929 ROBOT ASSISTED RADICAL PROSTATECTOMY IN PATIENTS WITH A HISTORY OF ENDOSCOPIC TREATMENT FOR BENIGN HYPERPLASIA OF PROSTATE

Abstract

(Cook Medical), and retrograde cold irrigant (32–36f) was perfused at 120cc/hr. RESULTS: With 3 probes, 700 data points were recorded for differential cooling. Bowel temperatures remained stable, though significantly colder using ice slurry (p 0.041). The average change in temperature for surface cooling was 1.60/min, reaching 68f over 600s, while retrograde cooling was 2.25f/min over 350s (p 0.013). Retrograde cooling provided more rapid and significant medullary hypothermia, while the cortex remained on average 6.4f higher. Surface cooling demonstrated an opposite pattern with significantly greater cortical cooling, compared to the medulla (p 0.001). CONCLUSIONS: Using a porcine model both techniques demonstrated differential cooling patterns. This is due to relatively superficial laterally oriented cortical vessels being more amenable to conductive surface cooling. Bowel bag usage was also important in minimizing run off, and maintaining serosal temperatures. With a laparoscopic off-clamp approach, renal perfusion is maintained, though somewhat diminished due to pneumoperitoneum. As hypothermia decreases ischemic stressors, this may provide further renal protection. Complete metabolic activity is not arrested with either method, as a significant renal fraction is above threshold.