Ureteroscopy and Holmium laser

I have just posted this video in Youtube, it has been edited by Dr. Luis Llanes. He is an expert in endourology and the minimally invasive treatment of ureteral and kidney stones.

Dr. Luis Llanes is the director of our urinary lithiasis unit at the Institute of Advanced Urological Surgery in Madrid, a true endourological artist. Sorry the video is in Spanish. Holmium-YAG lasers allow to fragment urinary stones with safety and allow patients to recover very fast and go back to their normal life.

Surgeries in Barcelona

This Monday I went to Barcelona, to the Fiatc Clinic, with Dr. Fakiani. He is interested in learning to perform the greenlight HPS laser prostatectomy. We did two cases and then I rushed to return to Madrid...

Surgeries in Gran Canaria

This Sunday I flew to Gran Canaria, to operate with Dr. Francisco Juarez del Dago. We have been operating together for two years now. What sarted as a collaboration to help him kick off and support him with his greenlight laser prostatectomy learning curve is now a fantastic friendship.



I am really proud to see him operate, transformed into a true master of the technique...

Participation in Spanish TV

Today I went to Spanish national TV, invited to speak about urinary infections and urinary incontinence. The programme "Saber Vivir", is the most important health related TV show in Spain. I had a great time, it was interesting and fun.

The video is online following this Link.

Surgeries in Montevideo

I spent this weekend in Montevideo, to help the Urologists of the British Hospital, Dr. Daniel Porto and Dr. Javier Zeballos to kick off with his Greenlight HPS 120 watt laser surgical unit. This is the first center in Uruguay to adopt this technique for the treatment of benign prostatic hyperplasia.

The trip was a little bit boring as my flight from Madrid to Buenos Aires was delayed 10 hours, but once there I had some time to tour Buenos Aires. Then I took a flight to Montevideo and after resting for the night we started the surgical sessions which were successful!!!


The following day my colleages took me out and showed me the highlights of Montevideo and then I returned to Madrid via Sao Paulo. Quite a long trip...¡But it is always nice to make new friends!

Visitor from Venezuela

This week we received the visit of Dr. Dario Soto, from Venezuela. He is a prestigious urologist from Maracaibo, who already was a pioneer in the adoption of extracorporeal shockwave lithotripsy. He is about to start operating with the Greenlight laser in Maracaibo and he came to see how we perform this operation. Between Thursday and Friday he witnessed six operations. We had time to comment all the technical aspects of this operation and we also had time to go out for dinner and enjoy some flamenco dancing at Casa Patas!! I usually do not have time to go out to see some flamenco, which I really love, so I take the opportunity of having a foreign visitor as an excuse to enjoy for a while....

Interview in "La Razón"

Today this was published in La Razón, one of the leading Spanish Newspapers.

Surgeries in Seville

Today I travelled to Seville, to help Dr. Rus to perform two laser prostatectomies in patients with big prostates. I already helped him start with his first cases, and he has been operating on his own since then, with good results. It is a good idea to have a second interaction with an expert after some initial experience, it helps polishing little technical details that can make a difference. As always, Seville is a wonderful city and a pleasure. We did a first case and then had a wonderful lunch, and then we did the second case. The high speed train connecting madrid and seville, as always, wonderful.

2nd Continuous Medical Education Course of the AEU

Today I participated in a round table at the II Continuous Medical Education Course of the Spanish Association of Urology. A fantastic initiative of the Spanish Urological Association.

With the current pace of technological acceleration, we urologists have to invest a good part of our time to keep updated on current scientific information, and courses like this are perfect to help us achieve this objective.


We commented the different minimally invasive treatment options of BPH, and I had to present on Greenlight laser treatment, we then had a very interesting discussion. It was a great honour to be invited to collaborate with the Spanish Urological Association.

Prostate MRI spectroscopy

This is a video I have recently produced to explain the usefulness of MRI spectroscopy in the evaluation of patients in whom we suspect the presence of a prostate cancer. In Spanish only, sorry!

Visit to Kuwait City

I have spent some days in Kuwait visiting my colleagues at the Al-Amiri Hospital. They have adopted the Greenlight HPS technology for the treatment of benign prostatic hyperplasia, and I went there to give them a hand with their first cases.


We did seven surgical procedures. First I did two operations, explaining the technique.

Then three Kuwaiti urologists from Al-Amiri Hospital performed the rest of the operations under my supervision, with great enthusiasm for this technique that allows patients to recover surprisingly fast. It was very impressive how well they did their first cases on their own.

On Monday night, we got together with other urologists from Kuwait City and Saudi Arabia, also interested to learn about the technique. I reviewed some basic science concepts, surgical technique and results, with a very interesting discussion at the end.



