Originally posted May 19, 2018

Again I went to San Francisco to participate at the American Urology Congress. This year there was no course of Advanced Techniques with the GreenLight laser as previous years.

My contribution this year was with four collaborative works. I am proud to see that the uptake of GreenLEP, the technique for enucleation of the prostate that I described is growing worldwide.

So posters and oral presentations plus another video on how to perform morcellation safely, that was presented by Dr. Enrique Rijo.

As always a very interesting congress full of new stuff. I also had time to see my old friends and to enjoy San Francisco a little. 

Originally posted May 11, 2018

Today I went to the Hospital de La Princesa in Madrid, where I trained as a resident many years ago, to help my colleagues to start their experience with HoLEP or Holmium Laser Enucleation of the Prostate.

We did two cases that went very well. My nurses Vanesa and Sandra came with us to make sure everything went well. The HoLEP procedure is quite simple and safe, but it needs very good team work to succeed.

It was a pleasure to operate in the operating room were I learnt so much as a resident and to see the last three urologists who remain from my time as a resident.

Originally posted April 5, 2018

Again we celebrated another course at ICUA - Clínica CEMTRO in Madrid, where we received foreign visitors interested in learning the advanced techniques with GreenLight laser that I described now some years ago, that have been adopted in many european countries.

We had two important invited professors, Dr. Vincent Misrai, from Tolousse, France, and Dr. Giovanni Ferrari, from Modena, Italy.

Dr. Misrai performed an anatomic vaporization and then I did a GreenLEP (GreenLight Enucleation of the Prostate) that was broadcasted to our main auditorium. Our Fellow. Dr Giusseppe Saita, moderated the session.

We also did some talks in between surgeries.

The following day we continued during the morning and the attendees had also an opportunity to use the wonderful surgical simulators developed by Boston Scientific.

In sum, another successful course, we are always happy to try to propagate the knowledge on these techniques and to help other colleagues to adopt these modern techniques for the benefit of their patients.

This year the EAU took place in Copenhagen. A congress full of new and interesting stuff.

I was first in charge of addressing the Young Urologists Group of the EAU with my talk on Tips and Tricks for HoLEP (Holmium Enucleation of the Prostate).

Then I was invited to present a semi-live surgery of Anatomic PVP (Photoselective Vaporization of the Prostate) during the plenary session of the congress.

Later that day I recorded an interview for a new education website on BPH (Benign Prostatic Hyperplasia) that Boston Scientific is going to release soon, similar to the one they have been running for stone disease  http://stonesmart.urologytimes.com/. I spoke about the GreenLEP technique that I have described for the treatment of large glands. I will announce it in this blog the moment in comes online.

Also in this congress I presented a live surgery recorded previously at the Boston Scientific Booth.

This video will soon be available at the prestitious AIS Channel, I will also announce it here when it becomes available online.

Also I had to moderate a session of videos on new techniques in the treatment of BPH. 

In this session we phad submitted a video on how to perform intravesical morcelation of BPH tissue with safety, that Dr. Enrique Rijo presented. He is a colleague and a friend from Barcelona who learnt to enucleate with me and has grown up to become a true expert. 

Finally I presented another video that we had submitted to the congress on Robotic Nephrectomy in a tumor with caval thormbus.

In summary, a very busy congress in which I have been able to ascertain that we are in line with other european high level centers offering the latest technologies in minimally invasive surgery to our patients. 

ICUA and Clínica CEMTRO have initiated their participation in the international multicenter clinical trial on the new device iTIND for the treatment of BPH and Marion's disease (primary sclerosis of the bladder neck).

The advantage of this device that is implanted in the prostatic urethra and is removed five days later is that it reshapes the anatomy of the bladder neck allowing for a much more comfortable micturition for patients without affecting ejaculation or sexual function.

We have carried out the first cases for the study and the recruitment is still open, so if you suffer from BPH contact us to see if you are a candidate to participate in this study.

Originally posted March 9, 2018

This morning we went to Hospital La Luz in Madrid, to participate in the Course on Benign Prostate Hyperplasia organised by the urology department leaded by Dr. Romero.

 
I was invited to perform a GreenLEP procedure (GreenLight Enucleation of the Prostate) that would be broadcasted to the main auditorium at the Hospital. I took my nurses Vanesa Cuadros and Nuria Torrego with me so everything would take place uneventfully.

