Originally posted February 12, 2014

This time we had two days of surgeries at Clinica CEMTRO with 4 patients programmed for surgery on tuesday and 3 on wednesday. We received the visit of Stefanie Thiele, Michael Gebauer and Luz Velázquez from AMS (American Medical Systems). This company manufactures the GreenLight laser we normally use.

They came to witness the Green Laser Enucleation of the Prostate Technique for the treatment of BPH that we performed throughout the two days.

On wednesday we also received the visit of Dr. José Ramón Pérez Carral, from the Fundación Hospital Alcorcón and Dr. Leticia López Martín, from the Fundación Jiménez Díaz, who also came interested to see this technique.

It was an intense session, with many surgeries, that went very well.

Originally posted February 7, 2014

Again I travelled to Gran Canaria to help Dr. Juarez with a patient who had a big prostate gland due to BPH (Benign Prostate Hyperplasia). We performed a Green Laser Enucleation of the prostate and everything went very well.

Dr. Juarez is the organizer of the XX Canarian Meeting on Andrology and Sexual Medicine and he invited me to participate speaking on the impact of surgical treatment of BPH for the sexual function of the male.

Originally posted January 31, 2014

This time I travelled to the Hill Clinic in Sofia, Bulgaria, to operate 9 patients in two days.

We had two international very prestigious guests, Dr. Henry Woo, Professor of Urology of the University of Sydney and Dr. Rainer Schmidt, from Germany, who already came to Madrid to visit us some years ago.

They are both international experts of Green Laser treatment of BPH (Benign Prostate Hyperplasia) and they both train urologists in their respective countries. They have both published extensively in international peer-reviewed urology journals. They came to Bulgaria to see for the first time the Green Laser En Bloc Enucleation technique that I developed during the last four years.

The operations went very well and they were impressed with the speed, safety and elegance of the technique. The truth is that it is a beauty and I think it will be more and more considered and important in the urological world.

Hill Clinic organized a press round due to its nomination as a European Center of Excellence in the treatment of BPH with the GreenLight laser. In the photo, Dr. Woo and myself with all the cameras in the back who came from the 5 Bulgarian TV channels to interview us.

Dr. Woo is editor of CME (Continuous Medical Education) of the British Journal of Urology (BJU International) and is always commenting things with Twitter. This time he made this comment of the session.

We had a great time and I was delighted to be able to show the result of very tough work during the last 4 years to my colleagues and I am proud to see that they appreciate it and consider it relevant. Both went home happy and willing to offer this technique to their patients.

Originally posted January 25, 2014

Today I performed a live surgical demonstration of a Green Laser En Bloc Enucleation followed by endoscopic morcellation (fragmentation and extraction) of the tissue (this is the technique I developed) at the Hospital Complex in Oporto,

The operation was retransmitted to the congress meeting room and it was recorded to be used as a webcast at the SIU (Société Internationale d'Urologie) website. I suppose they will publish it online soon.

I was constantly communicating with the meeting room and they asked me about the technical aspects of the operation. Everything went very well and then Dr. Luis Osorio, the organizer of the meeting, commented that the patient recovered very well.

This operation generates a lot of interest, as it is simple, safe and tremendously efficacious. The patient had a 60 cc prostate with a big middle lobe, and I could finish the operation in 30 minutes.

I could also demonstrate the morcellation with the Piranha morcellator from Richard Wolf, and the new Vmax blades, that are very fast.

Originally posted January 18, 2014

As part of the close and constant collaboration we have at ICUA with the Gabinete de Urología y Andrología of Las Palmas de Gran Canaria, I travelled to the island to help Dr. Juarez del Dago to operate a patient with a huge prostate with the GreenLEP technique (Green Laser Enucleation of the Prostate).

I am more and more convinced of the advantages of this approach for the endoscopic treatment of BPH. The GreenLight laser offers an unparalleled reliable coagulation of prostatic tissue that avoids bleeding during and after surgery. It allowed us to solve the big problem this patient had elegantly and smoothly.

Everything went very well, and Dr. Juarez told me the postoperative recovery was excellent. It is always a pleasure to travel to Gran Canaria, although the weather was a bit fresh this time.

If there is any international reader of this blog who needs laser surgery for his BPH condition, a nice plan would be to contact Dr. Juarez, travel with the family to Gran Canaria for a Holiday and have us operate him over there!

Originally posted January 8, 2014

This is the new technique of "En Bloc" GreenLEP (Green Laser Enucleation of the Prostate) that I have developed over the last 4 years.

It is a very safe procedure and extremely efficacious. Normally we operate patients in the afternoon and they return home the morning after without a urinary catheter. I hope it is useful for urologists wanting to adopt enucleation with this laser type.

