Originally posted August 31, 2014

After the summer holidays I started working in Sofia, Bulgaria, as I do every month. This time we received visitors who travelled all the way from Japan to witness the session. They preferred to remain anonymous.

Two days of surgery that went very well. I am sad to see how the days are getting shorter as the summer comes to an end. I returned to Madrid to start the season, back to work!

Originally posted July 31, 2014

Again I went to Portugal, this was my last trip before my summer holidays, to operate with Dr. Antonio Oliveira at Hospital Sanfil in Coimbra. When I arrived the luggage handling company at the airport was on a strike, so we had to delay the start of the session significantly.

We performed three operations , all en bloc enucleations, that went very well. Then I returned to Madrid with great delay... late at night, really tired after a long day. Fortunately I started my summer holidays the following day!

Originally posted July 29, 2014

At last the website of the congress Challenges in Endourology 2014 has published the video of the live surgical transmission I performed in Paris recently.

The video feed can be accessed here.

Originally posted July 25, 2014

Again I went to Sofia, Bulgaria, to participate in a training session at Hill Clinic. This time we operated 24 patients with the GreenLEP technique for several days.

We received the visit of Dr. Antonio Oliveira, from Portugal, and we enjoyed much the interaction with him. Hill Clinic celebrated its 5 years and I think I can say that it is one of the best teams in the world for surgery of BPH. The quality of the team work we do there is exceptionally good.

At the end of the session I took a photo with all the specimens of the patients operated, more than 1 Kilo of prostatic tissue.

Also, we managed to extract 230 grams of tissue from a single patient with a huge prostate. I was very impressed myself to see the size of this prostate and how well the patient did postop. GreenLEP is a very solid technique, and of course, the Piranha system for morcellation with the Vmax blades help a lot.

Originally posted July 21, 2014

Again I went to Australia, this time invited by the USANZ (Urology Society of Australia and New Zealand) to participate in the 7th Asia Pacific Photoselective Vaporisation of the Prostate Workshop that was held at the Sydney Adventist Hospital, directed by Prof. Henry Woo.

With Prof. Woo, we also had in the faculty Dr. Syd Weinstein and Dr. Tom Dean, also from Australia.

When I arrived at the course, they were carrying out the observed advanced techniques observation part of the course, with many simulators in several working stations. I was impressed by the quality of the installations devoted to teaching at the hospital.

I had to give a talk on the development of the GreenLEP technique after a very kind introduction from Prof. Woo.

Then we went to the Hospital, for the live surgery part of the congress.

Prof. Woo performed a conventional PVP and then I performed three operations on three patients. An anatomic vaporization, a hybrid technique with enucleation of the median lobe and a GreenLEP procedure.

After the operations we came down to the auditorium where the surgeries were transmitted and we answered the questions from the audience. Everything went very well, and I think we managed to break the preconceptions of may attendees and showed the fantastic versatility of the GreenLight laser.

We had a great time and I think this is the best laser prostatectomy for the treatment of BPH course in the world. It was a great honor to participate.

Prof. Woo was a really nice and generous host and the USANZ gave me an exceptional present, a pair of Australian boots from RM Williams, the best manufacturer of boots in Australia. A great present!

Originally posted July 10, 2014

Again I travelled to Barcelona to participate in a surgical teaching session, invited by Dr. Javier Sánchez, Head of the department of Urology of the Hospital de Mollet del Vallés, in Barcelona.

I performed a GreenLight en bloc enucleation in a patient with a relatively big prostate. There was Dr. Placer as well, he is a reference in Spain in the treatment of BPH with the Holmium laser. It is always a pleasure to meet with colleagues who share the same passion. We took a photo and laughed when Dr. Sánchez Macías took the warning sign from the operating room door saying DANGER!

I could then return home early, wonderful.

Originally posted July 7, 2014

This time I did not have to travel far. It only took me 15 minutes to reach the Hospital Fundación Jiménez Díaz from home where I had prepared a training session with 5 patients.

First I did an informal talk to the urology department staff and to the staff of the Hospital de Valdemoro, who attended via video-conference. I commented the controverted aspects of the use of the GreenLight laser, the relevant physics, how to use the fiber correctly and the new techniques I have developed and how to learn sequentially.

