Originally posted October 18, 2012

This week I went to London, to participate in a course on transperineal prostatic biopsy organized by  Mr. Rick Popert at Guy's Hospital in London.

Very interesting, a move is taking place in the UK and Germany from the transrectal biopsy of the prostate for the diagnosis of prostate cancer (a simple procedure that can have serious infection complications) towards the transperineal biopsy, with a near zero risk of serious infection and allowing much better targeting based on MRI image fusion with Ultrasound and with a higher diagnostic yield.

The new 3 Tesla MRI is providing a much better diagnostic study of the prostate and there is now technology that allows to import the images from the MRI study into a special Ultrasound device, and the FUSION of both images allows to direct the biopsies to the suspect areas in the MRI. It allows to be sure that the suspect areas are properly targeted.

To me this approach seems totally logical and it improves diagnosis and reduces the risks. It is going to be extremely useful for those cases where we consider no treatment (active monitoring), to increase the diagnostic precision in cases with prior negative biopsies and to indicate which patients are suitable for focal treatments with cryosurgery and HIFU.

We have been doing transperineal biopsies for some time in Madrid, in patients with prior negative biopsies and we are happy to see that we were in the right track. Clinica CEMTRO has acquired a new 3 Tesla MRI that will be active soon, and I hope to be able to offer this type of transperineal biopsy targeted with MRI-US fusion to my patients very briefly.

The following day I participated at the meeting of the Ginsburg study group for transperineal biopsy with MRI-US fusion, and from now on I will contribute to the investigations of the group on this type of biopsy.

Originally posted October 12, 2012

Right after my visit to Milán, I went to the Azienda Ospedaliera San Giovanni Addolorata in Rome.

There Dr. Gianluca D'Elia welcomed me to perform a GreenLight XPS laser surgical operation. He runs a minimally invasive surgical unit with emphasis in Robotic surgery.

I showed them the technique for capsular localization, that they had never seen. Unfortunately we did not have time to operate the second patient that was programmed that day. I rushed back to Madrid to rest during the weekend.

Originally posted October 11, 2012

This time I travelled to Milano, with Dr. Marco Raber, who has decided to incorporate the GreenLight technology to be able to offer his patients the 180 watt laser prostatectomy.

In the morning we performed three operations that went very well. I showed him the maneuvers to localize the capsule and allow to perform a radical removal of the adenomatous tissue. Soon I will return with him to demonstrate other techniques, as the GreenLight Enucleation.

Originally posted October 7, 2012

Again I travelled to Lebanon to help Dr. Mohamad Aluuan, head of the urology department at the Central Military Hospital of Beirut, to learn to operate patients with benign prostatic hyperplasia with the new laser GreenLight XPS 180 watts.

It was a tough schedule, as I got there at 3 am and slept only some hours before starting a long surgical session. We operated six patients, one of them with a 150 gram prostate, and then that night I returned to Madrid.

It was a very nice session and the head of the military healthcare of Lebanon offered me a beautiful plaque of the Lebanese army as a reminder of my stay there.

In the photo, with Toni Abboud, Dr. Mohamad Aluuan and Bassem Zarif, at the end of the surgical session.

Originally posted October 4, 2012

As every month, Dr. Richard Gastón visited us from Bordeaux, and came to Clínica CEMTRO to operate patients with localised prostate cancer with us. This time we performed several laparoscopic radical prostatectomies using the new laparoscopic videolaparoscope from Karl Storz, a system that provides high definition (HD) and three dimensional view (3D) inside the patient's abdomen.

This was the first time this system was used in a private center in Madrid. It uses a special laparoscopic camera that allows the surgeons, through the use of special 3D glasses, to have a vision in three dimensions (3D) and High Definition (HD) of the interior of the abdomen of the patient. It is an important development because it allows to be more precise with the movements and facilitates enormously the complex laparoscopic manouvers, as intracorporeal suturing.

The operations went really well, and we were all convinced that this visualization system in 3D and HD facilitates laparoscopic surgery enormously and it is a big advantage in our daily work and logically will result in faster and safer operations for patients.