It has been a great experience, Kuwait is a modern and vibrant city, and all the people I met here were really nice and warm. I had a great time.

2nd Meeting on Urology for GPs and Urology Residents

Today I participated in this congress addressed to primary care physicians, organised by my colleague and friend. Dr. Juan Carlos Ruiz de la Roja. The meeting gathered more than 300 GPs and urology residents and there were 26 prestigious urologists from all over Spain as faculty.


Dr. Ruiz de la Roja, besides being a great urologist is a first class medical communicator and author of the famous book "Let's talk about your prostate (hablamos de tu prostata?)" a highly recommended read for men and women alike, available at Amazon.

Wonderful Istanbul

Last thursday I travelled to Istanbul, Turkey, to participate in the international meeting "Hands-On Live Endoscopic Surgery Conference" organised by the ESUT (European Society of Uro-Technoogy) and the Turkish Urological Association.

Istanbul is a city between Europe and Asia, crossed by the Bosphorus and a mixture of culture, influences and religions. A remarkable place. One would like to be able to dedicate more time for tourism and less to work in places such as this.


After arriving we celebrated a reception dinner, where Dr. Jens Rassweiler from Germany surprised us all and played the guitar live and Prof. Dr. Ali Riza Kural sang classic symphonic turkish songs as well as modern ones (I bought one of his records in a music shop).

Then the congress started. I first participated in a "observed advanced techniques observation" training session in which the attendees could try technology with their own hands using surgical models. We usually use bull prostates to evaluate these new surgical instruments. There was of course a Greenlight HPS laser and I was there to answer questions on laser prostatectomy.


Then I left towards the hospital, where I performed an operation that was retransmitted to the congress venue. The patient had a 65 cc prostate. The operation was uneventful, unfortunately we did not get much time left and the operation was not broadcasted entirely.



The congress followed with very interesting sessions on endourology with many live surgical procedures. I had some time to visit the Great Bazar and I entered a nearby Hammam, a Turkish bath, to enjoy the sauna and a Turkish foam massage!! An unforgettable experience that I recommend.

It was sad to have to go back, Istanbul is one of the most fascinating cities in the world.

Helsinki University Hospital

I am writing this post from Brussels. I am returning to Madrid, waiting at the airport (my flight has been delayed) after spending two days in Helsinki to participate in a symposium on Greenlight laser prostatectomy for the treatment of Benign prostatic Hyperplasia (BPH).

The programme of the meeting

The symposium took place in one of the buildings of the Helsinki University Hospital, where I first gave a lecture covering physical basis of laser prostatic treatments, and mainly recommendations on surgical technique.

Then we went to the surgical theatre, where I performed a Greenlight prostatectomy in a patient while I anwered the questions coming from the auditorium. The Auditorium was equipped with a direct link to the theatre, and urologists and nurses could witness the operations and formulate questions.


Then we ate something and then Dr. Hannu Koistinen (in the photo below) did a second operation.


A very nice scientific session. Both patients recovered very fast. I love Finland... Today I go back to my clinics and I will also see patients tomorrow. Then on thursday I depart to Istambul, Turkey.

A good start after my holidays

This weekend I flew to Gran Canaria to operate some cases with my friend Dr. Juarez. It is a great way to start this working year, and I took the opportunity to bring my daughters with me and we had a great time.

This year promises to be very interesting. The adventure continues....

Australia (IV)

Today we went to visit St. Vincents Hospital in Sydney, where I met Dr. Striker and Dr. Brenner. They had programmed two cases for today, one of the patients had a very big prostate and high surgical risk and the other patient had a smaller prostate...


Both operations were uneventful and again the experience was very interesting....


There are many centers worldwide starting to use this technology, and there is a great interest in learning all surgical tips and tricks and advanced strategies...

The following day I had to return to Madrid, and I took the chance to visit some beautiful spots in Sydney. Both the city and the inhabitants touch your heart.... I will be back down under!!!

Australia (III): Royal Prince Alfred Hospital

I was honoured today to visit the Urology Department at the Royal Prince Alfred Hospital in Sydney, where I met Drs. Boulas, Wong, Eisinger, Visilaris and Sved.


They had recently bought a new Greenlight HPS laser and wanted to obtain the best possible results with it. We did four operations throughout the day, and all cases were successful... all of them had a good chance to sit down to operate under my supervision and they did a jolly good job!!!. I told them all my tips and tricks and strategies to avoid getting in trouble and obtain the best possible results...


Then they invited us to go to a wonderful chinese restaurant in the Fish Market in Sydney, where Dr. Wong chose a fantastic menu for all of us... I tried the raw lobster for the first time... a noteworthy experience... We had a great time and I was really pleased to be surrounded by these great urologists and amazing human beings...

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