Surgeries in Sofia, Bulgaria, to try the new Auriga XL system

This time I flew to Sofia to operate at the Hill Clinic, and to try the new 50 w Holmium laser Auriga XL.

In Madrid we have a 100 w Holmium laser from Lumenis, and I was curious to try it. I had heard that it allowed to perform endoscopic enucleation for the treatment of BPH, but that it maybe was a little slower than the 100 W lumenis laser.

I played with the output parameters of energy and frequency until I did with the settings that provided the tissue effect I like for the en bloc enucleation technique, and the truth is that we could work wonderfully with this laser, and we did not perceive any difference in the time we needed to complete a procedure as compared with GreenLight and Holmium 100 w.

The more I try different lasers the more I believe that despite the technical differences among different lasers, the most important factor is the experience of the surgeon. If the surgeon understands laser physics and knows the anatomy of the prostate well enough, there shouldn't be very significant differences among lasers. At the end, patients recover equally well, do not bleed much, and are very happy with their operation, irrespective of the wavelength. I do believe that Holmium and Thulium are technically more demanding for the surgeon (more difficult to use).

I also think that GreenLight en bloc enucleation is the most beautiful procedure, it allows visualizing the anatomy much better and it is extremely elegant and efficacious.

I got this from the staff at the Hill Clinic, a photo that summarizes the international visitors who came to learn to use the GreenLight laser during the last three years. Watching this gets to my heart, so much work, so many friends!