Originally posted September 30, 2012

This time I went to Sofia to operate at the Hill Clinic, and we started a study to evaluate the performance of the new Vmax blades for the Piranha Morcellator, from Richard Wolf.

We did 10 GreenLight Enucleations of the prostate in two days, and we took the opportunity to register the time it took to morcellate the tissue with the new blades. It was really impressive, in one of the patients we could morcellate 70 grams of tissue in 5 minutes!!

I firmly believe this improved morcellation is going to make enucleation more easy and affordable for surgeons, as the morcellation step of the operation was so much shortened that we could operate the 10 patients in less than an hour!

We will submit the results of the study to the European Association of Urology congress that will take place next year in Milan.

Originally posted September 21, 2012

After my trip to Morocco, I flew to Milano and from there I drove to Genoa, where I participated at the AURO (Hospital urologists association) congress in Italy.

It was a very interesting session where we spoke of Holmium Laser, Tulium Laser and GreenLight laser for the treatment of BPH. I always learn so much from my colleagues...

I specially enjoyed a video of an enucleation en bloc of a bladder tumor presented by Dr. Migliari, a very interesting technique, maybe with a bright future.

Originally posted September 20, 2012

This time I went to Morocco to show the Urologists at the Military Hospital in Rabat the wonders of the GreenLight laser for the treatment of benign prostatic hyperplasia.

We did a surgical session with two patients, one with a 60 gram prostate and another one with 100 grams, that went very well.

After sleeping that night in Rabat, I departed from Casablanca to Milano, to participate at the AURO Congress.

Originally posted September 14, 2012

I am in Minnesota, USA participating in a meeting with a group on experts in BPH. In one of the recesses I was looking up papers in Pubmed and found this. It is an editorial comment I was invited to do on a recent paper. It has already been published online by the prestigious journal Actas Urologicas Españolas.

Originally posted September 11, 2012

Again I travelled to Modena, Italy, to the Hospital Hesperia. I was invited to help Dr. Giovanni Ferrari to operate his first patients with BPH with the new GreenLight XPS 180 watt laser.

We did three cases during the morning that went really well.

Dr. Ferrari told me that this hospital has the best statistics in cardiac surgery in the country, and he proposed me to collaborate with him and travel regularly to Modena to treat his patients. Then I returned to Madrid.

Originally posted September 7, 2012

After my trip to Pordenone, finally I made it to Brescia, and Dr. Alessandro Marano took me out for dinner to a fantastic restaurant.

The next morning we woke up early to go to the Instituto Clinico Santa Ana for the surgical session. 

There he introduced me to his colleague, Dr. Alessandro Gatti, who was with us all morning. We did three operations. The first was more difficult and I did it, and in the second I assisted Dr. Gatti and in the third I assisted Dr. Marano. They are two great endoscopists and they got it all very fast.

Then I returned to Madrid to rest with my family over the weekend. The summer stayed behind... all the good things pass fast ;-)

Originally posted September 6, 2012

After my visit to Pordenone in July, the local urologists were convinced of the wonders of the GreenLight laser for the treatment of BPH, and this time they asked me to mentor them with their first cases.

We did three morning cases that went very well. Normally in the teaching sessions I try to teach my colleagues two things. Firstly the physics regulating the interaction of laser and prostatic tissue, and the correct application to surgical technique. Secondly, the surgical strategy that allows to perform these procedures safely and efficaciously. Also I am by their side in these first cases to be able to assist them if any problem arises and to confirm that the endpoint of the operation is the best possible.

That same day I took the train to Brescia, where I would participate in another training session the following day.

Originally posted September 5, 2012

Yesterday I performed a live surgery at the World Congress of Endourology that took place in Istanbul, Turkey.

In the same session there were other surgical procedures that were transmitted to the congress auditorium and there I met old friends, like Dr. Martov (Moscow), Dr. Erol (Istanbul), Dr. Aho (Cambridge), and I did new ones, as Dr. Hermann (Germany). We had to operate with different technologies on patients with Benign Prostatic Hyperplasia (BPH).

