH and prostate cancer.

Originally posted July 15, 2015

This time we received the visit of Dr. Leopoldo Cogorno, from Hospital Infanta Sofía, from Madrid, Dr. Ernesto de Nova, from the Hospital Gereral de Elche, Dr. Alvaro Juarez Soto, from the Hospital de Jerez, Dr. Jose Manuel Fernández Montero, from the Hospital Marbella Highcare. We also were accompanied by Dr. David Rendón, ex-staff member from ICUA who is now living and working in Medellín, Colombia.

I performed 5 operations during the afternoon that went very well, and allowed us to demonstrate the versatility of the GreenLight laser for the treatment of BPH, for enucleation, vaporization, ejaculation preserving techniques, etc.

We had good critics in twitter ;-)

Originally posted July 10, 2015

This time I went to Barcelona early to perform a surgical demonstration at Hospital Quirón in Barcelona, where I did two GreenLEP (Green Laser Enucleation of the Prostate) operations to two patients with big sized prostates, 95 and 110 cc.

Everything went very well and I could demonstrate the efficiency of the technique, as the operations only took 35 and 45 minutes from beginning to end.

Urologists at Quirón were fascinated with the technique. It is very impressive to see the easiness with which it is possible to treat these big adenomas, with little bleeding, and very fast. It is an elegant, intuitive, anatomic and safe technique.

They told me later that patients were very well, although I already knew they were ;-). I returned to Madrid to rest for the weekend, summer is coming!

Originally posted July 3, 2015

Again I went to Cimbra to operate with Dr. Antonio Oliveira at Hospital Idelamed. Dr. Oliveira is now performing GreenLEP regularly and he is happy with his results.

We had a patient who had been submitted to prostatic arterial embolization despite having a stone in the bladder, and a prostate 170 cc in volume. After a total failure of embolization and not experiencing any improvement, he decided to undergo endoscopic enucleation with the GreenLight laser.

To me it was a new clinical situation and it was interesting to see how the dissection of the capsular plane could be performed without any trouble. In the postoperative TRUS control the prostatic fossa was very huge.

I am very skeptical about prostatic arteries embolization. It seems to me a relatively illogical concept, to produce a prostatic infarction and then wait for the tissue to evolve, to atrophy. Very unpredictable. Some interventional radiologists are promoting it without having much scientific evidence to do it, and they apply it without any urological criteria (¿in a patient with a stone in the bladder?).

I think endoscopic enucleation in the hands of a properly trained urologist is today the best option for the surgical treatment of BPH. Endoscopic enucleation is without doubt the best option in patients with large prostates.

Originally posted June 29, 2015

Again I travelled to Paris to participate in the congress "Challenges in Endourology" in Paris. The last two years I was invited to perform live surgery, but this time I was invited to give a talk at the plenary session on the treatment of BPH.

The talk will be available in webcast format in about a month at the congress website.

Originally posted June 26, 2015

We were performing a Da Vinci Xi Robotic session at Clinica CEMTRO in Madrid with Dr. Gaston when we received the visit of the prestigious Dr. Henry Woo, from Sydney, Australia.

It was a pleasure to demonstrate Dr. Woo the robotic radical prostatectomy with Dr. Gastón. He was very impressed with the quality of the work we do at Clínica CEMTRO.

Also during these dates we launched our new web on robotic surgery at www.icirugiarobotica.com and the new twitter acount for our robotic unit @UroRobotica, as well as the new corporate image of the joint work of ICUA and Clínica CEMTRO.

Visit our web if you want to see Dr. Gastón explaining the advantages of robotic surgery and the opinion of the patients!

Originally posted June 24, 2015

As usual, we received the visit at our operating room from Dr. Miguel Angel Alonso and Dr. Mario de Arriba Alonso, from the Hospital de León in Spain.

I performed several operations and was able to show the different techniques of anatomic vaporization and Green Laser enucleation of the prostate. They were very happy to have seen the new possibilities of the GreenLight laser in the treatment of benign prostatic hyperplasia.

Originally posted June 22, 2015

This time I went to Bulgaria invited to participate in an interview at the National Bulgarian TV. It was very difficult because the presentar spoke to me in Bulgarian and the translator did simultaneous translation both when I was asked and when I was answering. I tried to spread the message that men should visit the urologist and that this is the way to prevent the consequences of prostatic diseases. In my experience in Bulgaria, men there do not visit the urologist and they only consult when they have serious problems.

The interview can be viewed here: http://hillclinic.com/lechenieto-e-lesno-kogato-patsientat-dojde-navreme/

Originally posted June 19, 2015

This time I visited the Hospital Charité, at the University of Berlín, Campus Bejamin Franklin, to show Dr. John Buckendahl and Dr. Hannes Cash how to perform anatomic vaporization and GreenLight enucleation.

I did three operations, this time without the luxury of a morcellator, so we had to do TURP morcellation, which makes surgical procedures a little bit longer. But everything went very well.

They were excited to see the interphase between surgical capsule and adenoma, and I am sure they will end up learning this wonderful procedures.

