Originally posted July 2, 2023

Visitors from Perú, Mexico, Philippines, and Italy came to our operating room at Hill Clinic in Sofia. They observed 30 En bloc HoLEPs, which provide a comprehensive understanding of the technique.

Originally posted May 12, 2022

Today I participated in the SIU Live congress of the Italian Society of Urology. We have broadcasted a case of anatomic En bloc endoscopic enucleation of the prostate with a new pulsed Thulium laser. This Revolix HTL laser is a new generation laser with interesting laser-tissue interaction properties.

The operation went very well, we could fit the 8o gram prostate enucleation in the 30 minutes of our slot. It is incredible to be able to participate in a congress that is celebrated in Italy from our operative room. It is a very popular congress as 4 surgeries take place at once. Urologists can watch in situ or online.

It is great to be able to contribute to these congresses and not have to go through all the travelling, hotels etc... it is fantastic.

Originally posted May 11, 2022

Yesterday I participated in the prostate cancer course organized by Dr. Luis Llanes, Head of the Department of Urology of the Hospital Universitario de Getafe.

I was asked to talk about the convenience or not to perform systematic biopsies during fusion biopsies for the diagnosis of prostate cancer.

I presented as well our experience with combining MRI with systematic biopsies and micro-ultrasound targeted biopsies, which we are presenting this week during the American Urological Association congress.

Originally posted May 11, 2022

It has been a while since I publish here... my workload is quite heavy and I haven't stopped, could not find a moment to publish. I did not stop participating in courses and congresses, to receive visitors to our operating room during this lapse.

In October I participated at the Panhellenic Virtual Congress with a talk on HoLEP. We carried out a HoLEP course at Hospital San Juan Grande, Jerez de la Frontera, and I also participated in the Fundació Puigvert urology course and participated in the Brasilian congress on prostate enucleation virtually.

In November I presented a semilive surgical case in the T&T in Endourology course, virtually. We received visitors in our operating room, I participated virtually in the congress of the Philippine Endourological Society, and in a Masterclass of the Peruvian Society of Urology.

December was a quieter month, although we received visitors in a surgical session at the Hospital Juan Grande, in Jerez de la Frontera.

In January I prepared a talk for the World Venezuelan Urologists, online. I also visited the Quanta System factory, to prepare a video that will be published soon. 

In February we launched courses of HoLEP where we do 5 HoLEPs in one afternoon, receiving visitors to our operating room, sponsored by LACER. We did the first course and also organised a live transmission of two HoLEPs from our operating room.

In March I did an online talk for the Turkish Society of Endourology. We received visitors to our operating room and we did a Course on Microultrasound for the diagnosis of prostate cancer.

In April we did two HoLEP courses sponsored by LACER, and I participated in the Masterclass on BPH organised by the European Scool of Urology, that took place in Heilbronn, Germany, performing a live surgical case. That same week I participated in the MEMIS virtual congress, organized in Bulgaria.

This month I also travelled to Berlin to participate in another Masterclass in BPH, where I also performed a live surgery.

The activity does not stop. I just hope to find time to update this blog. It is an online CV of sorts and I love to look at the old posts and remember my trips around the world... Lately I travel much less, thanks to the widespread of online congresses and the possibility of transmitting live surgeries from the operative room... but it is still a fascinating trip. I. published photos and info in my Twitter, just in case someone wants to have a peek.

Originally posted September 11, 2021

This year I was invited to lecture during the AUA Congress, invited by the CAU (Confederación Americana de Urología), to speak about different types of lasers and their advantages and disadvantages for endoscopic enucleation of the prostate.

The congress was going to take place in Las Vegas, but the AUA decided to make it fully virtual due to COVID and the difficulty to travel to the US. I had to send a video with my presentation.

Almost every year, the industry of medical devices launches new products and I have the privilege to be able to try all technologies for Endoscopic Enucleation of the prostate. At ICUA-Clínica CEMTRO we work with cutting-edge technology and in this talk, I discuss my conclusions after trying all different surgical tools.

Originally posted September 10, 2021

This time I received and invitation to participate in a webinar explaining the En bloc technique for HoLEP in a forum called PURE Urology in Facebook, via Youtube. 

This is the video:

Originally posted July 11, 2021

This time I participated in the European Urology Congress with a semilive presentation of a surgical procedure. I did a Holmium laser en bloc enucleation of the prostate using a pulse modulation laser (Virtual Basket).

During the presentation I spoke about three big steps forwards in prostate endoscopic enucleation, the en bloc approach with early apical release and preservation of sphincteric mucosa, published by our group, the enormous advantages of pulse modulation like Virtual Basket and the high speed of newer morcellators, that has changed the paradigm of Holmium laser enucleation. It is now a very fast surgery, usually less than 1 hour, very safe and it allows for a fast return to a normal life, significantly reducing the risk of temporary stress urinary incontinence postoperatively.

Originally posted July 7, 2021

This time, trying to adapt to the worldwide situation, we performed a live transmission from our operating room at ICUA-Clínica CEMTRO, of several en-bloc HoLEP cases. It was a pilot experience, open to everyone, without any commercial support from any company.

211 urologists registered, who could watch our work and specially the en-bloc endoscopic enucleation of the prostate with early apical release using a pulse modulated laser.

We are exploring the option to retransmit our operations via ZOOM to urologists who wish to learn these techniques. Before we would receive visitors from all over the world to our operating room, so now we feel obliged to offer them a chance to visit us virtually in times of COVID.

Originally posted June 4, 2021

We have a great team of urologists at ICUA, always learning and so motivated to work and publish new papers...

Originally posted May 22, 2021

This time I participated in a webinar where I discussed the integral management of BPH of big size. This was addressed to Peruvian urologists and also from other latinamerican countries. The session was sponsored by Jam Pharma, who is launching a collection of new drugs and combinations for the treatment of BPH.

