Technology in GI surgery !!
Bloodless surgery is not in true sense its Namesake. It doesn’t mean there will be no visible blood during surgery but rather means that bleeding would be so less that it won’t need any allogenic blood transfusion or the blood loss is saved by cell savers and other modern devices to be purified and returned to the Same body by autologous blood transfusion and hence avoiding any other source blood transfusion .
We have been using this technique to our benefits for years now and there are several methods and benefits to this .
This is a method that initially we learned from Liver Transplant surgeries to be applied later to major GI HPB and colorectal and upper GI surgeries.
If correct tissue planes are dissected and uniplanar dissection can be Meticulously followed then chances of bleeding naturally goes down . Control of mother vessels ie the main feeder vessels early helps to achieve control on bleeding and creates relatively Bloodless fields . Control of inflow as well as outflow ( eg in Liver spleen etc ) also allows for surgeries in Bloodless fields with lesser or minimal blood loss . Use of energy devices especially Harmonic, lagsure , vessel sealer etc further reduces blood loss by instant coagulation of bleeding points allowing for safe dissection in almost blood less fields. Age old methods of suture ligatures , suturing and clips also take early Control of blood vessels thereby further reducing chances of blood loss . Optimum volume replacement along with hypotensive anaesthesia or low CVP maintenance during operation also adds to lesser intra vascular volumes and pressures adding up to benefits of all above methods . Advantages of Bloodless surgery are not only clean surgeries with minimal homestatic variations but also clean fields leading to best visions and precision surgery. Also Minimal duration surgery leading to early recovery . Also less chances of complications due to less hemodynamic instability. Also cancer patients may benefit from less likely or delayed chances of Recurrences leading to better disease free surgical ( a benefit that is proved by trails in colorectal surgeries , less than 3 transfusions or more has different recurrence rates ) and also visible in other cancer surgeries .