Then we went to the operating room where I performed two En-bloc GreenLight Enucleation and then I helped the urologists from the department to perform another three cases. Everything went very well. It was such a nice thing to finish the session at 10 pm and then be at home just in some minutes!

Originally posted July 4, 2014

Again I travelled to Gran Canaria to help my friend and colleague, Dr. Juarez del Dago, to perform two En bloc Greenlight laser enucleations at Clinica San Roque in Las Palmas de Gran Canaria.

The operations went very well and then I took the opportunity to spend the weekend with my friend and family.

Originally posted July 3, 2014

Again I flew to Barcelona and from there I drove to the University Hospital in Tarragona, where they had prepared a surgical session with three patients.

The operations went very well and I could demonstrate to my colleagues at the urology department the different techniques of anatomic vaporization, vapo-enucleation and en-blog Green Laser Enucleation of the prostate. These techniques are very convincing, as the final result is exceptionally good.

The session finished a little earlier than expected and I could return earlier to Madrid and rest a little in the afternoon at home.

Originally posted June 30, 2014

Again I was invited to participate at a meeting in Italy, where live surgeries were performed from the hospital's surgical rooms to the main meeting hall. I flew to Rome very early and a driver took me all the way to the Hospital Umberto I in Nocera Inferiore, near Napoli.

First I gave a talk on the comparison of TURP (Transurethral resection of the prostate) and the GreenLight Laser treatment of BPH.

Then I went to the operating room and I performed an anatomic vaporization that was retransmitted to the main hall. Everything went very well and then I returned to Rome to fly back to Madrid very late!

Originally posted June 27, 2014

From Barcelona I travelled to Lisbon to visit the Hospital Beatriz Angelo, where I was invited to participate in a surgical session.

Sadly, the organization of the session was terrible, and despite being there at 8.30 in the morning we did not start operating the first patient until 11 am, and then we could not operate the next until 4 pm... surgeries went very well, we performed an anatomic vaporization in a patient with a mid sized prostate and an en bloc enucleation in another patient with a bigger gland. The hospital is impressive with fantastic installations, but very bureaucratic.

I spent a very boring day there, waiting, and with the sensation of losing my time. My plane was delayed and I arrived at home at midnight. I do not think I will ever go back to that hospital.

Originally posted June 26, 2014

This time I was invited to visit the Hospital de Martorell, near Barcelona, where I performed three operations to demonstrate the versatility of the GreenLight laser in the treatment of BPH.

There we had time to talk extensively about the best way to start a program of surgery with the GreenLight laser. I explained that the learning process must be approached seriously, paying attention to the details and choosing the patients with small prostates, easier to operate, for the first cases.

In oder to learn to operate with the GreenLight laser one must have the attitude of the wise man " see the difficult things as easy, and the easy as difficult" I told them. Many people think it is an easy surgery, but the truth is it is not so much. It requires a thorough training and progressive and structured learning.

Originally posted June 25, 2014

Again we had another surgical session and again we received visitors. This time we hosted Dr. Sergio Zubillaga and Dr. Mario Dominguez from the Hospital de Valdecilla in Santander, Dr. Alberto Budía from Hospital de la Fé in Valencia and Dr. Luis Castellanos from the Hospital de Avilés.

As usual, we first discussed laser physics and how to manipulate the laser fiber correctly to achieve an optimal vaporization.

Then I performed four operations to show the different surgical techniques with the GreenLight laser. It was an interesting and fun session and everything went very well.

Again this time they wrote some comments in the visitors book.

Originally posted June 24, 2014

Today we received visitors in our operating room at Clínica CEMTRO. We received the visit from Dr. Carlos Reig, from the Hospital de Manises, Dr. Beamud, from the Hospital Universitario Dr. Peset from Valencia, Dr. Guevara, from Hospital San José from Vitoria and Dr. Fernández of the Clínica Viamed Los Manzanos, from La Rioja.

I performed four operations with the GreenLight Laser for the treatment of Benign Prostatic Hyperplasia during the day and we had a great time commenting the new surgical techniques. They left these very kind comments in our visitors book (in Spanish).

