American Urological Association Annual Congress in Atlanta

Tomorrow will be the last day of the AUA Annual congress. This is the most important urological meeting in the world, and every year new tendencies and technologies are presented. I try to visit the USA every year, because here is where important new treatments and trends are presented. It has been a hard congress, because apart from attending scientific sessions, I had a lot of work.
Laserscope invited me to do two presentations on advanced concepts in Photoselective Vaporization of the Prostate. I also had the honour of being invited to participate in an informative session addressed to laserscope's investors, with Dr. Collins and Dr. Malloy, two world class surgeons and expert users of the GreenLight laser. I exposed my views on this technique and its future and I explained how fast it is being adopted by urological surgeons in Europe. There is a webcast available at laserscope's website, if anyone is interested to hear it).
Apart from that, I presented a poster on my experience with this technique in the congress. My contribution was to prove that as the surgeon gets more experience with Photoselective Vaporization of the Prostate, postoperative complications, although not serious, are reduced and also the energy used and the operative time diminish with experience.


It has been a tough but very interesting congress. I had the oportunity to try extensively the new higher power GreenLight laser, the brand new HPS system (High Performance System), and I have been able to confirm that it is an instrument far better than the KTP Greenlight laser we have been using, specially because it will make operating larger prostates much easier. After this initial experience, I have been invited to present it at the National Urological Congress in Spain, that will take place in Seville the 10th of July. Then we will take the HPS system to Madrid, where we will be able to start using it.
With 120 watts power and a colimated beam, a pedal to vaporize and another pedal to coagulate, operating with it will probably feel as driving a Ferrari. This coupled with its safety, will make the best ever existing laser for BPH...


Tomorrow I will attend the take home messages session at the congress and I will fly back to Madrid. I am desperate to see my daughters...

A dream come true: The new Greenlight HPS in Madrid !!!

Laserscope, the manufacturer of the Greenlight laser system, has announced the launch of a new device that improves the previous Greenlight laser. The new Greenlight HPS (High Performance System) improves the performance, allowing to operate patients in a shorter time. Being more powerful (up to 120 watts, from the previous 80 watts), it vaporizes tissue more efficiently. It will be a leap forward because it will allow to operate patients with bigger glands easily. It also has other advantages for surgeons and hospitals...
We had a system that had revolutionised surgery for Benign Prostatic Hyperplasia, but now we see a dream come true, we will have the definitive tool. It is great news for all patients and urologists around the world!!!
Laserscope has communicated me that the Institute of Advanced Urological Surgery from Madrid will be one of the 6 centers of the world to have access to this new system prior to it's big scale commercialisation. I will be one of the few first lucky surgeons to use this wonderful new laser!!!!
I will update this information in this blog as I get more details.

Double training session in Barcelona

Yesterday I went to Barcelona to participate in two consecutive training sessions. One took place in the Puigvert Foundation, where we operated two patients. I spent the night in Barcelona because we started a very complex case at TEKNON, a high risk cardiac patient that was operated uneventfully. Then I flew back to Madrid to prepare my case. I leave to Atlanta this thursday to participate at the American Urological Association Annual Meeting.

Puigvert Foundation II

I visited Puigvert Foundation today, in Barcelona, to participate as a mentor in a surgical teaching session. We operated two patients with the GreenLight PV technique (Photoselective Vaporization of the Prostate). We had the chance to try two new prototypes of cystoscope from a company specialised in the design of surgical instruments, so the session was specially interesting. Some surgeons very used to TURP (Transurethral resection of the prostate) need to adapt to this new technique, because the scope is handled with the left hand unlike the resectoscope for TURP. Also, the laser fiber has to be rotated in a sweeping motion that is different from the in-out excursions of the resection cutting loop. The manufacturers of endoscopes try to make this adaptation easier for surgeons adopting PVP. In an case, I thought these prototypes have a long way to improve to fulfil that goal...
I then came back to Madrid, I have to operate this saturday, my workload is increasing and most weeks I am operating 5-10 patients now.

New training session in Barcelona

Today I jumped to Barcelona to participate in a teaching session at the prestigious TEKNON hospital in Barcelona. In this ocasion we treated two patients with relatively small glands, so everything was uneventful. Today I will sleep in Barcelona, tomorrow I will participate in another session at Fundació Puigvert. My wife is here with me, so we will try to dine at Sergi Arola's restaurant at the Hotel Arts... his "patatas bravas" (hot potatos) have a reputation over here...

Virtual reality laparoscopy simulator

Today we have installed at the Institute of Advanced Urological Surgery (ICUA) a virtual reality simulator for laparoscopic surgery, with the help of Ethicon Endosurgery. Our institution cooperates closely with the European School of Urologic Laparoscopy (EELU), directed by Dr. Castillón, our laparoscopy expert.


This simulator is an amazing tool. It consists of a small robot connected to a computer that allows the surgeon to simulate a real surgery. It also allows to develop laparoscopic skills and familiarize with different instruments. The robot gives tactile feedback to the instruments, so when you use the simulator, you can feel the resistance opposed by tissues exactly as you would feel it in real surgery. The modules for intracorporal suturing are outstanding. The objective of these simulators is allowing the surgeon to train BEFORE engaging in mentored surgeries on patients. The European School will allow local urologists to use it by appointment.