Recording of a teaching video on GreenLEP in collaboration with Richard Wolf

This time I went to the Hill Clinic in Sofia, Bulgaria, to film a teaching video on the Green laser en bloc enucleation technique that the surgical instrument manufacturer Richard Wolf wants to distribute worldwide.

We performed several operations and we filmed the technique step by step as well as many explanations on surgical technique.

It is a good opportunity to teach the technique I developed now 6 years ago to urologists worldwide. I am very happy with the simplicity of it as well as with the results we obtain. It is a very important advance on the surgical treatment of BPH that is going to allow many urologists to learn the technique in a simple way.

Visit to the European Institute of Oncology in Milan, Italy

This time I went to Milán to visit the European Institute of Oncology in Italy. There I met Prof. Ottavio de Cobelli who invited me to his operating room to witness a Da Vinci robotic radical prostatectomy in a patient with prostate cancer.

It was an interesting morning in which I could see the strategies they use systematically. It was their first day with the new Robot Da Vinci Xi and they had to use some tricks to be able to work with the alexis access port which was perfect for the 12 mm tracers, but not so good for the 8 mm robotic ports from the new Da Vinci Robot.

It was a very interesting morning. Dr. Cobelli is a great expert. These experiences let me copy the good ideas from other centers, but it also makes me realize the incredible quality level of our work with the Da Vinci Robot, inspired by Dr. Richard Gaston.

Then I went to the airport to travel to Sofia the next day, I have been invited to produce an educational video on GreenLight Enucleation of the prostate.

New robotic radical prostatectomy session with Dr. Richard Gaston

As usual, Dr. Gastón came to Madrid to work with me at Clínica CEMTRO and we performed two days of radical prostatectomy cases prostatectomía radical robótica.

We are very impressed with the functional results we are obtaining in the patients we have operated during the last few months with the latest generation Da Vinci robot. The robot itself is a technological wonder, but what is really important to be able to achieve these results, a high quality urinary continence and the preservation of erectile function, is the vast experience of Dr. Gaston in robotic surgery. To me it is an immense privilege to be able to assist him every month and to learn from a master like him. In surgery it is paramount to share the experience, what has been learnt by one surgeon performing thousands of cases, to avoid mistakes, to achieve objectives. Learning from a true master is a luxury and an unparalleled opportunity.

After many years dedicated with devotion to the treatment of prostatic diseases, I feel we have managed to build up a urology department where we offer the best in the diagnosis of prostate cancer and in the treatment of BPH and prostate cancer.

New course at Clinica CEMTRO with spanish visitors

This time we received the visit of Dr. Leopoldo Cogorno, from Hospital Infanta Sofía, from Madrid, Dr. Ernesto de Nova, from the Hospital Gereral de Elche, Dr. Alvaro Juarez Soto, from the Hospital de Jerez, Dr. Jose Manuel Fernández Montero, from the Hospital Marbella Highcare. We also were accompanied by Dr. David Rendón, ex-staff member from ICUA who is now living and working in Medellín, Colombia.

I performed 5 operations during the afternoon that went very well, and allowed us to demonstrate the versatility of the GreenLight laser for the treatment of BPH, for enucleation, vaporization, ejaculation preserving techniques, etc.

We had good critics in twitter ;-)

Surgical demonstration at Hospital Quirón in Barcelona

This time I went to Barcelona early to perform a surgical demonstration at Hospital Quirón in Barcelona, where I did two GreenLEP (Green Laser Enucleation of the Prostate) operations to two patients with big sized prostates, 95 and 110 cc.

Everything went very well and I could demonstrate the efficiency of the technique, as the operations only took 35 and 45 minutes from beginning to end.

Urologists at Quirón were fascinated with the technique. It is very impressive to see the easiness with which it is possible to treat these big adenomas, with little bleeding, and very fast. It is an elegant, intuitive, anatomic and safe technique.

They told me later that patients were very well, although I already knew they were ;-). I returned to Madrid to rest for the weekend, summer is coming!

Surgeries in Coimbra, Portugal, with Dr. Antonio Oliveira

Again I went to Cimbra to operate with Dr. Antonio Oliveira at Hospital Idelamed. Dr. Oliveira is now performing GreenLEP regularly and he is happy with his results.

We had a patient who had been submitted to prostatic arterial embolization despite having a stone in the bladder, and a prostate 170 cc in volume. After a total failure of embolization and not experiencing any improvement, he decided to undergo endoscopic enucleation with the GreenLight laser.

To me it was a new clinical situation and it was interesting to see how the dissection of the capsular plane could be performed without any trouble. In the postoperative TRUS control the prostatic fossa was very huge.

I am very skeptical about prostatic arteries embolization. It seems to me a relatively illogical concept, to produce a prostatic infarction and then wait for the tissue to evolve, to atrophy. Very unpredictable. Some interventional radiologists are promoting it without having much scientific evidence to do it, and they apply it without any urological criteria (¿in a patient with a stone in the bladder?).

I think endoscopic enucleation in the hands of a properly trained urologist is today the best option for the surgical treatment of BPH. Endoscopic enucleation is without doubt the best option in patients with large prostates.