Surgical demonstration in Manresa

This Monday I woke up early to travel to Barcelona, and from there to Manresa, to the Hospital San Joan de Deu, to make a demonstration of the high power Greenlight HPS at work.

The hospital is considering to offer this technique to its patients, but they needed to see it with their own eyes...

So I was asked to operate four patients with prostates weighing 40, 100, 75 and 70 grams, and all of the operations were uneventful and satisfactory. They were positively impressed. As always, on my return to Madrid, Iberia provided another delay, and I got home relatively late. Tomorrow I will do the last clinic before my holidays and I will depart to EL CAIRO, my last trip before I leave on holiday.

New surgical session in Gran Canaria

This thursday I took an early flight to Gran Canaria. Again I operated with Dr. Juarez four patients. All the operations went fine and we had fun spending the day together in theatre. This is the good thing of laser surgery, it is very relaxed, not only for the patient, but also for the surgeon.

It is relatively sad to get to Gran Canaria and have to leave right away. In this time of the year one feels like staying there... so I had no choice but to wake up early again on Friday to return to Madrid. I had scheduled a full day operating list, with some minor operations, a PVP of a large prostate and a Cryosurgery of a recurrent prostate cancer after radiotherapy.

Dr. Juarez gave me a print of a newspaper published recently in the Canary Islands covering the first installation of an HPS laser in the region.

Invitation to operate in Cancún, Mexico.

Today I received an invitation to participate in the World Congress of Endourology in Cancún, Mexico, in October. I will perform a Greenlight HPS prostatectomy live, that will be transmitted to the congress venue, for all the urologists attending the congress to see...

It is an immense honour. Operating live in the World Congress of Endourology is for a urologist as competing in a final of the Olympiad for a sportsman. I am delighted with the invitation. From all of the urologists in the world they could have chosen to invite, they chose me.

Triple surgical session in La Coruña

This Monday I travelled to La Coruña, in the North-West of Spain to participate in three surgical sessions with the new High Power Greenlight HPS laser. We conducted two surgical sessions, Monday afternoon and Tuesday morning at the Abente y Lago Hospital, training two prestigious colleagues from La Coruña. We did six operations in total. All cases were very satisfactory. This hospital belongs to the Juan Canalejo Healthcare complex, and they mainly do short stay surgery here.

On Tuesday afternoon we went to the Modelo Hospital in La Coruña, where we performed another operation, that was also uneventful. The truth is that it is a great pleasure and honor to help my colleagues to perform their first steps with the greenlight, specially when they are such outstanding pupils, and learn so fast.

Anyone reading this blog might ask what moves me to travel so much and to train so many urologists, today here, tomorrow there, always on the move.... it is really a big effort, and something must justify this huge effort.

Well, what really moves me to do this is that I learn a great deal in these training sessions. First, because I am training seasoned urologists, who know a lot and have seen a lot. They share their views with me. I learn much from them and ultimately they become good friends. Secondly, each prostate is different (I have not seen two prostates that are exactly the same), and the fact that we review once and again the basic concepts of endoscopic laser surgery, and that I explain thousands of times why hold the scope this way, or how fast to rotate the fiber, or what is the ideal working distance, how to approach a median lobe, how to avoid and handle complications, etc... helps me reflect and understand more deeply and grasp the immense amount of details that one should know to perfom this operation with excellence.

This technique is evolving constantly, getting better and better. We learn day by day how to make it better and safer. It will change the current worldwide panorama of the surgical treatment of BPH (Benign Prostatic Hyperplasia). In my opinion, classic surgical techniques, open prostatectomy and TURP (Transurethral resection of the prostate) are obsolete, but they are being performed and offered to patients in hospitals worldwide, and many patients still suffer the secondary effects and complications, sometimes very severe, of these classic operations.

It is a true adventure to be able to play a part in this movie... operating so much, in so many theatres, having the opportunity to interact with urologists, nurses, patients all over Spain and the rest of the World is really a privilege and an enriching activity. More importantly, this enables me to learn more and to be able to offer my patients a better operation, safer and more close to perfection.

Masterclass with Dr. Gastón

Today we have operated two patients with prostate cancer with Dr. Gastón and Dr. Piechaud, from Bordeaux, France, in the new Hospital Pardo de Aravaca, in Madrid.



