3.6.4 Surgical devices to minimise blood loss

Read through these techniques. Then have a look at the map at the foot of the page and see how they fit into the context of blood conservation.

The cornerstone of "bloodless surgery" is the use of meticulous surgical techniques, making small icisions and stopping all bleeding.  This compares with the historical practice of cutting through tissue to the operation site.  It was not considered a major priority to avoid blood loss, as it could always be replaced by donor blood.

The many devices and techniques used to achieve this "meticulous haemostasis" are explained here.

        Electrocautery/Electrosurgery

Cautery is the deliberate surgical destruction of tissue, either because the tissue is abnormal or to seal off a bleeding area. Cautery is a method of reducing bleeding during transfusion-free surgery. It may be achieved through heat, freezing, chemical scarring, electricity, light, and ultrasonic or microwave energy.

Electrocautery uses an electrical charge to accomplish this.

        Laser surgery

A surgical technique that uses the energy from light to cut through tissues. It can reduce bleeding compared to traditional scalpels and may therefore be valuable for bloodless treatment of some conditions.

        Argon beam coagulator

A surgical tool that uses a beam of ionised argon to conduct a high-frequency electric current to stop bleeding of tissues.

A description of the benefits of this approach, presented by one of the manufacturers of such tools, can be viewed here

        Stereotactic radiosurgery

A technique for locating the exact area needing treatment by using advanced imaging techniques that verify the three-dimensional coordinates of the abnormal area. By pinpointing the exact area, the surgeon can minimize the amount of cutting (and hence bleeding) that occurs during surgery.

        Microwave coagulating scalpel

A device that employs microwave energy to perform similar activity to that of electrocautery, but is capable of cauterizing greater areas of tissue at one time. This device has limited availability and is useful mainly for surgery on highly vascular organs such as the liver and spleen

        Ultrasonic scalpel

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The Ultrasonic (Harmonic) Scalpel is a surgical tool that uses ultrasound waves to cut tissue and seal bleeding vessels at the same time -- a helpful characteristic in transfusion-free surgery, because it helps keep blood loss to a minimum.

        Gamma knife radiosurgery

The Gamma knife is a high-tech surgical tool that can be used for brain surgery. This technique utilizes a powerful and precise form of radiation to destroy tumors or abnormal blood vessels with less blood loss than a traditional scalpel.