Originally posted June 18, 2015

This time I travelled to Nuremberg, Germany, to participate in a mentoring session for Dr. Lubke in the GreenLEP (Green Laser Enucleation of the Prostate) technique.

For two days we operated together and Dr. Lubke was able to perform cases independently, and he did very well!

From Nuremberg I flew to Berlín, where I had to do a surgical demonstration the following day.

Originally posted June 4, 2015

This time I was invited to perform a surgical demonstration at Hopital Cochin in Paris. Everything went very well, I performed two operations in patients with relatively large glands (95 g and 155 g) that went very well.

Dr. Mikael Peyromaure, chief of the urology department from this hospital, was with me, he was very impressed by this technique of Green laser enucleation of the prostate.

Originally posted May 31, 2015

This weekend I travelled to Sofia as usual, to run a surgical course on GreenLight laser enucleation at the Hill Clinic.

This time we received the visit of several urologists, Dr. Tev Aho, from the University of Cambridge, UK, my old friend Dr. Botan Hawas, from the Central Hospital of Vasteras, Sweden, Dr. Augusto from Florence, Italy and Dr. Jorge Mora, from Bilbao (who is not in the photo).

Dr. Aho is an international expert in surgery with the Holmium Laser and he was curious to see the GreenLight laser in action to perform enucleation. We had very interesting conversations.

Originally posted May 26, 2015

Today we received some visitors to our operating room at Clinica CEMTRO who came to see the new surgical techniques for the treatment of BPH with the GreenLight laser.

We received the visit of two french urologists, Dr. Christophe Pollux and Dr. Mathieu Demesmaeker from the hospitals Aunay Sur Boix y Marne la Vallu and Dr. Carlos Vallejo from Hospital CIMA in Barcelona.

Everything went very well, as always in these sessions we spoke comprehensively about all the details of this amazing surgical procedure for the treatment of BPH.

Originally posted May 21, 2015

This week we kicked off the robotic surgery unit at ICUA-Clínica CEMTRO. Dr. Richard Gastón came to operate 9 patients in three days of intensive surgery. All the operations went very well and I am very proud of the high quality robotic surgical team we have created.

Assisting Dr. Gaston during the surgical session

We had visited Clinique Saint Agustin in Bordeaux several times to copy step by step all the processes, all the tricks, al the materials they use there. We had trained all the personnel involved, nurses, auxiliary personnel, anesthetists, and of course our urology team. We also did courses on the operation of the new Da Vinci Xi Robot as they do not have it in Bordeaux yet.

Dr. Richard Gastón, a team member at ICUA, operating with the Da Vinci Xi

Everything went very well. The intensive training of all involved really paid off. We could do the operations as we had planned and we all felt comfortable and happy, each of us with our own function and Dr. Gaston felt very comfortable with the support of the team at ICUA and Clinica CEMTRO and with the new Da Vinci Xi robot, that brings new advantages for the surgeon and the patient compared to the older system.

With Dr. Romero preparing a patient prior to docking the robot

We are very happy for two reasons:

- One, to be able to offer our patients the most advanced technology in the diagnosis of prostatic diseases (with our prostate mapping system, Biopsee, for the diagnosis of prostate cancer based on 3 Tesla magnetic resonance imaging fusion), and also in the treatment of Benign prostatic Hyperplasia (GreenLight laser and Holmium laser) and prostate cancer (Da Vinci Xi Robot, Criosurgery, Focal One- HIFU).

- Two, to bring together the unmatchable experience of Dr. Gastón in robotic surgery of urological cancer with our huge experience in the minimally invasive treatment of BPH with laser.

This positions us as one of the centers in the world with more experience in the treatment and diagnosis of prostatic diseases. It is not so easy to find another center where patients can benefit from so much experience.

It is a true privilege to be able to work in optimal conditions with cutting edge technology.

After eight years of collaboration with Dr. Gastón in conventional laparoscopic surgery, now we enter the world of the most advanced surgery hand by hand with a true master of surgery.

Originally posted May 19, 2015

Again I went to the annual congress of the AUA, this time in New Orleans. My role in this congress was to participate as faculty in the course on Green Laser surgery and more specifically to speak about surgical technique for vaporization and enucleation.

The congress was as always very interesting, featuring a lot of novelties in all fields of urology. There were more than 15.000 attendees from all over the world.

Sadly I unexpectedly had to return to Madrid before the course and my friends Dr. Henry Woo and Dr. Oliver Reich gently exposed the presentations I had prepared.

Originally posted May 12, 2015

At last the day arrived. We celebrated a course at Clinica CEMTRO in Madrid on the modern use of the GreenLight laser. We received the visit of at least 50 urologists from Spain, Italy and Portugal.

The course went very well and we alternated many 10-15 minute talks with three operations that I performed and were retransmitted live to the main auditorium at Clinica CEMTRO.

Dr. Luis Llanes presenting on the Physics of lasers

We were very happy for the scientific quality of all the presentations and for the great deal of participation of the urologists attending the course. The sponsor of the course, AMS, commented that we received excellent reviews for the course.

Dr. Romero reviewing the literature on lasers and BPH

Dr. McVeigh, from our department of anesthesia at CEMTRO

This video in Spanish reflects how it went and some opinions.