Another surgical session at Hospital de Torrejón in Madrid

Again I went to the Hospital de Torrejón in Madrid with my nurse Vanesa to help the urology team captained by Dr. Luis Llanes, head of the department of urology and his colleagues with their learning process with Holmium laser enucleation.

We did two cases that went really well. It is a complex technique and the learning curve is long, but with very good results.

Visitors from France

Today we had a surgical session at Clínica CEMTRO and we received the visit of two urologists from France, very interested in the surgery of benign prostatic hyperplasia with the GreenLight laser, Dr. Vincent Misrai, from Toulouse and Dr. Sebastian Vincendeau, from Rennes.

I performed three operations and I could show them he GreenLEP procedure (GreenLight Laser Enucleation of the Prostate), one anatomical vaporization and one vapo-enucleation (enucleation of the middle lobe). They enjoyed the experience:

And these were the comments they wrote at the visitor book.

New surgical session in Sofia, Bulgaria

Again I went to Sofia to operate at the Hill Clinic. I had to participate in a two day surgical session.

I am always happy to hear from my bulgarian colleagues that the patients from the previous session are doing well after their operations.

I am very happy with the evolution of the GreenLEP (GreenLight Enucleation of the Prostate) technique. During the last three years I have introduced small variations, changes in the steps I followed to detach the adenomatous tissue from the surgical capsule, that allow us to perform it more safely.

Surgical session in Lovere, Italy

The 21st I travelled at night to Milano, to depart to the Hospital in Lovere early in the morning. Lovere is a small city by a beautiful lake and surrounded by mountains. The hospitals attends patients from all the region.

There I met Dr. Rainieri and Dr. Paganelli, who had prepared three patients to operate with the GreenLight XPS laser. The views from the hospital are beautiful.

The session went very well, and Dr. Paganelli could do his first steps with GreenLight under my supervision. He had been working with the simulator the previous day, and I really think it is a wonderful tool for learning.

We had a nice session and enjoyed it, everything went very well.

Then I departed to Milano, to catch a flight to Bulgaria.

Minimally invasive surgery course in Borgosesia, Italy

I arrived in Borgosesia on Thursday afternoon to participate as invited professor at a course in minimally invasive urology.

The hospital is located between mountains, in a really wonderful place.

First I gave a 20 minute talk covering the different generations of GreenLight lasers and the advances in surgical technique, and I presented the anatomic vaporization, the vapo-enucleation and the GreenLEP (GreenLight enucleation of the prostate) procedure. Then we performed a simulator session that was used by all attendees at the course.

The simulator is a wonderful training tool, that reduces greatly the surgeon's learning curve and obviously benefits patients who have to be operated by a surgeon in training.

Then we went to dinner to a typical restaurant, to enjoy the "cucina piamontesa". I had no choice but to leave apart my recently started diet ;-)

The next day there were surgical sessions where the attendees could participate. I performed two interventions. A vapo-enucleation of a large prostate and a GreenLEP procedure in a patient who had two previous biopsies with inconclusive signs of prostate cancer. The GreenLEP procedure allows for the retrieval of the adenomatous tissue for histological analysis.

Both operations went pretty well, and as always I could see the surprise of my colleagues when they see the versatility of this laser and the beauty of these techniques. I had a lot of fun, enjoyed to see new techniques, as the single port radical prostatectomy performed by Dr. Vincenzo Ferrara, and I made new friends. Then I drove back to Malpensa to return to Madrid to rest for the weekend after three intense work days in Italy.

Surgeries in Ponte San Pietro, Italy

Again I arrived at the Hospital at Ponte San Pietro to assist Dr. Oscar Fenice with his training in GreenLight XPS 180 watt laser prostatectomy for BPH.