Dr. Gastón visits us regularly, he invented the technique of laparoscopic radical prostatectomy. Dr. Piechaud is another international expert in laparoscopic surgery, with a special interest in robotic surgery.

Greenlight HPS world experts meeting in Madrid

This weekend we celebrated the second meeting of world experts in Greenlight laser surgery of the prostate, again in Madrid. The organization was carried out by the ICUA, with the unrestricted support of AMS (Americal Medical Systems). The idea was simple and innovative, put together the surgeons with more experience in Greenlight HPS laser surgery to allow them to share experiences and reach consensus on how this operation should be done and then be able to share what we learnt with the rest of the world.


Doctors attending were Mr. Gordon H. Muir (London), Alex Bachmann (Basel, Switzerland), Oliver Reich (Munich, Germany), Jean de la Rossette (Holland), Benjamin Choi (New York, EE.UU.), Shahin Tabatabei (Boston, USA), Edward Collins (San Francisco, USA), Henry Woo (Sidney, Australia) and I was chairing the meeting. We named this group the IGLU group (International Greenlight Users Group).


We jointly performed 9 operations with prostates from 15 to 92 g in the Sanatorio del Rosario, in Madrid. We had a chance to observe different techniques and to share surgical tips and tricks, strategies and opinions during the whole day. On Saturday, we went to Toledo, where we had a wonderfu round table discussion and then on Sunday we discussed how to spread the conclusions of this meeting, so the can reach the rest of the urologists in the world.


It has been an excellent meeting. I have learn a lot from my colleagues. We all share the same passion for the Greenlight HPS Surgery. We, also, enjoy a very nice atmosphere and camaraderie...

Soon we will start publishing our results and the recommendations on how to perform this technique, so everybody can benefit from the experience we have gathered over the last four or five years. The group will continue working together and aiming to improve this technique and the way it is applied worldwide. We are all quite certain that this treatment option will dethrone the classic surgical options...

Surgeries in Santiago de Compostela

Today I was invited to operate at the University Hospital in Santiago de Compostela. They wanted to see firsthand the new Greenlight HPS and the small Holmium laser Stonelight at work. They prepared two cases, one of them with bladder stones, so I first operated the prostate and then the stones. Everyone enjoyed the session and both cases were spectacular. Then I returned to Madrid. The world experts meeting in Madrid will start the day after toworrow, everything is ready....

Weekend in Gran Canaria

I have spent this weekend in Gran Canaria. Again we had a surgical session with Dr. Juarez. His case was perfect, he was able to complete it even when the prostate was relatively big (80 grams). He is really good and has learned fast. The patient left the hospital the following morning, very happy. This time I took my family with me and we enjoyed the rest of the weekend in Costa Meloneras, enjoying a fantastic weather and the hospitality of Dr. Juarez and his wife. We are interested in furthering our collaboration and establishing a closer work relationship in Gran Canaria. We thought of offering a package for patients including prostate surgery and a week recovering in the canary islands, enjoying the sun and the good life.... attractive, isn't it? Then we went back to Madrid to start the week on Monday.

Surgical session in La Coruña

Yesterday I went to La Coruña, to help two urologists from the Juan Canalejo Hospital Complex with their first operations with the new HPS laser.

Specifically we went to the Hospital Abente y Lago, one of the hospitals in the complex. It is an old refurbished hospital, really beautiful, by the seaside.

We did three surgeries during the morning that were uneventful. They have learned the technique with ease... Soon I will come back to help them with six more cases to finish their mentoring before they can fly on their own.

This Hospital Complex is evaluating the technique in order to incorporate it to their services. They want to see how these patients fare after surgery. I think that there will be no residual doubt in their mind that this treatment is here to stay and to displace classic surgery.

Invitation to the Spanish TV

Today I went to the National TV - Televisión Española TVE - to participate in the most important health related TV program in Spain " Saber Vivir". We spoke about the disorders of the bladder, including cystitis, stones and bladder cancer. Although it was not specifically on prostate, I mentioned that bladder stones are often a result of prostate problems, and that both the causing problem - the prostate- and the effect - the stone - were treatable with modern laser techniques. It was a nice experience, Manuel Torreiglesias, the director of the program is a great communicator. He has succeeded with this program for ten years, it is already a classic of Spanish TV.




Then I spent some minutes answering questions online in the program's internet forum.... I had a very good time this morning!