BLOODLESS SURGERY

Blood can lifesaving during surgery, however, blood transfusions have a risk associated with their use that should be appreciated. In the state of California, the Gann act governs the consents requirements for blood transfusion.

The practice of surgery where all precautions are taken to avoid blood transfusions also called bloodless surgery is gaining attention due to the risks associated with blood transfusions.

Some of the potential risks of blood transfusions are:

• Transmission of viral and other infections:The precautions and safety measures taken to ensure a safe blood supply, has markedly reduced the possibility of transmitting viruses such as HIV and hepatitis through blood transfusions, however, this risk cannot be completely eliminated.
• Allergic reactions: Though uncommon, this may occur.
• Effects on postoperative recovery?: Patients who do not require blood products may recover faster, avoid potential side effects such as fever and allergic reactions and usually have a shorter hospital stay.
• Impact on survival after cancer surgery?: A number of studies have suggested that blood transfusions may have an adverse effect on outcome in patients who undergo surgery for cancer. For example the survival is poorer in patients with colon cancer who require a blood transfusion compared to no transfusion.

Techniques to minimize blood transfusions during surgery

Various alternatives to blood transfusions have been made possible through advances in medical and surgical techniques and technology. Blood loss can be minimized through:

• Performing a careful and meticulous dissection of the body tissues with and control of the blood supply to the tissue structures being removed during surgery.
• Utilizing intraoperative hypotension anesthesia to lower blood pressure during surgery minimizing bleeding.
• Enhancing circulation of the patient's own blood during surgery by using volume expanders or intravenous fluids.
• Tracking oxygen levels during surgery with skin monitors.
• Speeding blood clotting during surgery with an argon beam coagulator.
• Stimulating bone marrow to produce red blood cells in advance of a procedure.
• Using cell saver during surgery to collect, recirculate and re administer the patient's own blood.
• Using lasers rather than scalpels.

Bloodless surgery by center surgeons

The surgeons in USC Center for Pancreatic and Biliary Diseases have employed these and other techniques to avoid blood transfusions in the majority of patients undergoing major pancreatic, biliary and liver surgery.

The Center provides specialized expertise in bloodless surgery for many complex operations in the abdomen such as surgery of the liver, pancreas and the bile duct.

The procedures offered for bloodless surgery at USC are:

• Whipple operation
• Pancreatic surgery
• Bile duct resection
• Liver resections
• Distal pancreatectomy
• Central pancreatectomy
• Surgery for islet cell tumors
• Surgery for endocrine tumors
• Advance laparoscopic surgery

Contact information: USC Center for Pancreatic and Biliary Diseases
1510 San Pablo Street, Los Angeles, CA
Phone: 323-4425837 dde-mail:PancreasDiseases@surgery.usc.edu
Programs: pancreatic cancer, pancreatitis, laparoscopic surgery, endocrine surgery,
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This web site provides select information about pancreatic and biliary disorders and is updated twice monthly. This information is not intended as a substitute for professional medical consultation with your physician.It is important that you consult with your physician for detailed information about your medical condition and treatment.The center will make every effort to update the site, however, past performance is no guarantee of future medical outcomes.
Copyright © 2002 USC Center for pancreatic and biliary diseases. All rights reserved.