Originally posted February 28, 2015

This weekend I operated at Hill Clinic in Sofia, Bulgaria and we received the visit of Dr. Bertrand Lukacs, from Hospital Tenon in Paris and Dr. Andy Thomas, from ABM university NHS trust in Wales, United Kingdom. They were very interested in learning the Green Laser En Bloc Enucleation of the prostate technique.

We shared two days of surgical procedures and I was able to share all the details of this technique. They both returned happy and impressed by the quality of the team work we carry out at Hill Clinic in Sofia.

Originally posted February 25, 2015

Again we received the visit of various urologists to our surgical room at Clinica CEMTRO, to witness the new techniques to operate benign prostate hyperplasia with the GreenLight laser.

This time we received the visit of Dr. Serafín Novas, from the Hospital de Santiago de Compostela, Dr. Antonio Jalón, from the Hospital Central de Asturias, Dr. Ana Soto, from the Hospital de Castellón and Dr. Cambronero, from the Hospital Infanta Leonor in Madrid.

Realizamos cuatro intervenciones que transcurrieron fenomenal. Siempre pedimos a los visitantes que firmen en nuestro libro de visitas.

Originally posted February 20, 2015

This time I went to Linz in Austria to help Dr. Sommerhuber with his first steps with the GreenLight En bloc Enucleation of the prostate technique.

Linz is a small Austrian city with a beautiful cathedral. 

We went to the Hospital in Linz, they had programmed five patients in two days. The hospital has a very active urology department, that participates in many international research projects. The first day I performed the first operation in a patient with a huge prostate gland, then Dr. Sommerhuber did the rest of the operations with my hall. It all went well and he had no major difficulty with the learning process. I believe this technique can be taught and learned by surgeons without major difficulties.

Dr. Luebke, from Germany, joined us during the session. He had already been visiting us in one of the training sessions in Sofia, Bulgaria. He also wants to learn the technique and he felt that it was a great experience to witness the difficulties Dr. Sommerhuber faced and he thought it was a very good experience that would help him with his own learning process.

Originally posted February 15, 2015

This time I had to travel far, to Boston, where there was a winter storm with terribly low temperatures, to help Dr. Shahin Tabatabaei, associate professor at MGH - Harvard University, to polish his technique of GreenLight En bloc enucleation of the prostate. He already came to visit me in Bulgaria and saw many cases and had initiated the technique on his own, but wanted to improve and learn some tips and tricks.

We spent the first day at the operating room, we did two very difficult cases of patients with large glands that took their time. The rest of the surgeries were cancelled because the city was blocked by the snow.

Both cases went very well and Dr. Tabatabaei was able to extract a huge adenoma from one of the patients.

The second day I participated in a training session for residents and urologists of the hospital with Dr. Tabatabaei.

We first gave two short talks on the principles of laser surgery and then we worked with the residents with the surgical simulators and studied the surgical instruments necessary for this technique.

The following day I gave a talk at the department Grand Rounds session to present the En Bloc Green Laser Enucleation technique. It was very interesting and we had the honor of receiving the visit of Lori Lerner, famous for her dedication to Holmium laser enucleation, who added her experience to a very intense and interesting discussion. The urologists from MGH thought this is a very interesting new avenue for the treatment of BPH and Dr. Tabatabaei is going to continue to perform it and I hope we can participate together in a multi center international study that is going to start soon.

The last day of my stay in Boston we went back to the operating room for another surgical session, that also went very well. Dr. Tabatabaei chose very complex cases and we spent the day operating.

I got this diploma as a reminder of my stay in Boston. It has been a great honor for me to share with my colleagues in Boston and to collaborate once again with my friend. Dr. Tabatabaei.

Finally I returned to Madrid, despite the weather getting worse, I managed to take off just in time to celebrate my birthday (I am now 47!).

The following day they cancelled 1800 flights in the northeast of USA, due to the intense cold.

Originally posted February 6, 2015

This time I went to this impressive hospital in Paris, to demonstrate Prof. Arnaud Mejean the new techniques of anatomic vaporization and En Bloc Enucleation of the prostate with the GreenLight laser for the treatment of BPH.

I performed three operations during the morning that went very well. Dr. Mejean showed me the department of urology, really impressive.

We had the chance to discuss the role of the GreenLight laser in the treatment of BPH and I insisted in the importance of proper training to obtain optimal results. He was very impressed with the operations, we could operate a patient with a prostate over 100 g in less than one hour.

Originally posted February 5, 2015

Again I travelled to Modena to operate with Dr. Ferrari patients with BPH (Benign Prostatic Hyperplasia). I reached the Ospedale Hesperia by car from Bologna, it was very cold and snowed all day long.