The operation went very well and we could show again the simplicity and elegance of the GreenLEP procedure, as the comment below in twitter illustrates.

Originally posted March 7, 2018

This year we are going to run several international courses on new advanced techniques of surgery for the treatment of Benign Prostatic Hyperplasia with the GreenLight laser. In the first of these courses we had the privilege of having Dr. Vincent Misrai, from Tolousse, France, and Dr. Giovanni Ferrari, from Modena, Italy. We had visitors from the UK and United Arab Emirates.

The course had two days, one with live surgical cases performed at Clinica CEMTRO, and another day at the Boston Scientific headquarters in Madrid, where we gave many talks on the different aspects of surgery for BPH with the GreenLight laser.

There was also time to practice with the new surgical simulator, that has improved significantly.

These courses will take place in Madrid several times this year, so if you want to join us, contact Boston Scientific. We cover the techniques that I described three years ago in this paper.

Originally posted December 13, 2017

Last December 2017 we tried for the first time the ExactVu system of high resolution microultrasound of the prostate for the diagnosis of prostate cancer.

It is a sophisticated high resolution ultrasound (conventional transducers for transrectal ultrasound imaging have 7 MHz, but this has a 29 MHz probe), that improves radically our ability to detect subtle anatomical details in the prostate.

After studying carefully what this technology can add to the diagnosis of prostate cancer, we have decided to adopt it at ICUA-Clinica CEMTRO, to make it available for our patients.

We believe it can be a very nice companion to 3 Tesla Multiparametric MRI and that it can be of great help in paitents who do not tolerate MRI or in which MRI is non conclusive. In some of the cases we performed we could see lesions that the MRI had not even seen and on biopsy there was a tumor lesion.

It is a costly technology, but we believe it will help us detect prostate cancer even earlier in men and thanks to that, improve the chances of cure in our patients.

Many other high level centers are also adopting this technology, and the data published to date is extremely positive.

A very interesting tech that can be better known at the website of exact imaging.

Originally posted December 11, 2017

This december we had the opportunity to try for the first time in Spain the Aquablation system, from
Procept Biorobotics for the treatment of BPH.

It is a robotic system that uses a very powerful water jet to deobstruct the prostatic urethra, and it does that in just 5 minutes. The patient is awake, tipically under spinal anaesthesia.

It needs some preparation, but it is surprising to see how fast one can treat prostates of all sizes in such a reduced time.

The main advantage of this system is that 90% of men treated preserve the ability to ejaculate normally.

This is why this technology is very interesting, as many men that need to face an operation for BPH would like to preserve ejaculation, that is tipically affected by other surgical techniques.

More info in spanish here, or watch our video below.

Originally posted December 8, 2017

I Spent this weekend in Paris participating in the ESU-ESUT-ESUI course on Focal therapy for localised prostate cancer.

It is interesting to see how this concept is gaining ground around the world, and evidence to support its use is acumulating. It was interesting to explore this option of management for very selected patients. The information obtained from MRI-Ultrasound fusion biopsies is allowing us to better select the patients who will benefit from this approach.

A very interesting course in Paris!

Originally posted November 29, 2017

As it is common every month, we had visitors in our surgical room. This time, various colleagues from spain came to witness a surgical session, where I could show them the advanced techniques for the treatment of benign prostate hyperplasia with the GreenLight laser. I showed them anatomic vaporization and GreenLEP and how to transtion from vaporization towards enucleation.

The reactions of visitors coming to our surgical room are always the same, they leave convinced of the versatility of this laser and the robustness of theste techniques, as they are very safe and efficacious. It is always a pleasure to receive visitors and make new friends.

Originally posted November 24, 2017

This weekend I travelled to Barcelona to participate in the ESU-ESUT masterclass on lasers in urology.

I was invited to give a couple of lectures, participate in a round table and to perform a live surgical procedure that was broadcasted to the main auditorium of Fundació Puigvert.

Everything went very well and I could present my techniques of anatomic vaporization and GreenLEP (Green Laser Enucleation of the Prostate), and a very interesting discussion followed. Despite I am trying to travel less offten to be able to devote myself to my patients at Clinica CEMTRO in Madrid, it is always a pleasure to see my friends and to participate in the training of other urologists in the minimally invasive treatment of prostatic diseases.

