Australia (II): Opinion Leader Meeting

The 24th we did not operate, but we spent the whole day meeting with two opinion leaders from Hong-Kong and Taiwan, to assist them to launch an initiative similar to the IGLU (International Greenlight Users) in this part of the word. Dr. Henry Woo and me are part of this IGLU group, and we were discussing how to export this idea to Australasia...


As always, we learnt a great deal with these sessions where we reviewed all aspects related with prostatic laser surgery.

We ended up the day celebrating in a wonderful restaurant in Sydney...

Australia (I): Greenlight Laser Prostatectomy Workshop

This has been my longest trip to date....The Urological Society of Australia and New Zealand invited me to participate in a workshop on Greenlight laser prostatectomy. The surgeons involved were Dr. Henry Woo, from Sydney Adventist Hospital and me.

When I arrived at the hotel, after a 30 hour trip, I was lucky to have a room with a privileged view over the famous Sydney harbour...

I took it easy and reseted in the hotel, and later that day we went out for dinner, and then the course started at the Sydney Adventist Hospital.


The programme was very dinamic and included short 15 minute talks and live transmission of surgical procedures. We had attendees from Australia, but also from Corea, China and Taiwan..

El Dr. woo, explicando el instrumental quirúrgico al público asistente en la sala...

My task was to operate a patient with a small, straight forward prostate, and give two short talks, and the second day I operated a patient with a big prostate and delivered two more speeches.... the course was a success and the attendees were very happy. We all learned a lot during these two days of hard work.

Dr. Woo observes one of my operations...

The attendees had a chance to try the Greenlight HPS laser in an experimental model

Gran Canaria: Dr. Juarez's Thesis

This time I travelled to Las Palmas de Gran Canaria to attend to my good friend Dr. Juarez's doctoral dissertation. The act was celebrated at the Medical College building in Las Palmas de Gran Canaria.

He defended vaso-vasostomy with TESE Sperm Retrieval as the first line treatment for men who had a vasectomy and want to have children. He did it passionately and successfully, as he recieved the best possible qualification "sobresaliente Cum Laude"!!!

It was a great honour to be there to see a friend shine as a star, presenting the results of the work of four long years. I felt very proud of him and of being his friend.

The following monday we operated together and I returned to Madrid on Tuesday.

TVE - invitation to Spanish TV program "Saver vivir"

Today I have been invited to participate in the TV program "Saber Vivir". The show today covered bladder problems and how to prevent them during the summer time.


The video can be seen here: http://www.sabervivir.es/contenido.php?modulo=Videos&idvideo=108. It is always interesting to participate in this kind of TV show, where they educate people on health related problems. It is also interesting to see how a TV show is performed and how many people are involved! The success of the show's director, Manuel Torreiglesias, is surely based on a great team.

International visitors

This week we were honored to receive the visit of Dr. Teodoro Sucre, from Venezuela, who was interested in learning about the use of the Greenlight HPS laser for the treatment of BPH. He attended two surgical sessions in Madrid. We had time enough to comment all details related to the surgical technique as well as tips and tricks that allow to optimize the result of this operation. Dr. Sucre is a delightful man and no doubt one of the most promising young urologists in his beautiful country.





For the second surgical session we had programmed three cases and we also were honoured by the visit of a group of American and Spanish Engineers from American Medical Systems, the manufacturer of this laser. They were in Madrid and decided to pop in to see some procedures so we could comment new aspects related with the proper use of laser fibres during surgical operations. In essence, I learned from them that when tissue particles adhere to the fiber, it degrades very fast, so it is imperative to keep it clean throughout the operation. I already had observed it, but when I saw the experimental data they showed, I could understand how paramount this is for this operation. So from now on I will clean the fiber more often, hoping to improve its performance. A very productive session!!

Surgeries in Gran Canaria

Again I travelled to Gran Canaria to operate with my friend, Dr. Juarez. He had scheduled four operations with the Greenlight HPS laser, and all of them were uneventful. As always I had great fun. Dr. Juarez will read his doctoral thesis soon and I will be there to support him!!!

Conference in Zaragoza

This Saturday I went to Zaragoza, to the XI meeting of the Asociación Urológica Navarro-Aragonesa (AUNAR), organised by dr. Antonio Villanueva Benedicto. I participated in a Round Table on the "Current Treatment of BPH" moderated by Prof. Luis Angel Rioja Sanz, with Dr. Carlos Rioja Sanz, Dr. Manuel Montesino Semper and Prof. Gabriel Valdivia Uría. A very interesting session of the highest level...

Right now, Zaragoza is very excited with the EXPO - the universal exposition of Zaragoza, but I did not have time to visit it, as I am travelling to Gran Canaria to do some work on Monday.

Trip to Moscow: Part three

At last, the third day of my stay in Moscow. I had some time in the morning to visit the famous red square, with Saint Basil's Cathedral.

