Another weekend in Sofia, Bulgaria

Again I travelled to Sofia, to operate at theHill Clinic where we did eight operations. It is quite tough to operate during the weekend as well, it basically means that your week lasts 15 days rather than 7.... no time to rest. The staff at the Hill Clinic is like a small family and after having worked here several times I can say I feel here as comfortable as if I was home.

In the photo with Dr. Kalchev, who pioneered the use of GreenLight in Bulgaria. After various surgical sessions with him he has acquired a very good technique and is now a proficient operator. The thing is that the complexity of the cases they receive here is really high, because patients in Bulgaria only go to the doctor if there is no other option, very late, when they already have complicated prostates, with bladder stones and diverticulums... and Dr. Kalchev, kindly lets me do these cases ;-)

New publication in Urology Times

The May Issue of Urology Times is devoted to comparing GreenLight vaporization of the prostate with the bipolar electrosurgical techniques in the treatment of Benign Prostatic Hyperplasia. My contribution was to participate in a round table with other international experts that was later published in this issue of Urology Times. It is a very popular publication among urologists, specially in the USA.

Visitors in Theatre

This thursday we had programmed a surgical session and we received the visit of some new employees of the company American Medical Systems, who wanted some training on GreenLight Laser Prostatectomy.

I performed two operations, a prostate vaporization and a GreenLEP procedure, and then we had some time to talk on the technique, laser basic science and its application to the procedure and the recommendations on how to train other doctors to perform these operations.

Visit from Dr. Bautrant

These days we have received the visit of Dr. Bautrant. Dr. Bautrant is one of the leading experts in pelvic pain in Europe.

The chronic pelvic pain syndrome is a group of diseases caused in the pelvis, from different etiologies and different clinical presentations (perineal pain, chronic prostatitis, urethral or vaginal pain...) generally very difficult to treat successfully.

During the last five years I have teamed with Dr. Fernando Itza (a pelvic pain expert), Lydia Serra (a specialised physiotherapist) and Dr. Zarza (a brilliant neurophysiologist) and we have succeeded in reaching a specific diagnosis of the problem in the majority of patients, and also in improving or even curing some of these patients.

Dr. Bautrant came to Madrid to help us with some difficult patients and he showed us the technique for pudendal nerve release, that can be very helpful in selected patients with pudendal nerve entrapment syndrome.

Visitors from Ireland

This friday I had the pleasure to receive the visit in Madrid of Mr. Keane, Mr. Thompson and Mr. McCarthy, from Ireland. They are about to launch a laser prostatectomy unit and they wanted to see procedures. It was very interesting to comment the surgical technique and all the tips and tricks I know to perform a good prostatectomy with them.

More surgeries in Caracas

The following day I went to the Instituto Metropolitano Docente de Urología (IMDU), a surgical day-care center participated by 26 local urologists. I first gave a talk on GreenLight prostatectomy and then I went to the surgical theatre, where I performed two operations.

Both went very well and we could comment many of the new principles of an anatomic prostate vaporization (localization of the capsule followed by vaporization down to the capsule).

Then we ate a wonderful "Pabellón Criollo" in the hospital before we departed to the Centro Médico de Caracas, where I met Dr. Jose Manuel Pardo, current President of the Sociedad Venezolana de Urología and Dr. Leonardo Borregales. They had prepared another case for the afternoon and I performed a GreenLight Enucleation of the prostate, and we discussed the steps to follow to perform it safely.

The next day I packed and took my case to the Instituto de Clínicas y Urología tamanaco, with Dr. Juan Carlos Vargas and other well known urologists, like Dr. Dario Soto, who had flown from Maracaibo. Dr. Vargas had prepared three patients with prostates weighing 60, 100 and 120 grams. I did three enucleations in the same theatre where we presented the GreenLight Photoselective Vaporization of the Prostate two years ago for the first time in Venezuela.

Then I went to the airport, back to Madrid. It has been another intense trip, with a lot of work, but very stimulating. All the urologists I met were excited by this technique and they thought that the GreenLEP technique is a very attractive operation for patients with big prostates. I love Venezuela, everybody here is nice and warm and I always have a great time!

Trip to Caracas

Last sunday I took a direct flight to Caracas. When I arrived I went to the hotel to spend the night, to start with a four day programme of surgeries in different centers.

The first day I had to visit the Centro Integral de Urologia UNO, with Dr. Gastone Valongo. Dr. Valongo has been performing greenlight operations for more than a year and he wanted to see advanced techniques, so we operated four patients and did four GreenLight prostatic enucleations (GreenLEP) throughout the day.

As this is an ambulatory center, all patients were discharged home carrying a catheter, that would be pulled out the following day in the outpatient clinic. It is very interesting to see the effect in my colleagues to realize how it is perfectly possible to enucleate prostates with this laser and with a side-firing fiber.

Then I was invited to have dinner in a wonderful Italian restaurant... we had a lot of fun and finally I went to bed very tired due to the time difference.

The following day, this morning, I went to the Policlínica La Arboleda, with Dr. Ivanhoe Acero and his team.

There I started with a lecture on GreenLight laser technique and then we did a procedure, that I started and was finished by Dr. Acero, who followed my indications to perform a perfect job.

Now I am at the Hotel, waiting Dr. Acero to pick me up for dinner. Caracas is not very safe to wander around, so I have slept for a while and I took the opportunity to write the blog. More tomorrow.

Visit from Prof. Tubaro, from Rome

Yesterday we received the visit in Madrid of Prof. Tubaro, from Rome. He is a very prestigious urologist, very well known in Europe, extremely active and an international expert in BPH. He was very interested to see the GreenLight Enucleation of the Prostate. I operated two patients and we had a chance to talk about the details of the technique. He also thought this technique has a bright future and many advantages over vaporization in big sized prostates.