Course on GreenLight laser new surgical techniques with foreign visitors

Again we organized a surgical course at Clínica CEMTRO, several foreign as well as national urologists joined us for the course.

I performed five operations that went very well. I could demonstrate the different techniques that can be carried out with the GreenLight laser, the anatomic vaporization, the vapo enucleation technique and the En Bloc enucleation (GreenLEP).

We received the visit of the french urologists Marc Shenider y Ludovic Obringer (Colmar), François Faur (Strasburg) y Daniel Gassman (Paris). Also two portuguese urologists joined Dr. Bruno Graca and Dr. Ferreira Coello (From the Hospital de la Luz at Lisbon) and we hosted as well two spanish urologists  Dr. Leticia López Martín, from the Hospital Fundación Jiménez Díaz in Madrid and Dr.  Jorge García Rodriguez, from the Hospital Universitario Central de Asturias.

Live Surgery at the 5th Course on Endoscopy of the Lower Urinary Tract at Policlinico Gemelli in Rome, Italy.

From Paris I flew to Rome to participate in the 5º Corso di endoscopia del basso aparato urinario at the Policlínico Gemelli de Roma, Of the Universitá del Sacro Cuore

They invited me to demonstrate the technique of anatomic vaporization of the prostate in a patient with a moderate enlargement. The Hospital has a beautiful statue of Juan Pablo II in the entrance, and patients and family members of patients make the sign of the cross when they see it.

The operation went very well and I managed to explain the evident advantages of this technique over the traditional transurethral resection of the prostate (TURP). Before it was my turn to operate I watched the other scheduled operations, as the TURP with suprapubic trocar.

Frankly, to me it was like traveling back in time to the pleistocene. In our center we abandoned open surgery and TURP many years ago.

The program had a lot of delay and I finally arrived late to Madrid, as almost always. Very tired after so much work and wishing to rest during the bank holiday.

Surgical session at Hopital Saint Joseph, París

After my visit to Hopital Tenon with Prof. Lukacs, I went to Hopital Saint Joseph, to visit Dr. Hervé Baumert. We had met years ago as he helped us to organize laparoscopic courses in Madrid.

It was a pleasure to see him again. He had prepared two patients to operate with the GreenLEP technique. Their prostates were not excessively big, about 80 g.

Both cases went very well, despite not having the optimal instruments to perform the operations.

It is important to use a cystoscope with a blunt tip and there must be some space between the telescope's tip and the cystoscope's tip to allow for direct visualization of the mechanical dissection as it is being performed.

Everything went very well, it was a pleasure to see Hervé again. A great French Urologist.

Surgical session at Hopital Tenon, París, France with Dr. Lukacs

I travelled to Paris the night before in order to start early in the morning. Dr. Lukacs received me at Hoptial Tenon in Paris. He had prepared a patient with a 150 g prostate for the session.

I performed a GreenLEP and the operation underwent really well, allowing me to show him all the technical details.

When we finished the operation we obtained 110 g of morcellated tissue. Dr. Lukacs was very impressed by the technique and by the fact that the patient can leave the hospital the following day.

Then we went to his office and he showed me his recent investigations on voiding cystoscopy, that consists in visualizing the micturition dynamics directly. He has observed different kinds of obstruction that might benefit from minimally invasive operations aimed to preserve ejaculation. It seemed all very revolutionary to me. A great man Dr. Lukacs and a scientist that thinks "out of the box".

New training session in Sofia

Again I went to Sofia to participate in another training session. This time we had two visiting surgeons Dr. Montaña from Uruguay and Dr. Muñoz, from Perú.

Both enjoyed the experience and were amazed by the incredible team work we carry out at Hill Clinic.

Course on GreenLight laser for BPH in Barcelona

Today I took the high speed train to Barcelona to participate in a course on GreenLight for the treatment of Benign Prostatic Hyperplasia.

I gave a talk on the new techniques, anatomic vaporization, capo-enucleation and enucleation and then we had an animated discussion with the attendees.

Then I returned to Madrid. Despite the high speed train being fast and convenient, going and returning in the same day is 6 hours in the train!

Invitation to operate in Gran Canaria

Yesterday I flew early to Gran Canaria to help Dr. Juarez del Dago, urologist and good friend, to operate a patient with a huge prostate gland.

We went to Clinica San Roque and there we performed a Green Laser enucleation of the prostate in a man with a big gland, with more than 150 g of adenoma. The operation went very well and we could finish it in 90 minutes. After the operation we started a bladder irrigation and the bleeding was minimal.

He had a huge middle lobe and this interestingly does not complicate the operation at all. Thanks to the new Richard Wolf morcellator blades VMax we could take out all the tissue in less than 20 minutes. This technique is incredible and it allows us to do things that seemed impossible some time ago. We hope the patient can return home the morning after the operation without a catheter!

Surgical training session in Florence, Italy

Again I travelled to Italy to work at the Azienda Ospedaliero Universitaria Careggi in Florence.