Originally posted December 14, 2013

Again I travelled to Sofia, to operate at Hill Clinic.

This time we performed 13 procedures in 2 days, and everything went very well. The GreenLEP procedure is so refined and mature that it is very fast, very safe and the results are extremely good and predictable.

We have worked so much during the last four years that things have simplified significantly. This is a photo of the sterile table where we prepare the necessary instruments. A 26 F laser cystoscope with a 30º lens, some dilators, a nephroscope or morcescope (as we use it for morcellation), the new Vmax blade for morcellation (really important) and the Piranha morcellator, from Wolf, that is not in the photo.

After performing enucleative laser surgery for the treatment of BPH, one understands how superior this technique is to vaporization or transurethral resection, and it is extremely safe!

Originally posted December 12, 2013

Again I travelled to Modena, to Hesperia Hospital, to operate with Dr. Ferrari.

This time we received the visit of three italian urologists, Dr. Timossi, Dr. Canovaro and Dr. Gianella, who witnessed the operations. I demonstrated the GreenLEP technique (GreenLight Enucleation of the Prostate) as well as the vapo-enucleation technique, as we only had patients with big prostates today.

Fortunately we could use the new Vmax blades from the Piranha morcellator, manufactured by Richard Wolf, that allows a super-fast extraction of prostatic tissue from the bladder, cutting down the surgical time!

At the end of the session I drove to Bologna Airport to travel to Sofia sleeping at Istanbul airport... a little tired, but very happy.

Originally posted December 4, 2013

Today we received the visit in our surgical room of Dr. Eduardo Reyes, urologist from Hospital DIPRECA, from Santiago de Chile, who came to witness two laser enucleations for BPH.

Dr. Reyes is going to be in Madrid in a rotation for three months, and will attend our operations during this time at Clínica CEMTRO.

Originally posted November 29, 2013

This time I went to Berlin invited to perform a live surgery that would be transmitted to the audience of the congress at Auguste-Victoria-Klinikum.

This Hospital has been the most active center in Europe in Holmium laser enucleation of the prostate, and his recently retired head of department, Dr. Kuntz, an enthusiastic advocate of laser prostatectomy for many years, very respected all over the world.

Getting ready for the operation and the TV transmission

It has been a great honor for me to have been invited to operate there. My role was to demonstrate the GreenLEP technique (Green Laser Enucleation of the Prostate), but the patient's prostate was so small that I decided to use a mixed technique, vaporizing anterior and laterally and enucleating the middle lobe. Then I showed a video of the GreenLEP technique.

During the operation I communicated with the audience in the congress

I got a tweet from one of the attendees at the congress:

Everything went very well, then I returned to Madrid to rest during the weekend, after two full weeks non stop.

Originally posted November 25, 2013

This time I went to operate to the Hill Clinic and we welcomed Dr. Ruban Thanigasalam, urologist from Australia who was already visiting us in Madrid at Clinica CEMTRO. Ruban is finishing a two year rotation in a Paris Hospital and is about to return to Australia to work.

The objective was to witness enough GreenLEP (Green Laser Enucleation of the Prostate) operations to understand this technique's complexities and we did 9 cases, a very fruitful session. There is yet another urologist convinced of the advantages of GreenLEP for the treatment of BPH.

More and more urologists express their interest to join us in Sofia to see this technique. In principle we plan to do another session on December 13-15th and another one in January 30-31st.

Originally posted November 23, 2013

This time I participated at the annual meeting of the German GreenLight Users Group.

I was invited to give a talk on my experience and ideas about the use of the GreenLight laser for the treatment of BPH and the role of the new techniques I developed, anatomic vaporization, vapo-enucleation and GreenLEP (Green Laser Enucleation of the Prostate).

These techniques are generating a great interest worldwide and more and more urologists are interested in learning them as they allow to obtain improved results in patients with bigger prostates, with minimal risk.

There were many questions at the end, many urologists find hard to believe that these techniques are easy to learn and perform, until they visit us to see them, they feel the enthusiasm and then they learn them.

Originally posted November 21, 2013

This time I went to the Ev. Krankenhaus Hospital, in Witten, Germany, to perform a surgical demonstration of GreenLEP and Anatomic Vaporization. The head of the urology department, Dr. Wiedeman was a very kind host of the session.

I performed two operations that went very well. Dr. Wiedeman has an extensive experience with the GreenLight laser and is convinced as I am that TURP (Transurethral resection of the prostate) is obsolete.

Dr. Schattka also came to see this session and when we finished the second surgery we took this photo with Dr. Wiedeman and his nurse, who helped us really well.

Then I took a flight to Berlin, as I was invited to participate in the Annual Meeting of the German GreenLight users.

