Originally posted February 15, 2013

This time I arrived in Bulgaria from Istanbul. From the airport I went to Hill Clinic, where we had prepared a surgical session with 11 patients suffering from Benign Prostatic Hyperplasia in two days.

The session went very well and it took place the day of my 45 birthday. My colleagues at Hill Clinic had prepared me a surprise, a picture inspired in Star Wars, where all the urologists from the clinic appeared with their laser sabers... I really loved it. I cannot hide that my fascination for lasers was born the day I watched this movie for the first time when I was 11 years old.

I always enjoy operating at Hill Clinic, the work atmosphere is exceptionally good and operating so many patients in a short time is always a wonderful learning and technical improvement experience.

We celebrated my birthday with a wonderful chocolate cake! Thank you very much Hill Clinic!

Originally posted February 14, 2013

Again I travelled to Modena to operate with Dr. Giovanni Ferrari. It had snowed and it was very cold. Dr. Ferrari had prepared four patients and we had a very interesting surgical session where I performed a GreenLight Enucleation (GreenLEP), a vapo-enucleation and two anatomic vaporizations. Everything went very well.

We had the visit of two urologists from other Italian hospitals to watch the operations. We stopped to eat some pasta in the middle of the session.

I enjoy these sessions with Dr. Ferrari in Modena. That night I took a flight to Istanbul and I slept at the airport to leave to Sofia, Bulgaria, the next morning.

Originally posted February 12, 2013

Yesterday I received an invitation to participate at a congress with live surgery transmission in Croatia in the month of April. I am asked to perform two operations in two different days. The program looks very attractive!

Originally posted February 9, 2013

I spent the weekend with Dr. Juarez en Gran Canaria, the head of the Gabinete de Urología y Andrología.

He invited me to help him with a patient who had a huge prostate gland, and we performed a GreenLight Enucleation technique.

Everything went really well. The patient had carried a urethral catheter for six years (sometimes we surgeons see this kind of thing, impossible to understand how he bore this). The next morning we took out the catheter and he could void perfectly.

As always, I enjoyed very much Dr. Juarez's company and we had a great time in Gran Canaria enjoying the atmosphere of the carnival.

Originally posted February 7, 2013

This time I traveled early to Bologna to visit the Hospital in San Giovanni in Persiceto, with Dr. Bulli and Dr. Bordini. They had prepared three high risk cases to operate with the GreenLight XPS laser.

I performed three operations in the morning that went really well, and I could show the subtleties of the capsular localization technique. I had a great time, they were all so nice people. Then we had a lunch that they kept jealously in the doctor's room.

Then I went to Verona to return to Madrid via Munich, that was all covered in snow. I was lucky we could finally depart. The following day I had to travel to Gran Canaria to operate with my good friend Dr. Juarez.

Originally posted February 6, 2013

Today we received the visit from two foreign urologists. Mr. Stuart Lloyd, from the UK and Dr. Canclini, from Italy, at Clínica CEMTRO

I performed three operations, showing the anatomic vaporization, the vapo-enucleation and the ejaculation preserving technique and we had a very nice afternoon commenting all the technical details.

Originally posted January 31, 2013

Today I drove to the brand new Hospital de Torrejón to help my friends urologists at the hospital to perform their first cases of HoLEP (Holmium Laser Enucleation of the Prostate). It is a very difficult to learn technique for the surgeon, and I helped them through the operations. My nurse Vanesa came with me to instruct the local nurses in the subtleties of the instrumentation of this technique.

We did two cases that went very well. Dr. Luis Llanes is the head of the department of Urology at this hospital and my colleage as well at Clinica CEMTRO. I liked the Hospital very much and I enjoyed being with my friends sharing my passion for laser surgery of the prostate!

Originally posted January 31, 2013

I have received an invitation to participate in the World Congress of Videourology that will take place in Casablanca in April, to participate in a session on the treatment of benign prostatic hyperplasia.

Originally posted January 30, 2013

Today we had 3 laser surgeries scheduled, and we had 3 visitors from Israel who wanted to witness the procedures!

Originally posted January 28, 2013

This time I flew to Milano, where I slept, and then I woke up early to take a train to Bologna, to visit the Ospedale Santa Ursula Malpighi, chaired by Prof. Giuseppe Martorana. It is the second biggest hospital in Italy and I was impressed to know that the department of urology had 73 beds!

