Surgeries at Hospital Gregorio Marañón in Madrid

Today I spent the morning with my colleagues at the Hospital Gregorio Marañón, the biggest public hospital in Madrid. I had been invited to show the GreenLight XPS 180 watt anatomic vaporization of the prostate. It is always nice to meet my friends again.

I did the first case of the morning, a patient with a moderately large prostate, where I showed them the way of identifying the prostate capsule to achieve a radical vaporization of the adenoma. Everything went smooth and nice.

Dr. Carlos Hernández performed the second case. He had previous experience with GreenLight and it was easy for him to reproduce the technique. He was very satisfied with the possibilities this new laser offers and surprised to see the radicality and elegance of the technique.

Dr. Hernández has always been in the avant gardé of technology and modern techniques in urology, pioneered many techniques in our country, specially laparoscopy and is a loved and respected reference for us spanish urologists. I had a great time with him and the urologists of his department. It is always a pleasure to share my experience and surgical tips with my colleagues.

European Urology Congress in Paris

This year the European Congress took place in Paris. In this ocasion my contribution for the congress was to participate in a observed advanced techniques observation session on GreenLight vaporization of the prostate in which we showed other colleagues how to operate with this laser with a computerized surgical simulator.

The simulator is fantastic, as it allows urologists without experience with GreenLight to train for hours before operating on patients. This way, their understanding of the technique improves a lot and any mistake is committed in a computer, rather than in a patient.

A very interesting session with my friends, Dr. Oliver Reich, Shiefelbein and Alivizatos.

Italian visitors

Again we received the visit of some italian urologists, and Dr. Miguel Angel García, from Salamanca. In this occasion I did two vaporizations and one enucleation with the GreenLigth XPS laser in a patient with a big prostate, all operations were uneventful and successful.

A very interesting session. I love to see the reaction of my colleagues when they come to visit, they leave convinced that this laser, well used, can work wonders on the treatment of BPH patients.

Surgical weekend in Bulgaria

Again I travelled to Sofia, for another surgical weekend. I worked hard at the Hill Clinic and then returned to Madrid.

I am always happy to know about the patients operated in previous sessions, and the feedback is fantastic, the results of GreenLEP (GreenLight Enucleation) are very good.

In this visit the marketing department of the clinic took some photos and gave me some for the blog.

In this photo during an operation at Hill Clinic. It is a very fast and efficient surgical room, it is a pleasure to work there.

In this photo with some members of the Hill Clinic team, with Drs Kocev and Georgiev in my right hand side and Dr. Bocevsky (with a white gown in my left hand side). With a blue head cover, Petia, a wonderful nurse who is really good and helps me during the operations.

Surgeries in Bergamo

Today I traveled to Bergamo, Italy, to help Dr. Deiana and Naspro with their first cases with the GreenLight XPS laser at the Ospedali Riuniti di Bergamo.

In the photo with Dr. Naspro this morning. We had very interesting discussions about the use of different types of lasers for the treatment of BPH...

Then I returned to Madrid late at night.

Surgeries in Ospedale San Antonio, Padova, Italy

Again I flew to Italy to participate in a surgical session at the Ospedale San Antonio in Padova, Italy. I did two operations with Dr. Del Bianco, on two patients with prostatic sizes of 80 cc and 70 cc, that went very well.

They have a fantastic urological surgical center, with three operating rooms only for urology.

A tough day, I departed Madrid at 6 am and returned at 12 pm... very tired!

Cirugías con el Dr. Gastón

Today we had another surgical session with Dr. Gaston at the
Clínica CEMTRO in Madrid.

He is an exceptional laparoscopist and his anatomical knowledge of the prostate and his surgical resources are unparalleled. Helping him operate is a true privilege. I had a great time operating with him and with Dr. Estefanía Romero. The surgeries were a true surgical masterclass.

He has also mentioned his intention to invite me to participate in a GreenLight laser training workshop he wants to organize in Bordeaux. It will be an enormous pleasure to collaborate with him in whatever he needs.

Surgeries in Bulgaria

I spent this weekend in Sofia, Bulgaria, where I did a surgical marathon of laser prostatectomies at the Hill Clinic. It was very cold, and Sofia was covered with snow. This was the view from the doctors resting room at the clinic.

All surgeries went very well. The GreenLEP technique detaches the adenoma from the capsule in one piece and we push it into the bladder and later we aspirate it out with a special device called morcellator. This technique has progressively evolved and is now very structured and reproducible. I am thinking this is the moment to start working on a video that describes the steps of this wonderful technique so I can publish it here.

Surgeries in Treviso, Italy

On thursday I left early in the morning to Italy, to perform a surgical demonstration with the GreenLight XPS 180 watt at the Civil Hospital of Treviso. There I was with Prof. Maccatrozzo, Dr. Merlo and Dr. Paolo Guaitoli, who came all the way from Udine to watch the surgeries (the last two doctors in the photo below).

I had a first patient with a monster prostate with a huge median lobe and I had to perform a hybrid technique. At first I could not enter the bladder with the laser cystoscope due to the humungous median lobe. I vaporized the lateral lobes using 600.000 joules and then I found the capsular plane on top of the veru montanum to progressively enucleate the median lobe until it was hanging from a small pedicle at the bladder neck. Then I used a bipolar resectoscope to resect the median lobe, in a totally bloodless fashion, and when we weighted the prostate chips, 70 grams! We checked with intraoperative transrectal ultrasound that we had removed the whole adenoma... a difficult case, but we managed it safely. The second patient had a smaller prostate and we did a good job too. I really enjoyed the session.

Then I went to the airport, where I had to wait to leave to Sofia, Bulgaria, because the airport had been closed due to heavy snowing. Finally I got there at 2 am...