Originally posted November 15, 2017

As usual, today we received the visit of Urologists from the United Arab Emirates and Saudi Arabia, who were interested to watch advanced techniques on the treatment of BPH with the GreenLight Laser.

I could show both an anatomic vaporization and two enucleations (GreenLEP). I think they were surprised as there are still many urologists that are unaware of the extreme versatility of this laser ot treat prostates of all sizes.

Originally posted November 2, 2017

We have edited this video of a recent surgery we performed at ICUA - Clinica CEMTRO in Madrid.

The Da Vinci Xi robot has improved the contitions to perform this kind of complex surgery that used to entail big open operations with a high risk of surgical complications.

It is in Spanish, I will see if I can produce an English version of this soon.

Originally posted November 2, 2017

This time I went to London to join a meeting with other international experts in surgery for BPH to discuss advanced techniques for the treatment of BPH, that at last are going to be promoted internationally in collaboration with Boston Scientific, the manufacturer of the GreenLight laser.

I had to present on my techniques of anatomic vaporization and GreenLEP (Green Laser enucleation of the prostate).

I am also working in the preparation of a manual describing step by step how to perform these techniques, that will be distributed to all GreenLight Users worldwide.

Despite the fact that these techniques that I described have gained wide support by urologists in various countries, as Italy, France and USA, up to now Boston Scientific had not supported them officially, but the good results obtained in studies published in Italy and France and the enthusiasm they generate in their users and patients finally have made it happen!

Originally posted October 18, 2017

As it is becoming a tradition now, we received visitors to our operating room for a new course on GreenLight Laser surgery for BPH.

In these courses we show the different techniques that can be performed with the GreenLight laser, as EP-PVP (ejaculation protective PVP), anatomic vaporization and GreenLEP (Green Laser enucleation of the prostate).

As always, it is very nice to receive visitors and to be able to exchange knowledge with other colleagues.

Originally posted September 16, 2017

This weekend I was in Vienna to participate in a monographic course on Prostate Cancer organized by the European Association of Urology.

It was quite interesting to be able to listen from international experts all the new aspects of the management of this disease. It is a very dynamic field where a lot of research is conducted worldwide every year. These courses are helpful to keep track of all that is changing and that is to come.

I was also happy to see the high standard of care we offer at ICUA Clínica CEMTRO, in line with the best centers of the world in prostate cancer.

Originally posted June 9, 2017

This time I travelled to Bordeaux to participate in the Challenges in Laparoscopy and Robotics course organized by the urology team at Saint Agustin in Bordeaux, where Dr. Richard Gaston, our colleague at the ICUA in Madrid, works.

Three days of many live surgical transmissions and update talks by international experts. I enjoyed so much! The quality of the course was amazing, and we enjoyed with the participation of first line experts like Indebir Gill, James Porter and others.

Dr. Gastón had as always a stellar role, performing a radical cystectomy that left everybody impressed and a lateral approach for radical prostatectomy.

During the congress a faculty dinner took place and I could not assist as I was having a terrible cold, that hit me very hard that night. Dr. Gaston made balance of his professional life in a talk he gave to the dinner guests. A resident working for Dr. Gaston sent me this photo where Dr. Gaston included me in the short list of "journey friends". I really felt very honored for his friendship and consideration and I was very sorry that I could not be there with him in such an important moment in his career. We have worked together for the last 10 years and it has been an honor to share so many moments and surgeries with one of the best robotic surgeons in the world.

Originally posted May 13, 2017

This time I went to Boston to participate in one of the Instructional courses the Congress organizes on specific topics. I spoke about the techniques I described for the treatment of BPH with the GreenLight laser, anatomic vaporization and En Bloc GreenLight Enucleation of the prostate.

I was very satisfied to see that other authors are publishing on these techniques with excellent results. 

One of the presentations in the congress was the first american experience with GreenLight enucleation, a paper coming from Massachussets General Hospital, Harvard University, by Dr. Shahin Tatatabaei and his team.

Two years ago I was in Harvard helping Dr. Tabatabaei with his first steps with this technique and before that he came to visit us in Bulgaria, and now we see the fruits of that collaboration.

Other authors from Europe also published on this technique.

I am very happy to see that my little contribution to urology is coming alive and starting to influence positively the life of many patients.