Athermal nerve sparing robot-assisted radical prostatectomy: initial experience with microporous polysaccharide hemospheres as a topical hemostatic agent

Purpose Microporous polysaccharide hemospheres (MPH) are hemostatic beads engineered from plant starch to accelerate the natural clotting cascade. The purpose of this report is to detail our initial experience with MPH as a topical hemostatic agent during robot-assisted radical prostatectomy (RARP)....

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Bibliographic Details
Published in:World journal of urology 2013-06, Vol.31 (3), p.523-527
Main Authors: Nunez-Nateras, Rafael, Hurd, Kimberly J., Ferrigni, Erin N., Castle, Erik P., Andrews, Paul E., Humphreys, Mitchell R.
Format: Article
Language:English
Subjects:
Administration, Topical
Aged
Blood Transfusion - statistics & numerical data
Hemostatics - administration & dosage
Hemostatics - therapeutic use
Humans
Male
Medicine
Medicine & Public Health
Microspheres
Middle Aged
Nephrology
Oncology
Operative Time
Organ Sparing Treatments - methods
Original Article
Polysaccharides - administration & dosage
Polysaccharides - therapeutic use
Postoperative Hemorrhage
Prostate - diagnostic imaging
Prostate - surgery
Prostatectomy - methods
Prostatic Neoplasms - surgery
Retrospective Studies
Robotics - methods
Tomography, X-Ray Computed
Treatment Outcome
Urology
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Summary:Purpose Microporous polysaccharide hemospheres (MPH) are hemostatic beads engineered from plant starch to accelerate the natural clotting cascade. The purpose of this report is to detail our initial experience with MPH as a topical hemostatic agent during robot-assisted radical prostatectomy (RARP). Methods We examined a single surgeon series of 30 consecutive RARP’s dividing patients into MPH or non-MPH groups. The last ten procedures utilized the MPH, which were matched 1:2 to non-MPH procedures for comparison. Nerve-sparing procedures were performed when clinically indicated and all done athermally. All demographic data, length of operation, margin status, blood loss, change in hemoglobin, and need for blood transfusion were prospectively collected and analyzed. Results The baseline characteristics were the same. The post-operative decrease in hemoglobin was less in the MPH group (1.8 g/dL MPH group vs. 3.2 g/dL non-MPH). One patient in each group required a blood transfusion. Conclusions These preliminary findings support the role for MPH as a potential hemostatic agent during athermal nerve-sparing RARP.
ISSN:0724-4983
1433-8726
DOI:10.1007/s00345-011-0815-8