And the Kremlin. An impressive city Moscow. A vibrant city, full of business and money running. Just in front of the Kremlin there is a huge commercial center, full of the most exclusive international brands... Prada, Gucci, and so on...

Then I went to the congress where I had to give a talk on Greenlight laser treatment of BPH. As russian doctors do not speak much english, there was a translator behind me who repeated in russian everything I said. Despite this, the talk run smoothly and it was very well received.

Then I went to the airport looking forward to returning home. I had to wait for one and a half hours inside the plane, waiting to take off... but I decided to take it easy and enjoy. An interesting experience, Moscow.

Trip to Moscow (part 2)

Today the plan was a little bit different... we would go to visit Hospital number 50 in Moscow. The department of Urology of this hospital is chaired by the famous Prof. Dmitry Pushkar, it is impressive, with more than 50 urologists and 200 urological beds. They perform 50 urological surgical procedures per day.

First it was my turn to demonstrate the new Greenlight HPS laser in action in a patient in retention with a prostate of 60 grams, which was a little bit difficult but finalised without much trouble (it received 550.000 joules).

Then Prof. Pushkar invited me to see how he repaired a vesico-vaginal fistula through the vaginal approach in a patient submitted to external beam radiation therapy for a cervix cancer with the interposition of a Martius flap. It was really impressive, a very complex case operated with simplicity and mastery, truly spectacular.

Then, after a brief visit to the hospital we went to the hotel, where I could sleep for a little while and had time to review my presentation for the following day. Then I went to the congress dinner, where I met my friend Prof. Jens Uwe Stolzenburg, (in the center of the photo below) with whom I had a good chance to talk for a while. Jens is one of the most seasoned laparoscopists in the world, and has visited us in Madrid tohelp us operate complex cases.


Then I went back to the hotel, where I communicated via videoconference with my school mates. 25 years had passed since the last time I saw many of them and a 25th years aniversary dinner was being celebrated... and I was in Moscow!!!

It was really nice to be able to greet them thanks to skype... it was truly emotive to see them and to be able to chat with the teachers I had when I was a child... Aula Nueva, a little big school, I started there when I was 8 years old, and I left when I was 14... the best of me was forged during those years in that school... thank you all!!!

Trip to Moscow: part 1

Today I took a direct flight to Moscow departing at 12 pm. I arrived at Moscow at 6 o'clock (more or less 4 am Madrid time). From there I went to the hotel (Moscow's traffic is horrible) where I could sleep for an hour and then left to the Railway Hospital of Moscow, where I had to operate a patient. The operation would be transmitted to the meeting room at the first International Endourological Congress celebrated in Moscow as well as to 8 hospitals from the Russian Railway Hospitals network.

There I found some other international experts, as Dr. Jens Rasweiller, who elegantly performed an endoscopic enucleation of the prostate. I was very impressed to see the efficacy of a new morcellator developed by the german company Wolf.

As I arrived I learned that my operation had been postponed until the afternoon... so I walked about the surgical theatres watching the laparoscopic procedures in the programme... a little bit as a "zombie" due to lack of sleep. I found a quiet room and I slept for a while, I felt much better after that. At 7 pm I started my operation, which was very succesful. A translator asked me questions and my responses were translated and transmitted to the meeting room.

When we finished, we had something to eat and drink in the doctors room, that was well provided with Russian vodka and other spirits... Nasdrovia!!!

Then I was taken to an Azerbaiyani restaurant, where some tipical plates were served (as the famous goat testicles), but I preferred to have a salad and a steak... then I fell on my bed feeling really tired...

Surgeries in Las Palmas

Again I flew to Las Palmas de Gran Canaria to operate with Dr. Juarez. He had prepared three patients and everything run smoothly as always. This time I did not remember to take photos until we finished surgery....



Dr. Juarez is getting ready to read his doctoral thesis soon. We were reviewing it together and it is an impressive piece of work. Francisco Juarez is an expert in reconstruction of the seminal ducts (microsurgical vasectomy reversal) and presents in his thesis impressive results. I will come back here to see his disertation.

Annual Congress of the American Urological Association

I spent from the 17th-24th of May in Orlando, Florida. At tne Annual Congress of the American Urological Association.

This year my participation consisted in the presentation of two posters, in collaboration with the IGLU (International Greenlight Users) Group. After our meeting in Madrid in June last year, we decided to gather the data from our patients treated with the Greenlight HPS laser in 7 international centers, and lastly we were presenting the conclusions of our studies in two separate posters.



One was presented by Dr. Shahin Tabatabei, from the Massachussets General Hospital, and the second poster by Dr. Henry Woo, from Sydney, Australia (although the man in the photo below is Mr. Gordon Muir, from London, also a member of the IGLU).

We also used the opportunity to plan new studies and new publications... We had several very fruitful discussions. On the other hand, it has been a vibrant congress, full of new concepts and discoveries...

