Presented by: Adib Rahman
Toowoomba hospital

Introduction

Background and Objective

PuraStat is a new synthetic haemostatic agent constituting peptides that self assemble into sheets when exposed to ionic charges.

We aim to report our initial experience with PuraStat as an athermic topical haemostatic agent for use on the neurovascular bundle in robotic assisted radical prostatectomy

 

 

 

 

Materials

Method

Demographic and disease data for 31 consecutive patients undergoing robotic radical prostatectomy were recorded. PuraStat was used as the primary haemostatic agent of the neurovascular bundle, without thermal or suture haemostasis, unless necessary. Total blood loss was recorded. A qualitative assessment of PuraStat’s transparency, efficacy, ease-of-use and overall satisfaction was made intraoperatively by the surgical assistant. Preoperative haemoglobin and Haematocrit were compared to 1-hour and next-day postoperative results. Results were compared to perioperative outcomes of robotic radical prostatectomy in published literature.

Results

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Results

31 males aged between 49 and 77 underwent a robotic radical prostatectomy under a single surgeon for clinically significant prostate cancer, with Purastat used as the primary haemostatic agent at the neurovascular bundle. 3 patients required an additional haemostasis, but only one of these was at the NVB where Purastat was applied. The median prostate volume was 36ml. Mean blood loss was 350ml compared to 443ml in Yaxley et als study. The median change in haemoglobin the next day was 27mg/dl. No transfusions were required.

Conclusion

Conclusion

Our Pilot study shows that PuraStat is a safe haemostatic agent in Robotic Radical prostatectomy with similar perioperative bleeding outcomes and a high level of intraoperative user satisfaction. Further investigation into postoperative and long-term continence and erectile function will be interesting. 

Funding

nil

Lead Authors

kale Munien,
Toowoomba Hospital