My role was to perform four operations to demonstrate the GreenLight laser in the treatment of patients with Benign Prostatic Hyperplasia. One of the cases was a man with a huge prostate gland, 170 g, who was a Jehovah's witness, and thus did not want to accept the chance of a blood transfusion.

Everything went well and I could return home that night after a long day of work and travel.

GreenLight laser course at Clinica CEMTRO with international visitors

Today we received the visit to our operating room at Clínica CEMTRO of various foreign and spanish urologists. We had programmed four operations for the course. We welcomed Dr. Scanzi Mauro, from the Ospedale de Brescia in Italy, Dr. Alessandro D'Addessi and Dr. Giuseppe Gentile, from the Policlinico Gemelli in Rome, Dr. John van der Hoeven, from Holland, Dr. Abad from Hospital Parc Tauli, in Sabadell, Spain and Dr. Leticia López from the Fundación Jiménez Díaz, in Madrid.

We also welcomed Dr. Emanuel Montaña, from the Hospital de Clínicas in Montevideo, Uruguay and Dr. Carlos Muñoz from Hospital Rebagliati in Lima, Perú, who will be rotating with us at ICUA the following two months.

El Dr. Muñoz y el Dr. Montaña, nuestros rotantes

Publication of a new scientific article in the Journal "Current Opinion in Urology"

Today I saw that my new scientific article on Green Laser surgery for the treatment of BPH has been published in the Journal Current Opinion in Urology.

In this paper I explain that the GreenLight laser has come of age and is now considered a standard option of treatment of BPH (Benign Prostate Hyperplasia) and that the new techniques that I described will surely contribute to improve the long term results obtained with this laser.

Participation in my first online congress!

This afternoon I participated in a congress which took place purely online, from my home. It was an amazing experience, very interesting.

Organized by Dr. Vincenzo Ferrara, we spoke of the treatment of BPH with lasers. I presented the new techniques with the Green Laser and Dr. Muto spoke of his experience with Thulium.

It was a very interesting experience, and it surely has a bright future, I loved it!

Two days of surgery and science at the CDU in Buenos Aires, Argentina

Finally I arrived in Buenos Aires, where we had programmed two days of surgeries and conferences at the prestigious CDU (Center of Urology) in this wonderful city.

There I met my old friends. Dr. Edgardo Becher, Dr. Marcelo Borghi and Dr. Luis Montes de Oca, who was generous enough to give me his recent prostate cancer book as a gift.

For two days we performed surgeries and I lectured to the urologist of this center and other hospitals from Buenos Aires. Everything went very well.

What is impressive from this center is that it is an ambulatory center, and we were able to send patients treated with GreenLEP (GreenLight Enucleation) home the same day of the procedure. We spoke of starting a study to see if it is possible to generalize this approach.

Buenos Aires is a wonderful city and it is always a pleasure to see old friends and learn from their spirit of continuous improvement. Finally I returned to Madrid after a long week of work in South America.

Surgeries at the British Hospital in Montevideo, Uruguay

After a night flying from Perú, I arrived in Montevideo, I took a good rest and then I went to the British Hospital, where Dr. Daniel Porto and his colleagues were waiting to perform a surgical training session with the GreenLight laser.

The session went very well and again I could show the different surgical techniques and talk comprehensively about laser physics and technical aspects of Green Laser prostatectomy.

I was happy to meet Dr. Zeballos there, also a pioneer in the country of the use of the GreenLight laser and to meet Dr. Montaña, who is coming to Spain with us to stay for a month.

That same night I departed to Buenos Aires, where I still had two more days of surgery remaining of this tour through South America.

Surgeries at the Hospital Edgardo Rebagliati Martins, in Lima, Perú

 

Today I went to the public university hospital Edgardo Rebagliati Martins in Lima, Perú, where we had a teaching program with lectures and four operations throughout the day.

The operations went very well and we could use the day to comment on all aspects of the treatment of Benign Prostatic Hyperplasia with the GreenLight laser.

Many residents and urology staff members as well as urologists from other hospitals in the country came by to watch the procedures and interact with us.

Dr. Elvis Sueldo joined me in the operating room and look after all the details to guarantee the success of the surgical session. We performed enucleation, anatomic vaporization and vapo-enucleation.

With the satisfaction of the work well done, I departed that same night to Montevideo, where I had to operate the following day, very happy to have had the chance to return to Perú after 4 years and see my friends there.

Conference at the Peruvian Urology Society

After the surgeries at Hospital Almenara in the morning, I went to the headquarters of the Peruvian Urology Society where I gave a lecture on the role of the GreenLight laser in the treatment of Benign Prostate Hyperplasia.

Dr. Elvis Sueldo did the introduction of the session in front of the attendees.

At the end of the talk we had a nice question and answer session and then we enjoyed a typical menu. The food is so good in Perú!