I had to operate a high risk patient, with a cardiac problem and with a prostate of about 90 cc, that went very well. I showed the capsular localization technique in detail and during the operation I answered to the questions of the expert panel at the auditorium.

It is always an honor to participate in this kind of activity in such important congresses. Live surgery allows us to show the truth of each surgical technique to the audience. I left very happy and satisfied. It was a pity that I had to return immediately to Madrid and I could not stay for the remainder of the congress.

With Tev Aho before departing to Madrid

Originally posted July 30, 2012

Today I received an invitation to perform a live surgery at the second congress "Innovations and Classics in Endourology and Imaging" from the ESUT (European School of Uro-Technology) that will be celebrated in Manheim. This meeting was chosen as this year's popular "Winter forum".

I have been asked to perform a GreenLEP procedure (GreenLight Enucleation of the Prostate). An operation that is generating more and more interest. It will be an honour to participate!

Originally posted July 30, 2012

Yesterday I returned from Quito, Ecuador, after participating at the third congress of the GRILUR (Iberoamerican group of laser in urology), organized by Dr. Ricardo Yépez and Dr. Saskia Suarez at the Hospital Carlos Andrade Marín.

My participation consisted in giving two talks and performing thres live surgeries, two vaporizations and one GreenLEP procedure. The surgical rooms at Hospital Carlos Andrade Marín are amazingly good and allowed for live transmission to the conference room.

There, among other friends, I met Dr. Marcelo Baptistussi, from Brasil. A great expert in endourology for the treatment of stones. He did several cases of flexible ureteroscopy and percutaneous renal surgery, he is a true master of the field.

In sum, a very interesting congress, very well organized and a great opportunity to share knowledge with other international experts. The next year congress of GRILUR probably will take place in Buenos Aires, or if this is not possible, in Lima. I encourage all urologists with interest in laser surgery to join us, they can also join the GRILUR facebook group.

Originally posted July 24, 2012

Yesterday I received the visit of Dr. Ricardo González, from Houston, Texas, at Clínica CEMTRO. Dr. González is one of the most relevant surgeons in GreenLight laser prostatectomy in the US and a very respected urologist at the American Urological Association.

I performed two surgeries, an enucleation and an anatomic PVP and we had a good chance to comment the differences and similarities between our techniques. We had a great time together.

Originally posted July 22, 2012

This weekend I worked at the Hill Clinic in Sofia, Bulgaria. We had an intense surgical session with many operations that went really well.

The connector of the electrical cable of the morcellator's motor got broken and in order to be able to finish the session I had to ask my nurse Vanesa to fly to Sofia with another motor to be able to complete the session.

The operations went really well, and all patients were recovering well when I came back to Madrid.

This is the urology team at Hill Clinic. After almost three years collaborating we can say that we are a very experienced team! 

Originally posted July 13, 2012

I have received an invitation to participate in the 30th World Congress of Endourology that will take place in Istanbul in September. I will have to perform a live operation that will be transmitted live to the audience. I love live surgery!!!

Originally posted July 6, 2012

This time, after sleeping in Venice I went to Pordenone, to visit the Ospedale Santa María Degli Angeli, to train the local urologists in greenlight PVP for the treatment of BPH (Benign prostatic hyperplasia).

There I operated with my colleagues, Prof. Garbeglio, Dr. Maruzzi, Dr. Ruggera and Maura, the fantastic urology nurse.

We did three operations that took place wonderfully... I think this is my last trip to Italy before the summer, I feel like resting a little!!

Originally posted June 29, 2012

Today I found some time to put my voice to this video on GreenLEP (GreenLight Enucleation of the Prostate). I hope you enjoy it.

Originally posted June 28, 2012

Again we had the pleasure of receiving the visit of Dr. Richard Gaston, from Clínique Saint Agustín in Bordeaux, France. He came to operate with us at Clínica CEMTRO. We did two laparoscopic radical prostatectomies.

Dr Gaston is a true master of laparoscopic surgery and has been coming to operate with us monthly for the last five years to perform radical prostatectomies, nephrectomies and cystectomies.

He told me that they have a GreenLight laser in Bordeaux, and that they will invite me in September to operate with them.