There they had prepared a surgical session with 5 patients, we did 4 vaporizations and one GreenLEP (GreenLight Enucleation of the prostate) in a record time. We worked in two operating rooms simultaneously, and as I was finishing one operation they were preparing the next patient, so I worked non stop all morning. Quite an experience, and all cases went really well.

This way the urology department could ascertain the versatility of the GreenLight Laser for the treatment of BPH, with the different variants, vaporization, vapo-enucleation and enucleation followed by morcellation.

Then I gave a brief talk to the residents of the department on this laser. Dr. Martorana invited me to participate in a congress with live surgery in his department later this year.

I went to have some delicious pasta and then I returned by train to Milano to take the flight to Madrid. A great experience!

Originally posted January 25, 2013

This time I went to Rome to perform a surgical demonstration with the GreenLight XPS laser at the
Policlínico Universitario Tor Vergata, the urology department is chaired by Prof. Vespasiani. Dr. Roberto Miano accompanied me, he has a lot of interest in becoming a GreenLight surgeon.

I performed three cases in three patients with Benign Prostatic Hyperplasia. An anatomic vaporization, a vapo-enucleation (enucleating the middle lobe) and an En-bloc GreenLight enucleation of the prostate (GreenLEP), in which we used a morcellator to extract the tissue for histological analisys.

The session generated a lot of interest and there were many urologists and residents watching. Two days later Dr. Miano informed me that patients had fared very well.

I slept in Rome and the following morning I went to Hospital Villa Claudia to perform another surgical demonstration to Dr. Roberto Giulanelli, and we had also the visit of Dr. Tonino Lagana. I did two operations on two patients with BPH who had recurred after a previous TURP (Transurethral resection of the prostate). One anatomic vaporization case and one vapo-enucleation that went very well.

It is always a pleasure to go to Italy. After finishing the session I returned to Madrid to try and rest a little during the weekend. Due to my trip to Bulgaria the previous week, this has been a 15 day non stop working week...

Originally posted January 22, 2013

My first trip of 2013 has been to Sofia, to participate in another surgical session in which we performed 15 GreenLEP procedures (GreenLight Laser Enucleation of the prostate) in four days. I was happy to hear that all patients from the previous session were doing well.

Several patients had advanced BPH (Benign prostatic hyperplasia) with big prostates and bladder stones. In such cases we first pulverize the stone with Holmium laser and then we perform the GreenLight Enucleation procedure.

The new Vmax blades for the Piranha morcellator have changed our lives, morcellation time has been reduced to more than half, now procedures are much faster.

It started snowing and everything turned white... winter is tough in Bulgaria.

Originally posted January 13, 2013

Today I got the news that the abstract we sent to the AUA (American Urological Association) Annual Congress for this year has been accepted. It is another paper from the IGLU (International GreenLight Laser Users Group) that includes our experience with the GreenLight XPS 180 watt laser from the year 2010 at the Instituto de Cirugía Urológica Avanzada, in Madrid.

Originally posted December 16, 2012

Again I travelled to Sofia for another surgical session. I departed on Sunday with the intention of operating the same day, but the plane broke down and I had to spend the whole day at the airport... finally I got a new flight and managed to reach sofia after a true horrible day at several airports...

The two following days we operated patients at Hill Clinic, some with very big prostates, with the help of the wonderful urologists at Hill, Dr. Kocev, Dr. Botzevski, and Dr. Georgiev. The combination of the "en bloc" enucleation technique and the new Vmax blades for the Piranha morcellator allows us to operate big glands in a reduced time.

This prostate weighed approximagely 170 grams and it only took 17 minutes to morcellate it. To me this represents a true step forward in enucleative surgery for the treatment of BPH.

The session went very well and then I returned to Madrid. Christmas holidays are approaching and I feel like resting a little!

Originally posted December 12, 2012

Yesterday afternoon, the mythic 12-12-12, we received the visit of two italian urologists, Dr. Claudio Dadone and Dr. Oscar Fenice at Clínica CEMTRO in Madrid. The GreenLight laser is generating a great interest in Italy!

Also we were joined by Dr. Julio Fernández del Álamo, from the Hospital of Torrrejón in Madrid, who is very interested in learning the enucleation technique. Julio works with Dr. Luis Llanes, my partner at ICUA in Madrid, an expert in the endourological treatment of stones and head of department of this hospital.

We performed two surgeries, an anatomical vaporization and a GreenLEP (GreenLight Enucleation of the prostate), that went very well. Then we went for dinner to el Corral de la Morería, a Flamenco restaurant, we had a great time!!!

Originally posted December 11, 2012

This time I went to Modena via Milán. I rented a car to drive to Modena and I slept there to start in the morning with a new surgical session with Dr. Giovanni Ferrari at Hesperia Hospital. In this occasion we were joined by Dr. Lorenci and Dr Malossini, from the Ospedale di Trento,  who came to see the operations.

We did four operations that went really well, one of them was relatively more difficult, a man with a huge prostate. We did a GreenLEP procedure (GreenLight Enucleation) and we extracted 160 grams of tissue with the Piranha Morcellator from Wolf. I then had to return driving to Milan and took a plane back to Madrid.

Dr. Ferrari told me the next day that all patients were feeling well!

Originally posted December 7, 2012

This time I was invited to participate at the congress "Innovations and Classics in Endourology and Imaging" that took place in Mannheim, Germany.

My role at the congress was to perform a GreenLight Enucleation of the prostate (GreenLEP) procedure, that was transmitted to the main auditorium at the Rosengarten Congress Center.

The patient they selected was very complex. Had a huge prostate and bladder stones, but everything went very well. The transmission time was reduced, but I could demonstrate the basis of the GreenLEP technique, specially useful in big glands.

It was a great honor to operate in the hospital where Dr. Peter Alken developed percutaneous renal surgery, I had a great time.

Originally posted November 30, 2012

This time I went to the University hospital in Brest, France, to participate in a meeting of urologists who are trainers of other urologists in the GreenLight Laser use for the surgical treatment of BPH in Europe.

The objective of the meeting was to unify criteria as well as to share ideas and knowledge. The meeting was hosted by Prof. Fournier, who told us about his experience and who showed us the technique for continous intraoperative monitorization of laser vaporization with transrectal ultrasound.

Dr. Fournier came to visit me in Madrid in September 2009, and already then we commented the importance of transrectal ultrasound (TRUS) as a quality control of the procedure. I normally use TRUS before the procedure and at the end of it, or intraoperatively if I find it necessary, but only punctually.

Prof. Fournier has developed in these years a very ingenuous way to use a standard TRUS device to monitor the operation continuously in a very simple way. I loved the idea and I think it would be most useful for surgeons learning the procedure.

This way the surgeon has two views, the endoscopic view and the ultrasound monitoring in the same screen, very interesting.

I contributed presenting the different technical variations I use with the GreenLight laser, the anatomic vaporization with capsular localization, the vapo-enucleation and the GreenLEP (GreenLight enucleation procedure). I believe both approaches are compatible.

A very interesting meeting in the company of my colleagues, also passionate for prostatic laser surgery.

Originally posted November 21, 2012

Today I went to the Spanish National Television - RTVE, to participate in the program "La Mañana de la 1", with the famous Mariló Montero.

As always, it is a lot of fun to participate, and I had a great time. We spoke a little bit about pelvic floor problems and we demonstrated the new 3D laparoscopic system from Storz, that allows us to operate with 3D vision inside the abdomen, using a dummy patient.

Here below, the full video.

Saber vivir - Vejiga y próstata

• Saber vivir - Vejiga y próstata

Originally posted November 17, 2012

Again we had a two-day surgical session at the Hill Clinic in Sofia, Bulgaria.

In this session we operated 10 patients in two days with the GreenLEP technique (GreenLight Enucleation of the Prostate). The technique has been improving and now we can start the procedure with an apical dissection, liberating the external sphincter from the apex of the adenoma, which protects it much better, and the surgical time is greatly reduced.

In this occasion, we had the visit of Dr. Andrés Sempere. He trained as I did at the Hospital de La Princesa in Madrid, he just left as a certified urologist when I became a first year resident. Dr. Sempere is going to start working in Dubai soon, and he wanted to learn this enucleation technique. We had a great time!