Skip to main content
RACS ASC 2025
Hyaluronic acid as a heat-resistant spacer: implications for prostatectomy
Poster
Edit Your Submission
Edit

Poster

Disciplines

Urology Surgery

Presentation Description

Institution: Austin Health - Victoria, Australia

Purpose Hyaluronic acid (HA) is increasingly used as a rectal spacer for prostate cancer radiotherapy to reduce the risk of proctitis. Given its ability to safely separate tissues, it may be useful in high-risk robotic-assisted prostatectomy cases. However, the safety of HA under high temperatures, such as during diathermy, is uncertain. This study aims to assess HA's heat conductivity to animal tissue using electrocautery. Methodology In a standard operating theatre, animal tissue temperatures were measured for HA and normal saline (control) in a plastic syringe. Bipolar diathermy forceps (Valleylab FT10) applied electrocautery (setting 15) to 0.5ml of HA or saline for 60 seconds. A temperature probe (Digitech Digital Thermometer) continuously monitored tissue temperature. Each experiment was repeated three times for accuracy. Results After 60 seconds of bipolar diathermy, HA showed a lower median tissue temperature (27°C) compared to saline (33°C), with maximum temperatures of 34°C and 51°C, respectively. Macroscopic changes were minimal in the HA group but significant in the saline group. Literature indicates that fulguration (cell death) occurs at 60°C, coagulation (dehydration) at 60-99°C, and cutting (tissue vaporization) at 100°C. Previous tests showed that HA gradually increased from ambient temperature to 100°C in 35 seconds (or 27 seconds starting at 37°C). Conclusion HA has lower heat conductivity than saline when exposed to electrocautery. Minimal macroscopic changes suggest that HA may serve as a protective barrier in radical prostatectomy, particularly in challenging cases with difficult posterior dissection such as salvage prostatectomy.
Presenters
Authors
Authors

Dr Matthew Alberto - , Dr Anne Hong - , Dr Jake Tempo - , Mr Dixon Woon - , Prof Nathan Lawrentschuk - , A Prof Joseph Ischia - , Prof Michael Chao - , Prof Damien Bolton -