Slashdot Mirror
Bloodless Surgery
isaacbowman writes "Dr. Charles Bridges, a Pennsylvania Hospital cardiologist, says says regarding new bloodless surgery options - "Among the benefits are reductions in recovery time, hospital stay, cost and complications -- as well as an estimated $20,000 in savings per patient." Advances in medicine have made this possible and Dr. Bridges also says, "There's no downside to it that we can see, and there's certainly no downside that's been documented." Dr. Patricia Ford, director of Pennsylvania Hospital's Center for Bloodless Medicine & Surgery, further states, why blood transfusions are dangerous, saying that they are "like getting a transplant; they can be risky and should be a last resort.""
$20,000 in savings per patient
That dull roar you just heard outside was the US's entire population of medical residents placing a revolver in their mouth and pulling the trigger.
We can thank Jehovah's witnesses for that. They are a driving force for bloodless surgery.
The sad part is that this procedure works only on Vulcans.
An Indian-American Hindu committed to non-violent thought/speech/action alarmed by the global explosion of radical Islam
Maybe I'm behind the times here, bu what, precisely, is bloodless surgery? I read TFA and I still don't know. How do you cut open someone's chest to fix a heart valve without there being blood?
TFA mentions "using high-tech scalpels that clot the blood as they cut tissue," but there is no elaboration. Does anyone know how these work or have a link to more information? Sounds like a cool invention and I'd like to read more.
This is absolutely amazing. This will help prevent the spread of diseases from blood tranfusions too.
Steve -- http://tail-f.net/
As a surgical resident I found most of the article pretty good, but the last line that a blood transfusion was the same as a transplant much have been taken out of context. I have take care of nearly 100 transplant patients during my residnecy and they are by far the most labor intensive petients in the hospital. They are chronically immune suppressed, often on the verge of liver and/or kidne failure, and generally coming in erey year or so with rejection issues.
On the other hand I have taken care of hundreds of patients who have had blood transfusions. While not harmless, a blood transfusion has a miniscule risk of infection (from potential pathogens we are not aware of or cannot test for) or reaction. Only two of my patients have had transfusion reactions which requires stopping the transfusion, some medication, and maybe two extra hospital days. These patients did not need long term immune supression or chronic doses of borderline toxic medications as a result of the transfusion.
Just my little nit pick with the article.
---sam
"Keyhole surgery" generated some fanfare a few years ago, but the reality is that it is more dangerous than open surgery, requiring greater skill. How the hell do you operate on something you can't see, digging around under flesh?
I can guarantee you, the only party involved in the process who will see that twenty grand is the insurance industry.
M
trustedworlds.net - gaming, security, and the gunk that lives in between
after bloodless surgery comes fluidless sex.
Not to mention stretching the blood supply for the patients this doesn't help ... a 27-unit obstetrical disaster, or a gut-shot cop.
If you really want to investigate why bloodless surgery is gaining ground in the medical industry then take a look at this article published by Jehovah's Witnesses. And before you turn up your nose because of the source of the article, you should really give it a read. The JW's have had a major impact on how the medical industry views this topic and many advances have been made because of them. Here's the article: http://www.watchtower.org/library/hb/index.htm?art icle=article_06.htm
TheTiminator
I think it's brilliant that they're starting to use suctioned blood to resupply the patient. This is, more or less, perfectly good blood. It may need to be mixed with some anticoagulants, but otherwise it's got to be better than transfused blood. It's fresh and still plenty capable of carrying a full load of oxygen.
I'm planning on applying to med school in the next couple of years with the goal of going into surgery, so seeing an article like this on Slashdot is nice. The advancements in medicine over just the last decade have been incredible and I see no end to it. I'm looking forward to how much more it will advance by the time I'm in residency.
You are thinking too deeply, their point was simply whenever possible one should avoid inserting things into the body that are foriegn, either other peoples blood or even your own blood that has been stored.
It also avoids potential problems like this. (synopsis: Red Cross Canada pleads guilty to killing over 3,000 people due to distributing tainted blood; 1000 contracted HIV, 20,000 hep-c). The less foreign substances you put in your body, the better, besides the fact that stored blood isn't nearly as effective as your own natural blood at carrying oxygen.
How do they get a 20k saving per patient? They must be selective in what they're quoting because most surgical procedures cost way less than 20k.