Originally posted November 20, 2013

This time I flew to Hamburg and from there I drove to Westerstede, to operate at the Ammerland Klinik, the public hospital in the region, with Dr. Schattka.

At the hospital this morning, prior to starting the surgical session of laser treatment of BPH

The plan was to teach him to perform the new techniques, anatomical vaporization with capsular localization and GreenLEP, Green laser enucleation of the prostate for the treatment of Benign Prostatic Hyperplasia (BPH).

Checking the instruments gently provided by Richard Wolf for this session

I performed three operations that went very well. As always, urologists who watch these techniques are highly impressed and they are convinced that this is the way forward in surgical treatment of BPH.

Performing a GreenLEP at Ammerland Klinik

Then I drove again to Dortmund, to participate in another surgical session tomorrow morning.

Originally posted November 13, 2013

Again we had a visitor at the operating room at Clínica CEMTRO. Dr. Jimmy Lam came all the way from down under to see some procedures.

Dr. Jimmy Lam is a very experienced urologist in the surgical treatment of BPH with GreenLight laser. He came interested in learning the new techniques, anatomic vaporization, vapo-enucleation and Green Laser Enucleation of the Prostate. Surgeries went very well and patients were discharged the following morning.

Originally posted November 4, 2013

Again I participated in the National TV program "La Mañana de la 1" at RTVE.  This time we talked about problems related with urine. I could talk a little about BPH and laser treatment. It is always good fun to go to this TV show.

Saber vivir - Problemas de orina

• Saber vivir - Problemas de orina

Originally posted October 25, 2013

Again I travelled to Bulgaria to operate at Hill Clinic. In this occasion we had a long session with 18 pacients scheduled over a few days.

I did 17 GreenLEP procedures (GreenLight Enucleation of the prostate) that went very well.

These were the specimens for histological analysis from the patients we operated. More than 1 kg of prostate tissue!

It is really wonderful to be able to work at Hill Clinic. The team works like a clock and we work hard but very happy. We are also very satisfied with the results of GreenLEP!

Originally posted October 22, 2013

This tuesday I flew to Gran Canaria to operate a patient with Dr. Juarez del Dago. We are friends from a long time ago and regularly either I go to Gran Canaria or he comes to Madrid to operate together. This time we operated a patient with a big prostate, we performed a GreenLEP (GreenLight Enucleation of the prostate together that went very well).

Then I returned to Madrid that same day.

Originally posted October 16, 2013

Today we had a surgical session scheduled at Clinica CEMTRO and we received the visit of two urologists. One of them Australian (originally from Sri-Lanka), Dr. Ruban Thani-Gasalam, who is finishing a two year fellowship at the Hospital Sant Josef in Paris, with our friend and excellent laparoscopist Hervé Baumert. We also received the visit of a Spanish urologist, Dr. Abel Mateos, from Gijón, Asturias, who had a lot of interest in seeing us work and is considering starting to do laser prostatectomy.

I performed two cases of GreenLight Enucleation in two patients who suffered Benign prostatic hyperplasia. One of them was a patient submitted previously to a TURP, but he had too much residual BPH tissue that caused hematuria and problems with micturition. Both cases went really well and we had a wonderful afternoon together.

I love to see the reaction of urologists watching this technique, they are impressed by seeing the anatomy of the prostate in a way they never did before, by the simplicity of this "en bloc" technique and by the quality of the dissection and preservation of the sphincter. We also commented the importance of the improved morcellation with the Piranha system and the new Vmax blades that cut down the surgical time. The second case was completed in just 35 minutes!

Originally posted October 6, 2013

This time I was invited to perform a GreenLight anatomic vaporization of the prostate at the Congress of the Italian Urological Society, at the Azienda Ospitaliera S. Orsola-Malpighi, in Bologna.

From this hospital, all surgical operations in the live surgery program were transmitted via satellite to the congress center in Riccione, a seaside italian city one hour away from Bologna by car.

They selected a patient with a small prostate with a lot of prostatic calcifications that usually form in the periphery of the adenomatous tissue, that make the procedure a little more complicated.

Despite this, everything went very well, and I could show how to access the prostatic capsule to guarantee a full vaporization of the BPH tissue. In Riccione there were many urologists in the plenary room of the congress watching the procedure. I would have liked to be able to demonstrate this technique in a bigger prostate, as it is more informative, but I did my best to make the most of this case.

In the surgical room next to mine, I met my colleague and ex-older resident from my residence at the Hospital de la Princesa, Dr. Manuel Fernández Arjona, who was also demonstrating the UROLIFT system for the treatment of BPH. I really enjoyed seeing him after such a long time and we had a chance to catch up while we waited to start our procedures. Then we returned to Madrid, as we both have to work tomorrow!