Italian visitors

Today we had a surgical session with three operations with the GreenLight XPS laser for the treatment of benign prostatic hyperplasia (BPH). We received the visit from four italian urologists interested in this type of laser. The operations went very well and we had a chance to talk in depth about the basic science and the different properties of various wavelengths.

New book chapter: PELVIC PAIN

Soon the new book "Pelvic Pain", edited by Mary Montenegro, will be available. We have contributed with a chapter on myofascial syndrome in patients with chronic pelvic pain.

The book can be found here.

Conference in Edinburg, Scotland

This thursday night I flew to Edinburgh to participate in the Celtic Urology Network Meeting, that brought together urologists from Scotland, Wales and Ireland, in an update session on the treatment of Benign Prostatic Hyperplasia (BPH).

I really liked to reach Edinburgh, a wonderful city. That night I had dinner with my friend Dr. Andy Thomas, and I got ready in the morning for my talk later that day.

I could only take this photo of the attendees. I spoke about the anatomic photoselective vaporization of the prostate as well as the GreenLEP (GreenLight Enucleation of the Prostate). I had a great time.

Then I returned to Madrid to spend the weekend, I could not enjoy Edinburgh enough, but I really look forward to coming back some day.

Visitor from Dubai

Today we received the visit of Dr. Ismail Abbara, from Dubai, who came to visit us and witness some surgical procedures with the GreenLight laser for the treatment of BPH, at our operating room at Clínica CEMTRO in Madrid.

I performed two anatomic vaporizations and a GreenLEP procedure (GreenLight Enucleation of the prostate) that went very well. Then we could enjoy dinner together, very nice. He said he wanted to invite me to perform a live surgery in a congress in Dubai in the next future.

Surgeries in Lebanon

This time I came to Beirut to accompany Dr. Imad Ghantous at the Hôpital Libano-Français, in Zahle, a city near Beirut.

We had a very tough schedule, with six surgeries and a talk to the hospital doctors, as well as other urologists who came to see the session.

I explained the basic science, the interaction of laser with prostatic tissue, basic concepts that are very important and need to be clearly understood in order to work with this laser.

A tough day, but very successful, all operations went well. The following day I returned to Madrid, a long trip Beirut-Rome-Madrid. I am starting to feel that I need to rest this Christmas.

Surgeries at Ospedale San Antonio, Padova, Italy

Today I flew to Bergamo and drove towards Padova, where I performed two operations in two patients with benign prostatic hyperplasia, to demonstrate the new technique of anatomical vaporization of the prostate with the GreenLight XPS laser.

There I was hosted by the head of the department of urology, the kind Dottore Massimo del Bianco. We spent a very nice morning in the operating theatre, discussing pros and cons of this laser and the effect of the economic crisis in the Italian healthcare system. The operations were successful and I could demonstrate the benefits of this technique for the patients.

Then I departed to Rome, to connect to Beirut. A very tough trip, I arrived in Beirut after 3 am...

Surgical session in Sofia

Again I travelled to Bulgaria to operate patients with big prostates at the Hill Clinic in Sofia. It started snowing showing that Christmas and the end of the year is near. Everything comes to an end!

New paper on European Urology

Yesterday I saw in European Urology the new paper I have published with other international experts in laser treatment of BPH (Benign Prostatic Hyperplasia), analyzing the results obtained with the new GreenLight XPS 180 watt laser.

It is the analysis of the early experience with this laser, that is very satisfactory.

This is the first paper published with results of this new laser in the world, and it surely will be thoroughly cited.

Surgeries with Dr .Gaston, from Bordeaux, France

Today I woke up early to pick up Dr. Richard Gaston at the airport. He came to operate two patients with us, to perform two radical laparoscopic prostatectomies.

As always, we operated with him Dra. Romero, from our team at ICUA, and myself, with the added pleasure of receiving the visit of two local urologists. Dr. Gastón told me today that he will operate this year more than 500 patients at Clinique Saint Agustin. He is a true genius of surgery and his knowledge of the micro anatomy of the prostate is amazing.

He also commented that he wants to invite me to visit Bordeaux so I can show them our technique of laser treatment of BPH. 

Visit of Prof. Amici, from Rome

Today we received the visit of Prof. Amici, from the Ospedale Fatebenefratelli Isola Tiberina in Rome, Italy. I did two operations to show the anatomic vaporization concept, very interesting cases. The first patient had a 75 cc gram prostate with a big median lobe. I did a mixed technique, vaporizing lateral lobes and enucleating the median lobe into the bladder, and later morcellated it. The second patient had a smaller gland, about 40 cc, I did an anatomic vaporization down to capsule in 35 minutes.

I could demonstrate with intraoperative transrectal ultrasound how it is perfectly possible to perform a radical vaporization of the adenoma, with no bleeding, in a simple and fast way. I think he was convinced that this laser GreenLight XPS allows to perform a fantastic job with minimum morbidity. I think I will go to his hospital soon to help him perform his first cases.

Surgeries in Buenos Aires, Argentina

This weekend I went to Buenos Aires, where I was invited by my friends Edgardo Becher, Marcelo Borghi and Victor Chernobilsky, from the prestigious Centro de Urología de Buenos Aires.

The Centro de Urología is an ambulatory surgical center where they have already operated more than one thousand patients with the GreenLight Laser. The objective of my visit was to help them start with the GreenLEP (GreenLight Enucleation of the Prostate) technique, so that they can offer this to their patients, specially those with bigger prostates.

Dr. Borgi, happy after finalizing an enucleation procedure

It is a great pleasure to work with expert surgeons, they had no problems to grasp the technique, we only had to polish small but important details to do this kind of operation, that is technically more demanding than simple vaporization.

I had a great time with them, they are wonderful urologists and remarkable human beings, now even more friends.