In this occasion we operated three patients, two with relatively voluminous prostates and one with a smaller gland. Dr. Fenice had been training hard with the computerized simulator designed to teach this procedure and I was impressed to see the qualitative leap in his surgical skill in comparison with the first session we performed recently. Dr. Angelo Gritti, head of the department, was very impressed with the possibility to visualize the prostatic capsule in such a clean and clear way, despite the big size of the prostates.

When we finished the session, at lunchtime, I took a rented car and drove up north to Borgosesia. I had to participate in a training course in minimally invasive surgery. Unfortunately it was raining and I do not know why the roads in Italy are always so busy, but I enjoyed the changes in geography driving up north and the beauty of the fields and the mountains in the region.

The followind day Dr. Fenice contacted me very happy to tell me that all patients had passed water without a catheter and were leaving the hospital.

Surgeries in Porto Recanati, Italy

This time I travelled to Ancona via Roma, in Italy. Frome there I reached the Civil Hospital of Porto Recanati to perform a surgical demonstration of the GreenLight XPS 180 watt laser for the treatment of benign prostatic hyperplasia.

There I met Dr. Enrico Caraceni, from Ospedale Generale di Zona a Civitanova Marche, Gabriele Mammana head of the department of urology of the Ospedale di Macerata and Doctor Emilio Sacco from Ospedale Policlinico Universitario Agostino Gemelli di Roma, who came to witness the three operations of the day.

It was interesting that we operated a young patient and we performed an ejaculation preserving technique, a relatively new technique that is offering very good results, and allows to improve urinary symptoms respecting the ejaculatory function of the patient.

The session went very well and that same evening I flew to Milan, as I had to operate at the Hospital in Porto Recanati.

New GreenLight Course with Dr. Ferrari in Modena, Italy

Again I travelled to Modena in Italy to operate at the Ospedale Hesperia with Dr. Giovanni Ferrari. This time I operated four patients with benign prostatic hyperplasia with the GreenLight XPS 180 watt laser.

This time we enjoyed the visit of Dr. Mario Fiorello from Policlinico Ospedaliero di Camposampiero, Padova, Dr. Motjaba Rahmati, from Ospedale ULSS no. 4 at Schio, Vincenza, Dr. Stefano Trovarelli and Dr. Fabio Mattei from the Casa di Cura Rugani, at Siena and Dr. Paolo Guido Dell'Orto, from Policlinico di Milano.

The course went very well, despite having to treat very complex cases, we did vaporizations and enucleations and had a great time. All cases went very well.

Presentation of our experience at the American Urological Association Annual Congress in San Diego

This time I could not join the AUA Annual Meeting, but there our Australian colleagues in this study presented our multicentric experience with the GreenLight XPS laser for the treatment of patients with Benign Prostatic Hyperplasia.

Also, at this congress, Prof. Alexander Bachmann presented the results of the important study "Goliath"that compares GreenLight XPS 180 watt laser vaporization of the prostate with conventional transurethral resection of the prostate (TURP) for the treatment of BPH. Despite the TURP arm obtaining excellent results, probably the best ever published in a study, GreenLight vaporization showed to be equally efficacious with less postoperative complications, catheterisation time and hospitalization. It is a very rigorous study, methodologically sound, that finally demonstrates the superiority of GreenLight for BPH over conventional TURP.

Surgical session with Dr. Gaston in Madrid

As it has happened almost monthly for the last 5 years, Dr. Richard Gaston joined us in Madrid at  Clínica CEMTRO to perform surgeries.

We operated several patients with a diagnosis of prostate cancer in which we performed a laparoscopic radical prostatectomy, with the collaboration of Dr. Estefanía Romero, from our team, the specialist in laparoscopy at ICUA. Dr. Romero was trained in Bordeaux with Dr. Gaston and performs all laparoscopic procedures in our center.

It is always a pleasure to receive the visit of Dr. Gaston in our center. He is a great expert and now a friend. Keeping this link with him on a regular base allows our patients to access the best world expert in the field, without needing to travel to Bordeaux in France where he works. For us it is a true privilege to collaborate with him and to keep on learning from him.