Engineering is the art of compromise.
An image of 144,000 Jehovah Witnesses leaping for joy.
*lol*
on a lawyer?
Well, I don't know if this specific technique was used on me, but I've already had "bloodless" surgery.
I had a bowel resection where they literally scooped my intestines out of my body cavity and laid them on the table beside me. After cutting out the bad bits and stitching the good ones back together, they tucked it all back in. While they were in there they took out my appendix and sewed up a fistula to my large intestine.
This left me with a scar from above my navel down to my pubic bone, but no transfusion was required. In fact, I asked before surgery if I should self-donate blood so I could avoid the dangers of a transfusion from someone else and they told me they didn't expect to need any blood.
Still amazes me.
Can I get Patricia Ford to operate on me?
Please???
Well, we know YOU'RE spectacularly stupid for using an apostrophe to make a plural.
Nobody cares. Reading Slashdot doesn't make you the stereotypical geek with no life - looking for every typo so you can tag it for the rest of the world and feel good about alerting them to it, however, does.
.
That $20,000 sounds like it's been pulled out of someone's exagerated butt - maybe for a very, very, very bloody heart transplant. Probably >90% of operations don't require a blood transfusion.
I'm an orthopaedic surgeon, and for those of you who don't know, most orthopaedic surgeries tend to resemble Aztec ceremonies. But anyway, my last 20 knee and hip replacements haven't required a transfusion. Most patients who do need a transfusion - i.e. bloody messes scraped off the pavement after being ejected from their car wreck, only need about 2-4 units.
Would it be cool if we found a safe, effective blood substitute? - yes. But today the risks from transfusion are approximately 1 in 350,000 of being exposed (not catching) hepatitus, and 1 in 2,000,000 exposure to the HIV. In other words, don't worry about it, your risk of being hit by lightning is about the same.
..........FULL STOP.
Pretty much ALL surgeons use it a lot! Originally invented in the 1940s? by a Neurosurgeon, it uses high frequency electric arc to cut, or cauterize tissue to a patient who has been grounded.
..........FULL STOP.
Glad to see the doctors are finally putting away their butcher knives! :P
Every joint procedure (knee or shoulder 'scope) allows the surgeon a better view than the open method,'cause the camera is so small, it can get into many places, that you normally can't even see. Gallbladder surgery now is overnight or same day, as compared to a one to two week stay for the open method.
And yes, I am a surgeon , and I have done both open and closed shoulder repairs, and the 'scope method is waaaaay better. You can see more anatomy, more pathology, less blood loss, and less tissue damage. Trust me, we all need to sleep at night, and want what's best for the patient.
..........FULL STOP.
He managed to get 'schools' right; the improper punctuation was probably on purpose. SPELLING METANAZI'd
Ninjas and pirates. How piquant.
No, that's how you count.
The question was how do you do bloodless surgery!
I don't know how people can claim to know anything without a good grounding in Sesame Street.
Okay, yes, good on Jehovah's Witnesses for reinforcing the desire for these types of procedures, but stop and think that this might not just be a religious issue. Theres a whole 7% of the population out there who, like me, are type O negative. And while we may be wonderful/magical/mythical creatures capable of donating our blood to anyone other human being on the planet (especially handy during time-critical emergencies), we are unfortunately incapable of accepting red blood transfusions from anyone BUT an O- donor.
So this is also good news to some of us who may be concerned with limited supplies of compatible blood in an a system already struggling to meet demand. Hooray.
6
Many hospitals in Europe have been performing mostly bloodless surgeries since late 80's early 90's. The fact that America is only just realising the benefits is pathetic. Yes Jehovah's Witnesses have been the major players with regards developing this but the medical benefits noted in this article have been known for decades. In most cases bloodloss can be replaced with volume expanders such as saline but for more complex operations there are a number of techniques including laser scapels which quarterise the wound when cuttin thus preventing bloodloss. There is also blood recycling where blood is pumped from the body and put through a machine to be cleaned then pumped back into the body thus reducing bloodloss. Doctors that insist on blood transfusions should be avoided because they are not keeping up with the latest procesdures and are probably not careful.
