title: Athermal nerve sparing robot-assisted radical prostatectomy: initial experience with microporous polysaccharide hemospheres as a topical hemostatic agent.
abstract: OBJECTIVE
  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.
authors.affiliation: Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ 85054, USA. nunez.rafael@mayo.edu
authors.forename: Rafael
authors.initials: R
authors.lastname: Nunez-Nateras
authors.forename: Kimberly J
authors.initials: KJ
authors.lastname: Hurd
authors.forename: Erin N
authors.initials: EN
authors.lastname: Ferrigni
authors.forename: Erik P
authors.initials: EP
authors.lastname: Castle
authors.forename: Paul E
authors.initials: PE
authors.lastname: Andrews
authors.forename: Mitchell R
authors.initials: MR
authors.lastname: Humphreys
mesh_terms: D000287:Administration, Topical; D000368:Aged; D001803:Blood Transfusion / Q000706:statistics & numerical data; D006490:Hemostatics / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D061646:Operative Time; D059351:Organ Sparing Treatments / Q000379:methods*; D011134:Polysaccharides / Q000008:administration & dosage / Q000627:therapeutic use*; D019106:Postoperative Hemorrhage; D011467:Prostate / Q000000981:diagnostic imaging / Q000601:surgery; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D012371:Robotics / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D006490:Hemostatics; D011134:Polysaccharides