LSP offers advantages over OSP in terms of shorter catheter time, shorter hospital length of stay, and fewer urinary tract infections.

Objective: To compare the calculated blood loss for radical retropubic prostatectomy (RRP) with the anesthesiologist’s and operating surgeon’s estimates of operative blood loss. Methods: A retrospective review of 52 consecutive patients undergoing RRP between January 1999 and February 2000 was performed. Patient charts were reviewed for preoperative hemoglobin (Hgb_i), preoperative hematocrit (Hct_i), body weight (Wt), anesthesiologist’s and surgeon’s estimated blood loss (EBL_A and EBL_S), and postoperative day one morning hemoglobin (Hgb_f) and hematocrit (Hct_f). For each patient, the actual blood loss (ABL), i.e., the amount of blood that left the patient’s body, was calculated as the average ABL_n resulting from two computations of the following formula: ABL_n = (EBV × (H_i – H_f)) / ((H_i + H_f)/2) + (500 × T_u) where: (1) estimated blood volume (EBV) is assumed to be 70 cm³/kg; (2) H_i and H_f represent Hgb_i and Hgb_f for one computation and Hct_i and Hct_f for the second computation, and (3) T_u is the sum of autologous whole blood (AWB), packed red blood cells (PRBC), and cell saver (CS) units transfused. For each patient, ABL was compared with EBL_A and EBL_S. Descriptive statistics of the pooled data were calculated. Results: The mean (± SD) age was 60 ± 7.1 years. The mean ABL was 2,774 ± 1,014 cm³. Patients received an average of 1.96 U CS, 0.14 U PRBC, and 0.42 U AWB. Five patients (9.6%) were exposed to homologous blood. The average ABL_net (i.e. ABL reduced by the amount of CS returned) was 1,794 ± 806 cm³. EBL_A and EBL_S were 1,337 ± 676 and 1,300 ± 658 cm³, respectively. Conclusion: During radical retropubic prostatectomy, anesthesiologists and urologists both appear to underestimate blood loss as determined by standard calculation.

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As the implementation of robotic technologies to treat prostate cancer continues to grow, randomized controlled trials will eventually provide a better comparison of results. The role of robotics in prostate cancer treatment is established, and continued technical advancements will ultimately improve patient outcomes.

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