I agree, the simple fact remains "There's no downside to it that we can see, and there's certainly no downside that's been documented - from MSNBC". So why shouldn't people be excited (yeah it sucks that the US has been way behind the EU. Cellphones and Surgery.)? Why would anyone want to bleed and lose needless blood? The real question is why are blood transfusions so popular if there are better options? The Red Cross makes enormous amounts of money for managing the nation's supply. Figure it out. Everyone donates blood, mostly for free, and then the blood gets sold in hospitals for huge costs. In 2004 Brookshospital.org was paying $249 for each pint. "The cost to the nation for these transfusions is approximately $4 billion annually [2001]" from America's Blood Centers. Why take a medical option that has even a small chance of complications when there is something cheaper and safer? Doctor says I can have bloodless op that costs less and I can go home early? aaaah I'll take that option.
http://isaacbowman.com
This isn't especially new. For a number of reasons (most of which I no longer subscribe to) I did not have blood given when I had major open heart surgery in 1979. Of course, I had one of the world's best surgeons in a top pediatric cardiological facility, so the difference may be mainstream vs. high-risk, but there's nothing but the medical field's tradition that would keep the practice from becoming common.
What's actually happened though, is that most surgery now is minimally invasive -- except for a few procedures (cardiac being an obvious one, though even that is changing) surgeons generally use laproscopic techniques anyway.
A large amount of insurance these days is provided in package form. A company buys an insurance plan for all employees through a given insurer. They then insure everyone, without prescreening. The insurance companies do this because it's lucrative, and odds are you get more healthy employees than unhealthy ones.
Well, of course, companies put this out to bid. They don't want to pay anymore than they have to since they generally pick up most or all of the cost. So insurance companies will give them as good a rates as they calculate to be worthwhile.
So, let's say medical costs suddenly dropped by 20% (they won't because this is only a fraction of total costs but for argument sake). Provider A, who's currently under contract with company X, decides that's more money for them and keeps it. Then bid time comes up. Provider B wants the contract, and because of the savings can make a better deal, they offer the company 10% less than they were paying before.
So no, insurance companeis aren't likely to reap the whole benefit. As with most cases, it's likely to be distributed. The hospital will make more, the insurance company will make more, the insured will pay well. With an efficency increase, everyone tends to win.
This is bad news for Antonio, and Shylock will be quite pleased.
Sig (appended to the end of comments I post, 54 chars)
Hi.
I've been sitting reading and re-reading your comment, and wondering what it is you're actually trying to say here.
The only idea I've had so far is that you're possibly disputing that the "bloodless" description of the surgery is incorrect terminology? Have I misunderstood this point?
Please clarify this comment, as I don't see why this would need an insane-sounding rant at the end.
If I've got it wrong, let me know, as I'd like to know what could have provoked such an extreme and intense comment.
Thanks.
My understanding is that a unit of blood costs $500 Australian dollars - in a system that doesn't price blood for sale or pay donors to donate.
The costs will be higher in countries that do (eg., USA)
The USA doesn't buy blood either. Bought blood in the USA can only be used for non-human testing purposes. Anything to be used in a human being has to be donated.
There are provisions for funding red cross for the actual collection purposes.
It might seem strange, but blood products intended for research can be cheaper than the donated materials. The money they pay the donors is lost in the shuffle, and is compensated by greater efficiency of labor.
I don't read AC A human right
Simply having the surgery site open for less time would, in theory, lead to less complications due to blood loss, tissue oxidation and contamination. Surgical anaesthetics are not "good for you" and the less time spent on the table, the lower the risk from complications with these chemicals.
Agreed, for the most part. However, the quote of "$20,000 cheaper", would, on average indicate that these issues are less indicative than the benefits of taking their time and doing it the 'bloodless' way. Besides saving the $500 or so per pint of blood not used, the quicker recovery time allows the patient to be out of the hospital faster. Of course, $20,000 would be about a day's hospital stay in critical care.
It seems like most of the 'bloodless surgury' thing is more along the lines of surgeons being more careful and doing less damage. You could say the same thing about small-incision techniques, where they go from a foot long cut to a couple, each less than an inch.
If the JW's want to be this way and end up being the guinea pigs for the development of these techniques, let them. It extends the blood supply(I donate) for those who still need transfusions(accident cases where victim has already lost alot of blood), and speeds the development of better techniques that can be used for everyone.