This time I helped him with his cases of GreenLEP (En bloc Greenlight laser enucleation of the prostate). I could ascertain one more time how this technique can be taught and learnt. Dr. Ferrari performed two cases wonderfully and independently. He is a great surgeon.

From Modena I travelled to Paris that night, to participate the following day in another surgical session.

Originally posted January 29, 2015

I went to Bilbao to participate in the annual meeting of the Endourology Group of the Spanish Urological Association.

The round table was moderated by Dr. Rodriguez Antolín and I participated with Dr. Placer (Holmium laser) and Dr. Ruibal (laparoscopic adenomectomy), my role was to defend the role of GreenLEP (Green Laser Enucleation of the Prostate).

Con el Dr. Placer (centro) y Ruibal (derecha)

I briefly presented the development of the GreenLEP technique, how to learn it progressively, starting with anatomic vaporization and hybrid operations, and the results obtained in the last 5 years.

I tried to express my conviction that we have to abandon conventional open surgery and TURP once and for all, and that there is no sense in doing laparoscopic adenomectomy when we have safer and less invasive techniques as laser enucleation. All the departments of urology in the world should embrace laser prostatectomy, making whatever efforts are necessary to learn and to replicate the excellent results we can achieve with Green and Holmium lasers.

Originally posted January 28, 2015

Today we received the visit of Dr. Francisco Bon and Dr. Alfredo Bohorquez from Hospital Dr. Peset, Dr. Narcis Camps, from the Hospital de Bellvitge, Dr. Virgilio Vaz, from Portugal, and Dr. Ramón Abascal from the Hospital General de Asturias.

We performed at Clínica CEMTRO a surgical session with 4 patients. I could demonstrate the different existing techniques for the treatment of BPH, anatomic vaporization, vapo-enucleation and the "en bloc" enucleation with the GreenLight laser.

Everything went very well, it is always a pleasure to receive the visit of other colleagues and to share with them!

Originally posted January 27, 2015

Again I flew to Porto to reach Coimbra with Dr. Antonio Oliveira, who is determined to learn the En bloc GreenLEP (GreenLight Enucleation of the Prostate) technique.

We went to the Hospital Idealmed to perform three operations. All patients had prostates over 100 cc.

I was very happy to see the fast progress that Dr. Antonio Oliveira had, he is now independent in the performance of this operation. I helped surpass some minor difficulties in two of the cases, but he was able to complete one on his own.

I am very proud to see that this technique that took me five years to develop is now reasonably easy to teach and learn and I liked the interest and determination of Dr. Oliveira to learn properly.

The following day we went to another hospital, the Hospital at Oia, to do another case. Dr. Oliveira completed it perfectly well!

Then I returned to Madrid to rest for the weekend. I was happy thinking that this technique is going to help a lot of patients.

Originally posted January 22, 2015

Again I travelled to Italy. I went to Milan and slept there, and then drove to the Ospedale di Guastalla, near Parma. In this occasion I had to help Dr. Frattini with his learning curve of anatomic vaporization of the prostate. This technique I developed is becoming the standard technique for Green Laser vaporization in Italy.

Two of the patients had very large glands, over 120 cc, and I performed an En Bloc enucleation of the prostate with the Green Laser. Both went very well. Al the urology staff was there for the session. Then I endured two more hours in the car back to Milan to take a late return flight to Madrid. These sessions are nice and gratifying but it is a hard job!

Originally posted December 17, 2014

Again we organized a surgical course at Clínica CEMTRO, several foreign as well as national urologists joined us for the course.

I performed five operations that went very well. I could demonstrate the different techniques that can be carried out with the GreenLight laser, the anatomic vaporization, the vapo enucleation technique and the En Bloc enucleation (GreenLEP).

We received the visit of the french urologists Marc Shenider y Ludovic Obringer (Colmar), François Faur (Strasburg) y Daniel Gassman (Paris). Also two portuguese urologists joined Dr. Bruno Graca and Dr. Ferreira Coello (From the Hospital de la Luz at Lisbon) and we hosted as well two spanish urologists  Dr. Leticia López Martín, from the Hospital Fundación Jiménez Díaz in Madrid and Dr.  Jorge García Rodriguez, from the Hospital Universitario Central de Asturias.

Originally posted December 4, 2014

From Paris I flew to Rome to participate in the 5º Corso di endoscopia del basso aparato urinario at the Policlínico Gemelli de Roma, Of the Universitá del Sacro Cuore

They invited me to demonstrate the technique of anatomic vaporization of the prostate in a patient with a moderate enlargement. The Hospital has a beautiful statue of Juan Pablo II in the entrance, and patients and family members of patients make the sign of the cross when they see it.

