More surgeries in Sofia, Bulgaria

Again I went to Sofia, to perform more operations with Dr. Kalchev. Sofia was beautiful, dressed in white. I am falling in love with this city and my friends in Bulgaria!

This was the view from the terrace of the Hill Clinic in Sofia. It was snowing and we had very low temperatures.

In this surgical session we operated two days, and two of the patients had huge prostates. We used the new GreenLEP technique, enucleating the adenoma with the Greenlight HPS laser. The size of the prostate fragments was so big that we decided not to morcelate and to extract them through a small incision over the pubis. This is one of the specimens we sent to the pathologist for histological study.

The weight of the adenoma was 245 grams in one of the cases and 260 in the second case (in the photo). This was really impressive. I am now convinced that Greenlight enucleation allows to treat prostates any size with minimal risk, removing the whole prostatic adenoma.

Then I returned to Madrid to celebrate Christmas, happy and hopeful that the year 2010 will be very interesting!

Surgical Marathon in Sofia

Again I travelled to Sofía to help Dr. Kalchev with his learning curve with the Greenlight HPS laser for the treatment of BPH. In a weekend we did 13 operations and operated patients with prostates of all sizes... Everyone of them left the clinic the morning after the operation. 

It was a surgical marathon, but we also had some time to enjoy. Dr. Kalchev showed me the video of an interview that was broadcasted by the Bulgarian National TV, they have published it in their webiste. The introduction of the Greenlight HPS laser in Bulgaria has generated an immense interest. My daughters came with me to Bulgaria this time, and they had a great time getting to know Sofia.

Flash trip to Boston

This was a flash trip to Boston. I had to meet there with Mr. Gordon Muir, from London, and Shahin Tabatabei, from Boston, to discuss some common projects related with prostatic surgery. I took the photos with my mobile, for some reason they looked pink!

With my friend Gordon Muir, visiting the Mass General Hospital.

With Dr. Shahin Tabatabei, during our visit.

I only spent a night there and I returned in a direct flight to Madrid. I landed in Madrid and went straight to my clinic, to work, a little tired.

Surgery in Gran Canaria

Again I travelled to Gran Canaria to operate with Dr. Juarez del Dago. In this ocassion he invited me to give him a hand with a patient with a huge sized prostate. The operation was very succesful, and we had a chance to talk after a "long time no see".

The following day I went back to Madrid, I had to connect with a flight to Boston.

Resident session at the University Hospital Gregorio Marañón, Madrid

This friday I had the great pleasure to be invited to the residents session at the University Hospital Gregorio Marañón, in Madrid, to talk about greenlight laser surgery for BPH. I loved to share my experience with the residents in this hospital and meet some old friends and colleagues as Dr. Lledó, Dr. Escribano and Dr. Durán Merino, among others.

Then I rushed to the hospital, I had patients waiting to be operated!

III Urology meeting for primary care physicians and urology residents

Shortly after my arrival from Taiwan I participated in this scientific meeting invited by Dr. Juan Carlos Ruiz de la Roja.

Dr. Ruiz de la Roja is an old friend and colleague and maybe the most relevant communicator of urology in Spain, after publishing his two books: Hablemos de tu próstata y Potencia tu vida sexual, consejos de un médico.

In this meeting urologists and primary care physicians interact and we communicate recent advances and advice for the management of urological patients in the primary care setting. My role was to discuss the use of the greenlight HPS laser in Urology.

Trip to Asia III: Taiwan

From Shanghai I flew to Taipei, and when I arrived I went to walk around it's famous night markets. Taipei must be the city with most motorbikes in the world, and it is a modern and nice city with heavy traffic.

The following day I visited the Tri-Service General Hospital, a military hospital serving Taiwan's army, the navy and the air force. First I gave a talk on Greenlight HPS treatment of benign prostatic hyperplasia.

Then we went to the surgical theatre, where I helped the hospital's urologists to perform a case, there were also urologists from other hospitals. It was a really interesting case.

 


That day Dr. Richard Santucci, a famous reconstructive urological surgeon, was also visiting the hospital, and we had a very nice chat over a Taiwanese banquet consisting on 11 or 12 courses.

That same night I took the speed train to Kwashioung, the second main city in Taiwan, where I had to make a presentation on greenlight laser and BPH in the 2009 Asia-Pacific Uro-oncology Summit.

The dinner after the congress was very nice and fun, with a lot of karaoke going on. I shared the table with Dr. Paibul Boonyapanichskul, from Bangkok; Dr. Hwancheol Son, from Seoul; our host, Prof. Po Hui Chiang, and Prof. Lawrence Klotz, from Canada. I had a lot of fun!

That same night I went back to Taipei to prepare my return to Madrid. I had time enough to visit the tallest building in Taipei, where I could see the city from above. It was a great farewell after a long trip.

Trip to Asia II: Shanghai

From Hong Kong I travelled to Shanghai, I arrived at night and it was incredible to see the amount of skyscrapers in this wonderful city. It reminded me very much of the movie "Blade Runner".

This is the view of Shanghai I had from my hotel room.

The following morning I was picked up by Dr. Henry Chen, the Chinese urologist with the largest experience in the treatment of BPH with the Greenlight laser. We went to Shanghai's Number 1 People's Hospital to perform a surgical operation that would be transmitted live to the venue of the 30th Congress of the Société Internationale d'Urologie.