I don't read AC A human right
More info here from the official website http://www.watchtower.org/medical_care_and_blood.h tm
Yeah MSNBC, along with most of what is on tv will do that to you...
http://www.watchtower.org/library/vcnb/article_0 1.htm
http://www.watchtower.org/library/vcae/article_0 1.htm
RUPERT! I TOLD YOU TO WATCH THE BAGS! You were looking at the boys again, WEREN'T YOU.
They mentioned valve replacement, which can be done on a beating heart without the use of a heart and lung machine. Doesn't help JWs, but is much easier on your body.
It is cowardly, and a betrayal of whatever it means to be a Jew, to act as a white man
-James Baldwin
I thought there were plenty of surgeons doing "bloodless" operations,
from years ago, in response to the need of groups like Jehovah's Wit-
nesses NOT to allow blood transfusions into members of their faith.
This doesn't seem like a "news" article to us...
It would be one of the examples of religious tradition necessitating
innovation in [here, medical] technology.
I was hurt badly in 1986 when a prescribed drug caused me to get real high. The drugstore pharmacist left off ALL THE WARNING LABELS about not operating machinery til I got used to the hallucinatory Superman feeling from it. The next morning I was making a delivery of windshields to Newport News Virginia, stepped completely off the back of the truck. I managed to save my life by holding onto the jack handle *just long enough* to spin me so that I landed across the length of my 275 lb. body on the pavement. I had one heckuva concussion. I extended my arm as I fell so that it was under my head, thinking it would be better than the asphalt.
hahaha An arm bone is pretty hard too. I never got a bruise because the force was distributed all down the side, but the concussion tore the brain membrane. I lost memory of many people's names who I had known in the congregation for 20 years and more. Since my thyroid hormone was unusable by my body cells, healing was almost nonexistent. I went back to work elsewhere & also took a course at E.C.P.I. in Roanoke for working on electronic circuitry. I did great in electronic theory but my color blindness stopped me from reading faded color bands on the sides of transistors & resistors so I dropped out.
In 1988 I got myself together (and made sure I had my balance back) enough to get back in a big rig. I wasn't healed in the head but the doctor doing the D.O.T. physical PASSED ME AS ALL THE OTHER D.O.T. DOCTORS HAD DONE SINCE 1975. So no one saw my thyroid hormone -chemically wrong for me- was poisoning me through my own blood. In 1989, I made a grievous error. The result was I opened my trailer doors and a 1,000 lb. bale came after me. Another driver (for Warrior Express) yelled Look Out! and I tried to move but the bale under force of gravity was accelerating like a bullet. It glanced my shoulder, propelling me forward at the speed of a rocket sled, yet by then it was moving so fast it landed across the backs of my knees, pile driving them into the ground. My forward velocity was turned into a downward vector into the ground. My entire chest was slapped off the asphalt like I was tied to the crack of a whip. By all rights I shouldn't have lived. My right foot took the downward brunt, was bent up to the shinbone. I always figured it was by the Grace of Jehovah God that I lived, not miracle triage in the hospital. In fact, the hospital did little for my internal damage. They sewed my splintered ankle together, leaving a bolt through it plus a metal plate on the side with a total of 6 screws plus a few other screws elsewhere to hold chipped bones back in place.
A year later a doctor here in Roanoke discovered the rare thyroid problem, which I wrote a webpage how I believe MANY AMERICANS HAVE THE SAME HIDDEN THYROID PROBLEM, un-diagnosed just as mine was, causing many Americans to have deadly accidents, car wrecks, on-the-job accidents.
Temperature Oscillation Health System in your basement on this link >
http://science.slashdot.org/comments.pl?sid=18422
Also some explanation how & why it solves the
United States Obesity Epidemic without expensive drugs, pills.
It also will help "open up" Outer Space Travel to civilian populations.
Oh is that what the Doctor "Says Says" now does he?
http://www.newpath4.com/gaspumpoilpumppricegougin
goes into much more detail from a Christian perspective why
we should not be burning fuels for our locomotion needs. I'll
have it online in about 30 minutes time.
Basically,
the engine I have designed is an advanced Newcomen engine (1712).
He didn't use steam for power, used it to collapse the heated steam,
drawing the piston back faster. My engine is a variation of that,
as explained on this new page some but explained in
greater detail on http://www.newpath4.com/enginewow.htm .