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Blood loss can occur in any surgical procedure. However, certain types of surgery, e.g., hepatic resection, are associated with blood loss of a magnitude that frequently leads to the need for transfusion. In the following sections, we will examine some devices and technical approaches that can help reduce transfusion need both in general and in specific areas of surgery. We have chosen hepatic surgery to highlight advances made in recent years, because it is a procedure traditionally associated with high blood loss and transfusion need. Most of the approaches we discuss are useful in other types of surgery. The surgeon must understand at the outset that basic surgical principles must be followed in all operations in order to achieve success (Table 1). These include careful attention to detail, careful perioperative planning, gentle tissue handling, precise anatomic dissection with meticulous technique, adequate exposure, and asepsis. Without these, even the most technically advanced surgical technique is doomed to failure. |
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