The operation was succesful, although we had to calibrate the camera because we had relatively bad camera image, but we managed to solve it. It was a pity that the transmission only lasted 30 minutes, because we could not show the final result of the operation to the audience. We had a good discussion though during the part that was transmitted.

The following day I presented the new technique of Greenlight laser enucleation in a congress session. It was very welcome by the audience. The combination of initial vaporization to facilitate subsequent enucleation could prove to be an optimal strategy to operate bigger prostates with safety and efficacy. Many urologists have problems treating big glands and also they were afraid of morcellation. The new Piranha Morcellator from Richard Wolf has improved this process significantly, and it is much safer than it was before.

 

Then my contribution to the congress finished, and I took the opportunity to get to know Shanghai, a surprising and wonderful city.

I had never seen Malls so huge. 10 floors and thousands of shops and restaurants. Amazing city, Shanghai.

Trip to Asia I: Hong Kong

I love to travel, but when I travel to Asia, I do even more. I think that globalization has limited the differences among countries and cities. We all live a similar kind of life, we drive to work, we buy in the same shopping centers. Many times when I travel I do not find much difference between places. But in Asia the differences are much deeper, you really have the feeling of being somewhere exotic and far away.

In this occasion I travelled to Hong Kong to participate in a full day of talks and surgeries, invited by the North District Hospital and the Chinese University of Hong Kong. From the airport I went to the Hospital to see the patients we would operate on the following day, and check that everything was in order for the meeting. Hong Kong is a wonderful city.

The following day I woke up early to go to the hospital. It has wonderful installations and an amazingly well trained personnel. I was positively surprised by the quality of the hospital and its people.

In the photo, with Edison Chung, the distributor of AMS in Hong Kong. A true gentleman and an amazing host. He took me to the hospital and accompanied me during my trip.

The meeting room was packed with urologists and hospital personnel. I did two talks on surgical technique and tips and tricks to obtain a better outcome with greenlight and I did two operations that were retransmitted live to the audience.

We were able to comment the operations live. I first operated a small prostate, about 50 grams, and then a bigger one, approximately 100 grams.

It turned out to be a fantastic session, we had plenty of time to discuss and comment all aspects of the surgical treatment of BPH with the Greenlight laser. The attendees were really interested and stayed there paying attention until the end. Chinese people are usually smaller than me, I had to pack myself into the biggest surgical jacket in the hospital.

That night we had dinner at the Hotel Sheraton, but before the dinner I gave a short talk on the comparison of Greenlight with other laser types. The traditional chinese banquets include 11 diferent courses, so the dinner was amazing. The Hong Kong chinese food is very different to the chinese food we are used to have in Spain.

The next day I had some time to enjoy Hong Kong. I visited a fantastic zoo where I could see the panda bears and other wonders of nature. I had a great time.

And went up to the peak, to see Hong Kong from above. Impressive.

That night I was invited to dine at Dr. Richard Lo's house. He fascinated me with his amazing hospitality and kindness. We enjoyed his cooking talents in the company of other urologists. I left Hong Kong wishing to come back, as always. It is a marvelous city, a pity it is so far from us.

A new technique: Greenlight Enucleation of the Prostate

This is a new technique to treat patients with big benign prostates with optimal results. Instead of vaporizing all the hyperplastic tissue, after a brief preparation, the middle lobe and then lateral lobes are enucleated, thrown into the bladder and later morcelated or fragmented in the bladder to be extracted.

It allows to remove the BPH(Benign Prostatic Hyperplasia) tissue completely, retrieve it for histological analysis and to obtain excellent results, similar to open prostatectomy, but with mininal risk and a hospital stay of 24 hours.

I hope to present this technique at the Spanish National Congress, the European Association of Urology Congress and the American Urological Association Annual Congress.

Article in the Spanish national newspaper ABC

This article was published last saturday in ABC, one of the leading newspapers in Spain. I write about technological acceleration, how medicine is changing exponentially. Sorry, in Spanish.

New trip to Bulgaria

From Beirut I took a plane to Istanbul, and from there I flew to Sofia.

Again I was invited by Dr. Ililya Kalchev to a surgical session where we operated several patients.

This time we were interviewed by the bulgarian TV, very interested in spreading the news about this new cutting edge technology for the treatment of benign prostatic hyperplasia.

Then I returned to Madrid, I had a lot of clinics and surgeries to attend to.

Surgeries in Lebanon

This is my first visit to Lebanon. I flew to Beirut to participate in a symposium on greenlight with a live surgery link to the audience. This symposium had been organised by the Centre Hospitalier du Nord.

After a brief presentation, we did four operations during the morning.

Between operations I did some short presentations on Greenlight HPS technique and results..

We visited the Hospital, that offers state of the art technological instalations, and then we had a wonderful lunch in a magnificent restaurant in the mountains.

There I met a good friend, a Lebanese urologist who was a resident in London during the time I worked at the Institute of Urology, Dr. Zareh Kassardjian, we had great fun remembering past times.

Then we went back to the hospital and there I helped Dr. Khalil Armache perform two additional operations.

Dr. Armache was kind enough to invite me to have a beer in his house. I finally reached the hotel, very tired after a very intense and interesting surgical session. I slept a few hours and  departed sleepy to Istanbul, where I connected to a flight to Sofia.