Wednesday, April 30, 2014

Visitors from Spain

Today we received at Clínica CEMTRO the visit of two urologists with a lot of experience in BPH laser surgery, Dr. Placer, from Hospital Vall d'Hebrón in Barcelona and  Dr. Sánchez Macías from the Hospital de Mollet.

We had programmed four operations but they only had time to see two of them prior to returning to Barcelona. It is always a pleasure to share time with BPH experts like them.


I showed them a hybrid technique, with median lobe enucleation and an En bloc GreenLight enucleation of the prostate. All patients went well and I only would have liked to share more time with them!

Tuesday, April 29, 2014

In Heidelberg, Germany, to learn transperineal prostate biopsies with MRI-US fusion imaging

Today we travelled to the Hospital in Heidelberg, Germany, to learn to do transperineal prostate biopsies with MRI-US fusion imaging.


I was accompanied by Dr. Estefanía Romero, from ICUA (left) and our super-nurse Vanesa.

Soon we will start to perform transperineal prostate biopsies based in the fusion of images of Multiparametric MRI with transrectal Ultrasound at  Clínica CEMTRO in Madrid.


This technique is based in that Multiparametric MRI "sees" the cancers and transrectal ultrasound rarely allows to see them. The biopsies are usually performed with ultrasound guidance and thus we do not know if we take the biopsy where the tumor is or not. With the Biopsee system we can use the data obtained in the multi parametric prostate MRI to fuse them with the real time ultrasound image we are seeing and direct the needle exactly to where the tumor is.

In the studies published with this technique, the diagnostic performance rises from 30% to 60% (it detects more cancers) and it allows to do it in the first biopsy, it allows us to differentiate tumors that deserve to be treated from those who do not, so it is really a technical wonder.

Also, performing the biopsies through the transperineal route reduces the risk of infection caused bu the biopsy from 3% (3 out of 100 patients develop acute febrile prostatitis that can be serious) to 0,4% (four infections in one thousand patients).


A very important step in the diagnosis of prostate cancer that we will start offering to our patients at ICUA this month.

Saturday, April 26, 2014

New surgical session in Bulgaria with important international visitors

Again I went to Bulgaria to participate in a new surgical session. We operated 7 patients in two days.


This time we received important visitors, like Dr. Andrea Tubaro, from La Sapienza University in Rome, Dr. Shahin Tabatabaei, from Harvard, Boston, USA, Dr. Edward Collins, from San Francisco, USA, Dr. Peter Weib from Siegen, Germany, Dr. Tobias Mebner, from Gehrden, Germany, and we also had Sasha Röhling and Glynn Burt, from AMS, the company that manufactures the GreenLight Laser.


The interest for the new techniques that I developed is progressively greater and that is why we receive more and more visitors from all over the world. These sessions are very interesting as they also allow to talk long on BPH surgical treatment and we all learn!


Dr. Shahin Tabatabaei and "Chip" Collins are my dearest friends and form part of the IGLU group (International GreenLight Laser Users) and we also had a chance to talk and enjoy to be together. A fantastic session!

Thursday, April 24, 2014

My participation in National TV

I went to the Spanish National TV to participate in the program "Saber Vivir" (know how to live) of the matinee program on the first channel.

We spoke about bladder hyperactivity, of the new drug Betmiga for its treatment, of laser surgery for BPH and transperineal biopsy of the prostate guided by MRI-US image fusion. I had a great time.

Also my colleague and laparoscopy and pelvic floor dysfunction expert Dra. Romero, from our team at ICUA, participated.

Wednesday, April 23, 2014

New training workshop at ICUA - Clinica CEMTRO with international visitors

Today we received the visit at ICUA - Clínica CEMTRO of the Drs. Ahmed Elshal and Mahmoud Laimon, from Mansoura, Egipt, Dr. Michel Jabbour, from Beirut, Lebanon and my close friend Dr. Edward Collins, from San Francisco, USA.


I performed four operations and we also had time to chat on the physics of lasers and all technical aspects between cases. I could demonstrate all technical variants of the use of the GreenLight laser for the treatment of BPH, anatomic vaporization, vapo-enucleation, and the En Bloc enucleation technique.


The session went very well, and then we went out for dinner together. Dr. Collins is joining me to Bulgaria as he is very interested in the GreenLight Enucleation technique that I have developed over the last 5 years. There we will meet other urologists and friends.



Tuesday, April 15, 2014

Training session in Sofia, Bulgaria, with visitors from Canada and USA

After the European Association of Urology Annual Congress I travelled to Sofia, Bulgaria. There I went to the Hill Clinic where we had organized a full intensive day of surgeries to demonstrate the En bloc Green Laser Enucleation of the Prostate technique for the treatment of BPH to two visitors from Canada (Dr. Dean S. Elterman) and Jeff Bennet, from USA, who had also been in Stockholm for the European Congress.


I performed 7 surgeries in a full day surgical schedule that went very well. Then I returned to Madrid to take some days to rest for the Easter Holidays.


Saturday, April 12, 2014

Live surgery during the Annual Congress of the European Association of Urology in Stockholm



This time I went to Stockholm to participate at the Annual Congress of the European Association of Urology, really the most important European Congress with more than 14.000 participants from all over the world.

My role was to participate in a session of the ESUT (European Society of Uro-Technology) that organized an amazing surgical program that took place at the Karolinska Hospital and were transmitted live to the audience of the congress.


These are very appreciated sessions as they allow urologists from all over the world to watch experts performing surgery in real time.

I had the great honor to be invited to perform an operation in a patient with Benign Prostatic Hyperplasia. I performed the GreenLight En Bloc Enucleation procedure that I have developed during the last 4 years.


Everything went well during the operation and I received many positive comments from some friends and colleagues, some of them through twitter.


The urologists in the auditorium could visualize both the endoscopic image (left) as the image in the operating room, and what my hands were doing during the operation.


I hope the patient will recover well and improve his quality of life. Next year during the next EAU congress they will present the results of the operation and will tell how the patient is feeling.