In both arms, a 60 cc syringe attached to an olive tip long curve suction is used to draw the irrigation fluid from the basin. The surgical field is flushed with 20 cc of hot or room temperature saline at five minutes intervals by a research assistant. Additional flushes with hot or room temperature saline can be administered in between the five-minute intervals upon request by the surgeon. The degree of bleeding in the surgical field is scored by the operating surgeon using the validated Boezaart and van der Merwe Grading System14. This 0 to 5-point scale will be used to outline the amount of suction required to rid the area of blood disrupting vision. A score of 0 is given for an area with no bleeding, 1 for slight bleeding with no suction required, 2 for slight bleeding requiring suction, 3 for moderate bleeding which improves for several seconds once suction has occurred, 4 for moderate bleeding which restarts directly after suctioning and 5 for severe bleeding which occurs faster then can be removed14. Surgical field of view will be assessed and scored every 15 minutes for the duration of the surgery. At the end of the procedure, the estimated blood loss is calculated by subtracting the total amount of irrigation fluid used from the fluid in the suction bottle. The total amount of HSI or RTSI administered and time of surgery are documented.