Bloodless Surgery

What is Bloodless Surgery?
Bloodless surgery, or patient blood management (PBM), is a team approach to surgery involving highly skilled surgeons, anesthesiologists, hematologists, nurses and other specialists focused on avoiding the use of blood transfusions. We utilize a variety of techniques and resources to minimize blood loss, save and re-infuse as much of your own blood as possible. Bloodless surgery may be requested for a variety of reasons:
  • Religious observance may prohibit the use of blood transfusions
  • Medical conditions may make you unable to receive blood transfusions
  • Personal concerns about safety of donor blood transfusions or other issues may lead you to request other medical interventions that reduce the need for transfusion

At Houston Methodist, our patient blood management techniques and strategies make it possible for us to perform some of the most complicated procedures without the need for donated blood.
Regardless of why you have chosen this approach, the advanced strategies used in patient blood management can offer you a range of benefits: 
  • Reduced risk of complications
  • Reduced possibility of an allergic reaction to donor blood
  • Protect your immune system from potential adverse effects
  • Faster recovery
  • Shorter hospital stay

How is Bloodless Surgery Achieved?
Bloodless surgery uses safe, proven and effective specialized strategies and techniques before, during and after surgery to conserve your blood and avoid the need for transfusion.

Before surgery, we use a variety of medications and lifestyle changes to make sure your blood is as healthy as it can be: 
  • Recognize and correct anemia (low red blood cell count)
  • Assess and correct bleeding disorders and ensure proper clotting
  • Implement dietary changes to build up iron supply and absorption
  • Administer medications/supplements to increase production of red blood cells and blood volume
  • Stop medications and herbs that affect blood clotting or lower your red blood cell count
  • Work with you on making lifestyle changes that can affect blood health, such as stopping smoking and alcohol use
  • Limit blood draws and use extremely small amounts when blood is drawn to maximize the amount of blood in your body

During surgery, we use special strategies and surgical equipment to minimize bleeding and conserve blood: 
  • Minimally invasive techniques such as laparoscopic or robotic surgeries that use small incisions and limit blood loss
  • Electrocautery and other surgical devices that “seal” blood vessels to stop bleeding
  • Cell salvage machines that collect any lost blood and clean and return it
  • Special adhesives to close the skin tightly
  • Acute normovolemic hemodilution to remove some of your blood, dilute what remains, and return the more concentrated blood at the end of surgery
  • Anesthesia techniques that affect blood pressure and body temperature so that you bleed less

After surgery, you are closely monitored and special strategies are implemented to ensure optimum blood health: 
  • Blood draws are limited
  • Medications/supplements and dietary changes are implemented to boost blood cell counts and iron stores
  • Blood pressure, temperature and fluid levels are closely monitored
  • Medications are given to help the blood clot and prevent bleeding
  • Hormones are used to stimulate the bone marrow to produce more red blood cells

A dedicated program coordinator will work with you, your family and your doctors every step of the way to answer your questions about how these strategies will be used during your surgery.

Which Specialties Offer Bloodless Surgery?
Houston Methodist offers bloodless surgery for a wide variety of surgeries and procedures across different specialties:
  • Minimally invasive surgical techniques for some heart and vascular disorders require only very small incisions in the side of the chest, which lets us minimize the amount of blood lost during surgery. Interventional catheter-based therapies allow us to repair or replace narrowed heart valves through a catheter inserted into the arm or groin, eliminating the need for an incision in the chest and resulting in minimal blood loss.
  • Special techniques for kidney and lung transplantation allow surgeons to use the latest in minimally invasive techniques, limiting blood loss. For example, kidney donors benefit from a technique that allows the kidney to be removed through a single small incision. For lung transplant recipients, strategies such as precise surgical technique, acute normovolemic hemodilution, cell salvage and low prime cardiopulmonary bypass circuits.
  • Many surgeries for gynecological disorders can be performed using laparoscopic and robotic techniques that are associated with minimal blood loss. Injecting lidocaine and a dilution of epinephrine at the incision site to cause the blood vessels to constrict and using electrocautery to seal blood vessels further result in less bleeding.
  • Advances in orthopedic surgery allow surgeons to repair damage in the shoulder, elbow, wrist, hip, knee and ankle arthroscopically in a way that minimizes blood loss and to pin unstable joints in proper position as the bones are healing, making open surgery unnecessary. Similarly, minimally invasive procedures and small incisions can be used to relieve disc herniation or nerve root impingement in the back and repair carpal tunnel surgery in the wrist.
  • The extensive use of robotic, laser, and other minimally invasive techniques in urology reduces blood loss compared to traditional techniques and minimizes surgical trauma
  • Abdominal surgeries such as the Whipple procedure, can be performed without the use of blood product transfusions

Download our patient blood management brochure to learn more.


Our physicians at Houston Methodist specialize in bloodless surgery at the following location: