Surgeries in Bilbao, Hospital de Basurto

Last thursday I took a plane early in the morning to go to Bilbao, to the Hospital de Basurto, to perform a surgical demonstration of the new GreenLight XPS 180 watt laser. We did two cases in the morning and the residents could perform most of the operations. Then Dr. Unda took me out for lunch "the vasque way". I like so much the Vasque Country ;-) Then I returned to Madrid to start my holidays!!

Visitors from Saudi Arabia, Lebanon and Galicia

This week we had two days full of GreenLight surgeries and we received visitors coming from Saudi Arabia,  (Dr. Maher Moazin, from Hospital King Fahd Medical City and Dr. Ali Bin Mahfooz, from King Faisal Specialist Hospital), from Lebanon (Dr. Fouad Honeine) and from Galicia, Dr. Andrés Rodríguez Alonso, from Hospital Arquitecto Marcide, in Ferrol.

Training in Casablanca

This time I travelled to Casablanca to participate in the training of Professors Abdennabi Joual and Rabii. They had recently visited Madrid to see GreenLight XPS laser operations.

We did five operations that took place without any trouble. Then we went to a local hotel for a press round because this is the first GreenLight laser that is installed in Morocco. Sadly I had no time to visit Casablanca...

GreenLight XPS 180 watt laser: Anatomic PVP Technique

Here I am presenting a new technique, the "Anatomic" PVP that aims to remove the whole adenoma from the prostate by localizing anatomical landmarks that will help achieving this goal. This enhances the durability of the procedure and achieve lower PSAs postoperatively.

I hope you enjoy, comments are welcome!


GreenLight XPS 180 watt laser "Anatomic" Photoselective Vaporization of the Prostate from Fernando Gómez Sancha on Vimeo.

Presentation of the new GreenLight XPS laser in Spain

This Friday I participated in the official presentation of the new GreenLight XPS 180 watt laser that took place at the University Hospital Fundación Alcorcón, in Madrid.

One of the talks was about how to apply the basic science to clinical practice. I used a new tool to make presentations called PREZI, that allows for online publication. Logically this is only the presentation, but not my voice explaining it... but it is certainly remarkable and that is why I publish it here (you will see it better if you click on more on the lower right and choose full screen).

Fisiopatología del láser on Prezi

Surgeries at the General University Hospital in Valencia

This thursday I took an early flight to go to Valencia. I had to show the new GreenLigth XPS 180 watt laser. There I met my old friends Dr. Emilio López Alcina and Dr. Enrique Illueca.

The hospital was in a messy state, as they are refurbishing, but the surgical session was fantastic. We did two operations during the morning that were very succesful. Then I returned fast to Madrid. This laser is impressing everybody that gets to see it in action.

More surgeries in Sofia

This weekend I was in Sofia. We had to operate on saturday and sunday, we had seven patients.

On Sunday we finished somewhat earlier than usual and Dr. Kalchev took me to see the Vitosha mountain, a wonderful place that belongs to the Balkan mountains, just near Sofia, where bulgarians use to sky in the winter. There was no snow yet, but one could feel that soon it will be really cold there.

It is an old vulcano, and it had this massive rocks flowing down... impressive!

On Monday I returned to Madrid early in the morning.

Live surgery in Santiago de Compostela

Thursday night I flew to Santiago de Compostela, the next morning I had to perform a live procedure on a patient with benign prostatic enlargement using the new GreenLight XPS 180 watt laser. The operation was transmitted to the meeting room at the Hospital de Conxo, where the congress was held.

The operation was uneventful and I could show the anatomic vaporization technique, in which the surgical capsule of the prostate is found to make sure that the adenoma is vaporized to completion.

Then I had to do a long trip Santiago-Madrid-Milán-Sofia to arrive in Sofia that same night.

Surgeries in Valladolid

This friday I went to Valladolid, to operate with Dr. Amón Sesmero, in the new Hospital Rio Hortega. A very impressive hospital, with very modern installations and all high quality.

As it is happening in many public hospitals now in Spain, they are considering the acquisition of a GreenLight XPS 180 watt laser. We did two operations and they could see the speed of this new laser and how it is perfectly possible to perform a "down to capsule" prostatectomy, a true endoscopic adenomectomy.

We had a great time, then I returned to Madrid, I had to see patients and operate in the evening.

Trip to South Africa

From Beirut I flew to Johannesburg. I flew during the night in one of the new Airbus 380, an impressive plane.

I arrived in the morning and we went directly to Linksfield Hospital, where my friends Dr. Fisher, Barmania, Cohen and Bowden were waiting to participate in a surgical session with two cases. First I had a good shower, shave and cofee, and then we started the operations.

We talked in detail of the subtle details of technique, that are paramount to obtain optimal results.

Then we went out for dinner and the next day we went to the Welgevonden Game Farm, an amazing Game farm. There we spent two wonderful days driving in the park and spotting wild animals.

We also saw Bushmen paintings on caves, really impressive.

A wonderful trip. South Africa is a really amazing place. (All animal photos are copyright Rai Landau).

New trip to Beirut

Again I was invited to go to Beirut. This time we were inaugurating a GreenLight unit in the Hospital du Levant. I flew through Paris and Air France lost my luggage where I carried my surgical instruments. Luckily we could find another set of instruments rather fast and we could perform four operations throughout the day. We also had time to meet the press. All cases went very well.

From there we went to Hospital Bahman to give a talk. Many urologists, radiologists and general practitioners attended. Then I went to the airport to finally get my luggage and then I took a flight to Johannesburg.

Surgeries in Vitoria

This time I went to Vitoria in the north of Spain to help Dr. Javier Extramiana and Dr. Alberto Marquina with their first experience with the GreenLight XPS 180 watt laser. We did two operations that were very successful. Then I came back to Madrid very fast, I had to operate that evening.

Surgeries in Fundació Puigvert

This morning I went to Fundació Puitvert, invited to assist Dr. Montlleó and Dr. Ponce de León with their first contact with the GreenLight XPS. We did two operations that went wonderfully and everyone was amazed to see the speed of vaporization of this new laser, and how this speed is maintained throughout the procedure. Then I came back to Madrid to prepare my luggage to fly to the USA.

Congress of the Italian Urological Society

In this ocassion I went to Milán to participate in a symposium on GreenLight that took place during the Congress of the SIU (Societá Italiana de Urología).

I presented the new GreenLight XPS laser and I had to talk about GreenLEP (Greenlight laser enucleation of the prostate), that generated a lot of interest.

I Learned that I have received invitations to participate in various congresses this year.... It is going to be a busy year. When the symposium finished, I went out for dinner and took a plane to Barcelona.

Trip to Bulgaria

Again I travelled to Bulgaria to perform more surgeries. In this session we operated 12 patients from friday to sunday. All of them had huge prostates. We did 11 enucleations that went very smoothly. Dr. Kalchev confirmed later that all patients were alright.

I am working on the concept of performing an en-bloc enucleation of the adenoma, and not in two or three pieces. Almost all enucleations in this session were en-bloc. The great advantage of this attitude is that it is extremely fast. In some of these patients the enucleation time was under 30 minutes. Of course, later on one has to proceed to morcellate the adenoma, that also takes time depending of its size.

A very interesting and nice surgical session. On Monday morning I flew to Milan, to participate in a symposium of the Italian Urological Society.

Visitors from Lebanon and Morocco

This time we received the visit of two urologists from Morocco and three urologists from Lebanon, also very interested in seeing the new GreenLight XPS laser in action.

I organised two surgical sessions where I could demonstrate the new laser, the anatomic vaporization technique and the basis of enucleation. They were very impressed with the surgical results we can obtain today with this laser. Probably when they start operating with this laser in their countries I will help them with their first cases.

Visit from Dr. Sahoo, from India

We received in Madrid the visit of Dr. Sahoo, from India. After his experience with the Greenlight PV, he wanted to get acquainted with the newer higher power lasers and the latest surgical tips and tricks.

We first went together to Barcelona, to the Hospital Remei, where I had to support Dr. Mandaña, a GreenLight expert who was performing his first cases with the 180 watt laser. Then in Madrid we had another surgical session where I could demonstrate both vaporization and enucleation techniques.

Surgeries in Menorca

This time I flew to Menorca to demonstrate how the new GreenLight XPS 180 watt laser performs. The staff at the Urology Department of the Hospital Mateu Orfila, from Mahón, leaded by Dr. Gascón received me warmly inviting me to dinner.

The following day we could check the performance of this laser in three surgical sessions. I took the opportunity to stay in Menorca until Sunday. It is a wonderful island, although it rained a lot... (I must recognize that I am being a little lazy with my camera and that the photographs are not so good).

Surgeries in Lérida

I woke up early to take the high speed train to Lérida, where I had to perform some surgeries to demonstrate the new GreenLight XPS 180 watt laser. I operated two patients that went perfectly well and then I returned to Madrid.

This new laser is now much more attractive. It vaporizes tissue twice as fast, reducing surgical time significantly. I am working on a new technique, the "anatomic PVP" that allows to vaporize the adenoma completely, localizing the prostatic capsule to provide a clear anatomical reference to surgeons. I will try to present it in this year's European Congress.

Incontinence on TV

After my holiday in August, this course started with an invitation to participate in a TV program. We spoke about urinary incontinence. It is always fun to participate in these programs.

http://www.rtve.es/mediateca/videos/20100920/saber-vivir---perdidas-orina-20-09-10/881722.shtml

National Congress in Lima, Perú

Finally, to finish working prior to my summer holidays, I went to Lima, Perú. I had been invited to the National Congress of the Peruvian Urological Society. I had to talk about lasers and BPH and also about cryosurgery and HIFU for the treatment of prostate cancer.

During the weekend I took the opportunity to visit the city of Lima and the ruins of Pachacamac. I enjoyed thoroughly.

There I met my Peruvian friends, Dr. Elvis Sueldo, César Quincot and Jorge Saldaña. On Monday they had arranged four operations. I could demonstrate different technical variants with the GreenLight HPS laser, including the anatomic PVP and the principle of the GreenLEP technique.

We had time to perform a presentation where I commented all the aspects of basic science and surgical technique.

As always it was a great pleasure to be with them and we had a great time. They later told me that patients fared very well. I returned to Madrid a little tired, but wanting to start my holidays after a very tough year, with lots of work and travelling.

Surgeries in the Military Hospital of Ammán, Jordan

I flew from Beirut to Ammán. It is a short flight, one hour or so. From the airport we went directly to the Military Hospital of Ammán, where I did two GreenLight laser vaporizations.

As we were in military instalations I did not take any photos of the hospital or the surgical theatre. The following day we had a second session with two additional cases. I was impressed with the urology department, a building with three dedicated surgical rooms, and a very capable and trained personnel, with experience in war surgery. It was a great pleasure to share two days with them.

Ammán gave me a very good impression, but I did not have time to visit Petra, a real pity... I had to go back to Madrid to catch a flight to Lima, Perú. I will return to Jordan, for sure.

Trip to Beirut, Lebanon

As a prelude to my summer holidays, I went to Beirut to participate in a workshop on GreenLight Laser, that took place at the Clemenceau Medical Center, a hospital associated with Johns Hopkins Medical International.

We did six operations throughout the day, two of which were transmitted to the audience that attended the workshop.  I demonstrated how to reach the prostatic capsule and perform a nearly complete vaporization of the adenomatous tissue using the new technique "anatomic PVP".

I also gave a talk on GreenLight HPS prostate vaporization and I presented the new GreenLight XPS and the new enucleation technique.

The next day I had to depart to Ammán, in Jordan, where we had programmed two days of surgery. I had a great time in Beirut, the libanese urologists are extremely nice people and we could enjoy libanese food!.

New trip to Bulgaria

Again I went to Sofia, where we had a surgical session for three days, very interesting. We did many operations and some of them were really challenging, with huge glands that we managed to enucleate with success. In this photo, some of the specimens for histological analysis... I like very much this collaboration with the Hill Clinic in Sofia. All the staff are now perfectly trained and everything runs smoothly, it is a great pleasure to operate there.

Trip to Milán

In this occasion I participated in a laser symposium in Milano, Italy. I watched several Holmium laser enucleations of the prostate. I am very interested in understanding all the technical variations of laser prostatic surgery. I learnt a great deal.

Talk and surgeries in Gran Canaria

After the first experience with the New GreenLight XPS, I took a plane to Gran Canaria, to participate in a meeting organised by my friend, Dr. Francisco Juarez del Dago.

My role was to contribute with a talk, with an impressive panel of experts. I took my daughters with me, who had a great time. I was exhausted due to the frantic activity I had had during the month of June, but it is always a pleasure to visit Gran Canaria and to see my great friends there.

On saturday morning, Dr. Juarez had prepared two operations in Clinica San Roque and we had a very interesting surgical session. We treated to patients, one with a huge prostate and the second patient with a small one. Both went very well. The next morning we sent both patients home, happy. Later that day I returned to Madrid.

First surgery in the world with the GreenLight XPS 180 laser and the new MoXy Fiber

This week I have had the pleasure to become the first surgeon in the world to use the New GreenLight XPS 180 watt laser with the new MoXy fiber. This new laser and this new fiber are a great step forward and they improve greatly what we could achieve with the previous generation, the GreenLight HPS 120 watt laser.

The plan was to evaluate this laser in 10 European Centers during the month of July. It was going to be evaluated first in Europe, because the EU approved it for clinical use prior than the american FDA.

I had the honor of being the first user worldwide!

We performed seven operations in the Clinica CEMTRO and we received the visit of various representatives from the manufacturing company, American Medical Systems, very interested to see the laser in action! Soon I will publish a video with my comments and my opinion on the new characteristics of this impressive new laser for the treatment of Benign Prostatic Hyperplasia.

We operated seven patients in two days and we could ascertain the superiority of this laser over the previous generation. It allows to operate patients with the same safety but much faster than before, almost twice as fast as we estimated in theatre. We checked with pre and postoperative ultrasound that we had done a great job extracting the hyperplastic tissue almost completely.

It is fascinating to check day by day how the vertiginous technological acceleration is impacting fully in medicine, allowing us to treat our patients safely, faster and more comfortably. It is really wonderful to be able to witness these advances first hand.

I am also happy because I have received an invitation to participate in the advisory committee of this company to participate in the development of the next generation of this laser. My role will be to help with my ideas and opinions to keep improving the treatment of Benign Prostatic Hyperplasia.