The last day I had time to visit the Universal Studios, a wonderful place. I saw the Hulk passing by and I took a photo with him... (It is the only photo I took of myself during the congress).

Surgery in Thesaloniki

From Athens I flew to Thesaloniki with Dr. Dimitris Hatzichristou, the first urologist from this city to use the new Greenlight HPS 120 watt system. He had invited me to operate a difficult patient with a 150 gram prostate, he wanted to see with his own eyes how these cases can be handled with the Greenlight HPS laser.

Interestingly, he had also invited my colleague at the Institute of Advanced Urological Surgery, Dr. Ignacio Moncada, who was travelling there to perform a penile implant in a patient with a very difficult clinical situation. We both operated at Saint Lucas Hospital, a private center with an impressive technological and human dotation.

Both operations were complex, but successful. I had to use the suprapubic trocar to improve irrigation and I used 800.000 joules, at the end I was very happy with the outcome of the case.

In the photo, Dr. Dimitris Hatzichristou and Dr. Moncada before entering the hospital. When we finished, we went back to Madrid. There was no time to try the local famous Ouzo...

Conferences in Athens

This Friday I flew to Athens to participate in the meeting "Athenian Days of Urology", invited by the Greek urological society. This is an extremely popular scientific meeting where 450 urologists gather. I had to talk about the new results of the HPS laser and how to deal with big prostates... There were other international invited speakers, and very prestigious ones, like Patrick Walsh (the father of anatomic radical prostatectomy), David Neal, Philippe Grange, and so on... with a fantastic scientific programme.

The meeting room was full, because the greenlight is generating a great interest lately worldwide... and there were lots of questions at the end. The moderator of the session was my friend Gerasimos Alivizatos, the biggest expert in greenlight in Greece and a recognized european expert in Benign Prostatic Hyperplasia.


Then I took the opportunity to visit the Parthenon, and I walked for two hours in Athens, a very nice experience...This afternoon I will fly to Thessaloniki, as tomorrow I will be operating there a patient with a 150 gram prostate...

Surgical day in Vigo

Last Tuesday I flew to Vigo, in Galicia, to help my colleagues David Jamardo, Miguel Devesa and Vicente García Riestra to initiate their experience with the Greenlight HPS laser is the Hospital Nuestra Señora de Fátima. First we had a wonderful lunch with octopus, mussles, peppers, "empanada" and "tortilla de patatas" and then we went to the Hospital where we operated three cases.

This event had a lot of impact in the local press, we even received the visit of Spanish TV during the operations...

http://www.atlantico.net/noticia/45362/L%C3%A1serverde/F%C3%A1tima/

http://www.20minutos.es/noticia/362575/0/UNIDAD/laser/prostata/

http://www.soitu.es/soitu/2008/03/25/info/1206442082_608769.html

All the cases were successful and then I rushed back to Madrid. This time I did not get many good photos...

Cirugías en Gran Canaria

On Sunday I flew to Gran Canaria, my friend, Dr. Juarez, had prepared a busy surgical session on Monday. We operated four patients and one of them had a 130 gram prostate. All operations were smooth and easy (I delivered 825.000 Joules to the big prostate), and we enjoyed the session a lot.



In the image, Dr. Juarez, who is rapidly becoming an expert surgeon... I love to come to Gran Canaria, it is a very special place...

Conference in Oslo, "Leading Lights in Urology"

After returning from Mexico on thursday, I took a plane to Oslo, to participate in a meeting named "Leading Lights in Urology", organised by the European Association of Urology and sponsored by Astellas.

The programme was designed to review the current treatment of hiperactive bladder, BPH and prostate cancer. I was invited to review the scientific works on new technologies for the treatment of BPH presented at the European Association of Urology meeting, celebrated in Milan.

I had prepared a multimedia presentation reviewing the role of laparoscopy, TURP, bipolar TURP, bipolar vaporization and the growing role of lasers.


It was sad not to be able to stay in Oslo for longer.... this was the view I had from my hotel room...


I would have loved to visit the Vigeland park again, with its marvelous sculptures. I visited it 15 years ago, and I was fascinated by Vigeland's powerful sculptures.... I really love Norway... it is a wonderful country.

Conference at the Mexican Urology Congress

Today I had to give a conference on "Applications of uroselective alpha blockers in the treatment of BPH" in the annual congress of the Mexican College of Urology, that takes place these days in Monterrey.

Monterrey is an industrial city with more than 6 million inhabitants, enormous. It is unfortunate that I cannot stay here for longer, as I have to rush back to Madrid.

I was referring to the medical treatment of BPH and specially to the relationship between lower urinary tract symptoms and sexual dysfunction, as well as the impact of medical treatment in sexuality. There was a lot of people in the auditorium, and the congress seemed very well organised. I met Dr. Claus Roerbohrn briefly, and I also saw that my friend Dr. Gaspar Ibarluzea was in the programme, but I did not have the time to see him.

Now I need to pack and return to the airport... it is a pity I cannot stay longer...