The operation went very well and I managed to explain the evident advantages of this technique over the traditional transurethral resection of the prostate (TURP). Before it was my turn to operate I watched the other scheduled operations, as the TURP with suprapubic trocar.

Frankly, to me it was like traveling back in time to the pleistocene. In our center we abandoned open surgery and TURP many years ago.

The program had a lot of delay and I finally arrived late to Madrid, as almost always. Very tired after so much work and wishing to rest during the bank holiday.

Originally posted December 3, 2014

After my visit to Hopital Tenon with Prof. Lukacs, I went to Hopital Saint Joseph, to visit Dr. Hervé Baumert. We had met years ago as he helped us to organize laparoscopic courses in Madrid.

It was a pleasure to see him again. He had prepared two patients to operate with the GreenLEP technique. Their prostates were not excessively big, about 80 g.

Both cases went very well, despite not having the optimal instruments to perform the operations.

It is important to use a cystoscope with a blunt tip and there must be some space between the telescope's tip and the cystoscope's tip to allow for direct visualization of the mechanical dissection as it is being performed.

Everything went very well, it was a pleasure to see Hervé again. A great French Urologist.

Originally posted December 3, 2014

I travelled to Paris the night before in order to start early in the morning. Dr. Lukacs received me at Hoptial Tenon in Paris. He had prepared a patient with a 150 g prostate for the session.

I performed a GreenLEP and the operation underwent really well, allowing me to show him all the technical details.

When we finished the operation we obtained 110 g of morcellated tissue. Dr. Lukacs was very impressed by the technique and by the fact that the patient can leave the hospital the following day.

Then we went to his office and he showed me his recent investigations on voiding cystoscopy, that consists in visualizing the micturition dynamics directly. He has observed different kinds of obstruction that might benefit from minimally invasive operations aimed to preserve ejaculation. It seemed all very revolutionary to me. A great man Dr. Lukacs and a scientist that thinks "out of the box".

Originally posted November 30, 2014

Again I went to Sofia to participate in another training session. This time we had two visiting surgeons Dr. Montaña from Uruguay and Dr. Muñoz, from Perú.

Both enjoyed the experience and were amazed by the incredible team work we carry out at Hill Clinic.

Originally posted November 27, 2014

Today I took the high speed train to Barcelona to participate in a course on GreenLight for the treatment of Benign Prostatic Hyperplasia.

I gave a talk on the new techniques, anatomic vaporization, capo-enucleation and enucleation and then we had an animated discussion with the attendees.

Then I returned to Madrid. Despite the high speed train being fast and convenient, going and returning in the same day is 6 hours in the train!

Originally posted November 26, 2014

Yesterday I flew early to Gran Canaria to help Dr. Juarez del Dago, urologist and good friend, to operate a patient with a huge prostate gland.

We went to Clinica San Roque and there we performed a Green Laser enucleation of the prostate in a man with a big gland, with more than 150 g of adenoma. The operation went very well and we could finish it in 90 minutes. After the operation we started a bladder irrigation and the bleeding was minimal.

He had a huge middle lobe and this interestingly does not complicate the operation at all. Thanks to the new Richard Wolf morcellator blades VMax we could take out all the tissue in less than 20 minutes. This technique is incredible and it allows us to do things that seemed impossible some time ago. We hope the patient can return home the morning after the operation without a catheter!

Originally posted November 20, 2014

Again I travelled to Italy to work at the Azienda Ospedaliero Universitaria Careggi in Florence.

My role was to perform four operations to demonstrate the GreenLight laser in the treatment of patients with Benign Prostatic Hyperplasia. One of the cases was a man with a huge prostate gland, 170 g, who was a Jehovah's witness, and thus did not want to accept the chance of a blood transfusion.

Everything went well and I could return home that night after a long day of work and travel.

Originally posted November 19, 2014

Today we received the visit to our operating room at Clínica CEMTRO of various foreign and spanish urologists. We had programmed four operations for the course. We welcomed Dr. Scanzi Mauro, from the Ospedale de Brescia in Italy, Dr. Alessandro D'Addessi and Dr. Giuseppe Gentile, from the Policlinico Gemelli in Rome, Dr. John van der Hoeven, from Holland, Dr. Abad from Hospital Parc Tauli, in Sabadell, Spain and Dr. Leticia López from the Fundación Jiménez Díaz, in Madrid.

We also welcomed Dr. Emanuel Montaña, from the Hospital de Clínicas in Montevideo, Uruguay and Dr. Carlos Muñoz from Hospital Rebagliati in Lima, Perú, who will be rotating with us at ICUA the following two months.

El Dr. Muñoz y el Dr. Montaña, nuestros rotantes