Originally posted June 22, 2014

This time I took the chance to being in Sofia for the World Congress of Video urology and I stayed to participating at a clinical teaching session at the Hill Clinic.

In this occasion we received the visit of three german urologists, Dr. Wiedemann and Dr. Schiefelbein, and two portuguese urologists, Dr. Antonio Rui Sousa Campos and Dr. Catarina Gameiro. In the photo, with the urologists who work at Hill and the representatives from AMS who were joining them.

We performed 9 operations and we had a good chance to comment broadly the details of the different surgical options for the treatment of BPH (Benign Prostatic Hyperplasia) with the Green Laser. We had a great time and the operations were very interesting.

Originally posted June 20, 2014

This time I travelled to Bulgaria to participate in the World Congress of Videourology. I was invited to speak about the news on the treatment of BPH (Benign Prostatic Hyperplasia) with the Green Laser.

I also participated as a panelist in two other sessions, one on surgical simulation in urology and another video session on surgical techniques for BPH.

I took the opportunity to present the description and videos of the surgical techniques that I recently published in the World Journal of Urology.

It is always a pleasure to share with other international colleagues in these congress. This month I took the opportunity to stay in Sofia and operate at the Hill Clinic, as usual.

Originally posted June 16, 2014

This week we received the visit at Clinica CEMTRO of a select group of international experts in the treatment of benign prostatic hyperplasia (BPH) with the GreenLight laser.

The objective of the meeting was to present them the new techniques that I recently published at the  World Journal of Urology and to try to reach a consensus with all of them on their application, on how to train other urologists and to kick off an international multi center study to validate them internationally. 

We received the visit of: (left to right in the photo) Dr. Shahin Tabatabaei (Harvard, Boston, USA), Prof. Oliver Reich (Munchen, Germany), Dr. Claus Brunken (Hamburg, Germany), Dr. Edward Collins (San Francisco, USA) and to my left Prof. Henry Woo (Sydney, Australia), Prof. Andrea Tubaro (Rome, Italy), Dr. Vincent Misrai (Institut Pasteur, Toulousse, France), Mr. Gordon Muir (King's College Hospital, London, UK) and Prof. Alexander Bachmann (Basel, Switzerland).

Firstly I performed three surgical operations, demonstrating each of the techniques that I have described for the treatment of BPH with the Green Laser. Clínica CEMTRO is fully equipped to transmit live surgical procedures to the main auditorium and although some of my colleagues preferred to come and witness the procedures in the operating room, the rest of the attendees watched them from there. All the operations went very well and all the patients were discharged the following day.

We also did a press round in which we told everything about these new techniques and the transcendence and impact that the Green Laser has had in the treatment of BPH worldwide.

Then we met for two days to set the basis of the clinical studies we are going to carry out jointly to validate internationally the excellent results we have achieved during the last four years with these new surgical techniques at ICUA and Clínica CEMTRO.

It was a very interesting meeting, and I am sure that the clinical study we have started will have a great impact worldwide. It was a pleasure to receive the visit of my colleagues and international friends and to feel fully supported by Clinica CEMTRO for its organization and development.

Originally posted June 16, 2014

At last my paper on new surgical techniques with the GreenLight laser for the treatment of BPH has been published at the World Journal of Urology. It can be downloaded for free as I decided to publish it with "open access" which means that everybody can see it without cost.

I am happy and proud to have described these techniques and to be able to share them with my colleagues around the world. It has been a five-year work of continuous learning and improvement and much effort, but finally there it is. It would not have been possible without the help of my nurse, Vanesa Cuadros and my team in Madrid, nor without having worked at Hill Clinic in Sofia, Bulgaria, for the last five years. I am deeply grateful to all of them.

We developed some drawings for this publication, describing three surgical techniques, from simpler to more complex, that allow the surgeon to improve his results and to learn step by step until he can perform the En Bloc enucleation technique.

This is the graphical description of the anatomic vaporization.

This is the graphical description of the vapo-enucleation or median lobe enucleation.

 This is the graphical description of the En bloc enucleation.

And these are images of prostatic transrectal ultrasound (before and after the operation) that demonstrates the excellent removal of adenomatous tissue obtained with these techniques.

I hope my colleagues find it useful and that these surgical techniques will help them obtain better results with their patients.