Surgical session in Hospital Almenara, Lima, Perú

This time I went to Perú to initiate a trip throughout three South American countries. My first stop was Hospital Almenara, a public hospital that is considering incorporating the Green Laser to their therapeutic armamentarium.

The program included two operations and several talks. At the end both surgeries proved to be very complex and I did two enucleative procedures. Everything went well despite the difficulty of the clinical situation of the patients that they had prepared.

Everything went very well and we had a chance to comment all the aspects of the use of the green laser in the treatment of Benign Prostatic Hyperplasia with the staff of the urology department.

Invitation to operate at the University Hospital Clínico San Carlos in Madrid

Today I went to the Hospital Clínico in Madrid, where I spent my medical student years, invited by Dr. Moreno, the head of the department of urology, to demonstrate the Green Laser Enucleation technique.

First I gave a talk explaining the development of the technique during the morning clinical meeting, and then we all went to the operating room where I operated two patients, both of them with big prostate glands. During the operation we had a good chance to discuss all the technical details.

Everything went very well and I really enjoyed sharing with my colleagues and returning to the Hospital where I spent so many hours studying!

Surgical session in Sofia with visitors from Italy, Germany and Austria

This time I went to the Hill Clinic in Sofia, Bulgaria, for another surgical session. This time we received the visit of three international urologists, Dr. Destefanis, from Torino, Italy, Dr. Sommerhaber, from Austria and Dr. Luebcke, from Germany.

I operated 25 patients this month at hill clinic, and performed GreenLEP (Green Laser Enucleation of the Prostate) in all of them, and everything went very well. We are really mastering this technique now.

I am very happy because my Bulgarian colleagues told me that a patient in which we had tried to perform a green laser enucleation with intention to preserve ejaculation was actually able to ejaculate three months after the operation. This is a technical variant we are investigating that preserves ejaculatory function, a very difficult objective, but very desirable.

We are going to start a study to measure if it is possible to preserve ejaculation when we perform enucleation with the GreenLight laser. My impression is that it will be more difficult in patients with bigger glands, but we will see.

Also, Hill Clinic does a lot to promote the Movember movement, that raises funds for research in prostatic and testicular cancer. For this reason I was interviewed by Bulgarian TV.

Spanish visitors to our operating room

Today we received the visit to ICUA, at Clínica CEMTRO, of various Spanish urologists who came to witness some green light laser surgeries. We received the visit of Dr. Manuel Ruibal, from the Complejo Hospitalario of Pontevedra, Dr. Gómez Pascual, from Hospital Carlos Haya in Malaga, Dr. Miguel Suarez, from the Hospital Universitario Central de Asturias in Oviedo and Dr. Juliana Escobar from the Hospital del Tajo.

I could demonstrate the different technical variants, as anatomic vaporization, vapo-enucleation and the Green Laser Enucleation of the prostate.

The session went very well and as always it was a pleasure to share with my colleagues passionate for GreenLight laser surgery for the treatment of benign prostatic hyperplasia.

Surgery at Hospital de Cruces, in Bilbao, Spain

This thursday I flew late at night to Bilbao, I slept there and went early in the morning to the Hospital de Cruces.

They had prepared two patients so I could operate them and show the GreenLEP technique. Unfortunately one of them was cancelled and I could only perform one of the operations. It was enough though to spark their interest in this wonderful technique. I then returned to Madrid to rest for the weekend.

Surgical Session with Dr. Richard Gaston

Again we received the visit of Dr. Richard Gastón, From Bordeaux, France. He comes to operate with us at ICUA in the Clínica CEMTRO every month. In this occasion we performed five operations in patients with cancer during two days, that went very well.

I am very happy as after seven years of collaboration with Dr. Gaston as an invited professor, briefly Dr. Gaston will become in full right a member of the staff at ICUA. So the collaboration with him will be intensified and he will come more often to Madrid to see patients in clinics and perform surgeries as a member of the team, and no longer as an invited surgeon.

In this occasion we had the pleasure to receive the visit of Dr. Georgi Georgiev, from the Hill Clinic of Sofia, Bulgaria, with which we have had a very special collaboration for the last five years. He helped us in the operations. In the photo he is in the center, with Dr. Gaston and Dr. Romero.

Participation at the world Congress of the SIU (Société Internationale d'Urologie) in Glasgow, UK

This time I flew early from Madrid, to reach Glasgow in time to participate in the Session of Surgical Tips: Surgical Management of Symptomatic BPH in the Laser Era" chaired by Dr. Mostafá El-Hilali (Canada) and Dr. James Lingeman (USA).

My role in the session was to present the technique that I recently published of Green Laser Enucleation of the Prostate. It was an honor to share the surgical session with the inventor of the technique of Holmium Laser enucleation, Dr. Peter Gilling, and other super experts in laser prostatic surgery.

As always in these congresses I could see many friends, and it was specially good to see Dr. Henry Woo, from Sydney Australia, who invited me to return soon to help him with his learning curve in Green Laser enucleation.