I had to wake up early as it took place in Perú at 8 pm, that corresponded to 4 am in Sofia, Bulgaria, where I was at that moment.

The organisers thrower a good show, that made me remember the sponsored dinners in urological congresses, when we could go to congresses in presence. Truly it was quite emotive.

The presentation, the discussion and the clinical case presented by Dr. Rocio Zavala were very interesting and it was really an emotive and interesting webinar. 

Originally posted May 21, 2021

During the month of May I have visited in three occasions the University Hospital in Getafe, Madrid, to help them initiate their HoLEP program. It is a surgical technique that might seem somewhat difficult at the beginning, and then becomes much easier and it is possible to learn to perform it safely. I hope the department of Urology if the Hospital keeps innovating and growing and it is a pleasure for me to help achieve that objective.

In the photo, with our nurse Marina, who joined us, and Dr. Luis Llanes, head of department of urology and Dr. Diego Torres as well as Carmen Rodrigo Donoso, one of the chief nurses in the hospital.

Originally posted May 6, 2021

I recently received a very nice invitation from the Brasilian Society of Urology - Section Rio de Janeiro, to contribute with a surgical video to the book on minimally invasive urological surgery they are preparing. 

Originally posted April 30, 2021

 Recently I got this invitation, that I accepted with pleasure.

Originally posted April 30, 2021

I was invited this time to participate in a clinical session with Turkish urologists, that were going to discuss our paper describing the En bloc HoLEP technique with early apical release. 

They did an excellent detailed review of our paper and then we could comment all the aspects about the technique, how to learn it and its results.

Originally posted April 28, 2021

This time I participated in a webinar addressed to Australian urologists. I showed two "semilive" cases, one a normal sized prostate, and then a huge one. 

Both cases were performed in under one hour, and it was well received, as HoLEP seems to be taking off in Australia and there are many urologists over there wanting to learn.

Originally posted April 23, 2021

This time I participated in this webinar organized by the Journal of Endourology on endoscopic enucleation of the prostate with Holmium laser MOSES 2.0. 

MOSES 2.0 is a recent sophistication of the Holmium laser that confers better hemostasis and cutting properties, allowing us surgeons to perform a HoLEP with less risk, faster and it even allows to perform this procedure in an ambulatory setting.

It was very well attended and very interesting to share with international experts in this field.

My talk explained how the En bloc technique with early apical release that we described combined with MOSES has pushed further and improved the results we obtain with this technique. 

This time I lectured Israeli Urologists on MOSES HoLEP with the Lumenis 120 W laser.

After the talk, we had a chance to debate on how the advances in technology and surgical technique make HoLEP (Holmium laser enucleation of the prostate) more affordable and the current standard for the treatment of BPH. 

I was specially happy to find friends that once were visiting us to learn HoLEP and to hear from them that they are successfully doing cases. 

This time I moderated this session online on the use of micro ultrasound in the diagnosis of prostate cancer. The presenters were Dr. Pereira, from Bilbao and Dr. López Alcina, from Valencia. Both presented their data and impressions on where this new technology fits in the diagnosis of prostate cancer and the potential role in active surveillance, monitorization of focal treatment and some new other applications that will possible gain force as this technology becomes more widespread.

Dr. Pereira's team was the first in the world to acquire this technology. We at ICUA-Clínica CEMTRO were the second team to use it in Spain and Dr. López Alcina right after us, so it was a very interesting webinar full of first-hand experiences. We have all published our data and we keep studying the data and the results we are getting to better understand how to make a better use of this potentially game changing technology.

This time I participated in the Masterclass in Endourology organized by the Endourology Society with a talk on the new Holmium lasers with pulse modulation. You can see it following this link.

Recently this editorial letter was published in the World Journal of Urology, where I reflect on the need to evolve from the traditional techniques for the treatment of BPH, open simple prostatectomy and transurethral resection of the prostate, to endoscopic enucleation. 

The paper can be accessed for some time in this link rdcu.be/cfM9a

 

In these trying times we have modernized to be able to broadcast surgeries online, so that other colleagues can learn the techniques we perform at ICUA-Clínica CEMTRO.

Before the pandemic, it was quite usual to have visitors in our operating room. Today that is no longer possible but we can use the internet to do the same.

Today we broadcasted two live surgeries for Australian colleagues, one patient with a normal sized prostate, and a second one with a very large gland. We obtained 180 grams of tissue at the end of surgery, that took approximately 1 hour.

A new way of communication, very useful to share experiences and knowledge. I am sure we will do many of these broadcasts from now on.

Originally posted March 4, 2021

This time I participated in the online congress UROVIVO. I presented a semilive surgery, an En bloc Holmium laser enucleation using the Lumenis 120 W laser with MOSES 2.0.

Everything went very well and I received positive feedback from the session. I have uploaded the video of the surgery to my YouTube channel, with my comments, as the urovivo session with moderator comments can only be accessed from the Urovivo website.

Originally posted December 8, 2020

This time I did a webcast for urologists from Australia & New Zealand who are interested in HoLEP- 

I explained how HoLEP has been simplified and how it is now a relatively easy to learn technique.

The meeting was lively and there was some interaction, it was nice for my colleagues down under that this is an affordable technique to learn if one follows the right path. I also spoke about the changes in technology that facilitate this technique, and ease the learning process, as advances in fast morcellation and Holmium pulse modulation, as the MOSES system from Lumenis.

One of the slides reflected how sometimes experts have overemphasized how this technique was only ment for extremely talented surgeons, which I do not share at all.

Soon we will perform a live surgical transmission of two cases, to demonstrate that all I said is real.