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.
How do you cut open someone's chest to fix a heart valve without there being blood?
Vampires.
KFG
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.
The artices does go ahead and admit that the more complex a procedure, the less likely this is possible: so a full-on heart transplant is far less likely to be bloodless than, say, an appendectomy or a stomach reduction (or other similar surgeries that don't require large incisions).
Jehovah's Witness have a theological objection to blood transfusions, but unlike Christian Scientists, not to medical treatment in general. In fact, they are quite insistent on high quality healthcare.
As such, they advocate the use of blood transfer alternatives.
There are various groups of Witnesses that advocate changing the doctrine, but, however odd it may seem to the rest of us, it's one of core teachings of the church and has survived even when other once-rejected medical technologies (organ transplants, certain immunizations) have now been accepted.
This doctrine has caused the Witnesses to push the medical community to come up with many alternatives to transfusion. These alternatives include Erythropoietin Therapy, Hemopure, a bovine-hemoglobin based blood substitute (this was quite a surprise, as previously even animal blood was considered taboo), perfluorocarbon based blood substitutes (back when I was young, I knew Witnesses who had been guinea pigs for this stuff), and a host of others. There are also specific surgical guidelines published in dealing with Witnesses.
All in all, the Witnesses are one of the main driving forces for research into lessening the need for blood transfusions. There are others to be sure (type matching, blood shortages, infectious diseases carried by tainted blood, etc.), but nothing beats having a large pool of otherwise healthy patients who are highly motivated to be test subjects.
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.
As one of Jehovah's Witnesses who has twice faced a serious blood-loss I can tell you how happy I am to see advances like this. Actually as a Witnesses, we give a lot of credit to courageous doctors who took on difficult cases without having the option of transfusing. The issue is actually surprisingly broad -- involving things like informed consent and various patient rights concerns. In regards to blood being a vector for pathogens, this is certainly well known, but our stand is purely religous based (based on the Biblical mandate expressed in Acts 15:29 and elsewhere). In my own case I was so glad to have avoided a transfusion in Canada during the early 80s, just before the AIDs-tainted blood supply issue became known. Canada was behind other countries, such as the US in implementing AIDS/HIV testing to routine blood screening. Ironically, even though I know live in the US, I had an accident while on vacation in Canada in 2001 which required emergency surgery. I can tell you that while I did fine, many hospitals in Canada simply can not afford some the equipment mentioned in the artical.
Jehovah's Witness have a theological objection to blood transfusions, but unlike Christian Scientists, not to medical treatment in general. In fact, they are quite insistent on high quality healthcare.
I work in one of the US' big children's hospitals in the neonatal ICU. Right now I'm watching a one month old 34 week gestation boy with a transposition of the great arteries slowly die because of these objections along with a bunch of treatment knots. This belief is utter nonsense. And if you don't believe me, come and watch this life of this little guy slowly ebb away as he struggles and struggles. You look into his eyes and tell me giving him blood will damn him.
on a lawyer?
Yeah that got me for a while too... by bloodless it more means blood-transfusion-less; there is obviously blood involved, but only the patients own.
The revolution will not be televised... but it will have a page on Wikipedia
The compensation is in keeping up repeat business and being able to brag about the new revolutionary procedure that will attract new business. A doctor you have a pleasant experience with is a doctor you keep going to, every time.
In my own experience, I've had supernumerary teeth removed by a specialist, went back a year later to the same guy to have some crowding issues resolved, and I'll be getting my wisdom teeth taken out this summer by the same guy. If I didn't like the guy on at least some level, he wouldn't be seeing this kind of repeat business, even if it is only three procedures across eight years.
I'm not overly fond of many of teachings of the church, but I'm also cognizant that most every religion has its nutty aspects. JWs also tend to be very nice and honest people, and live lives of moderation that tend to reduce their need for medical assistance, all of which are also a requirements of the church. It's a very mixed bag.
Unfortunately, rationally looking at your own religion is not a strength that many possess.
Basically the scalpel consists of a handle, an on/off switch aka. an Activation Matrix, a blade arc tip and a stabilizing ring. By directing energy through crystals stored in the handle of the scalpel an arc wave energy field is formed as the blade. This extremely powerful "light" scalpel cauterizes wounds as it cuts. However it must be noted that to use this tool a surgeon must be well endowed in the "force"
That all depends on your faith. You see, some people have such faith in their beliefs that they are willing to die for them, by abstaining from any kind of blood. Many people have a problem with this. But remember, Jehovah's Witnesses are simply messengers. They aren't trying to promote any kind of violence or bloodshed. And refering to the comment about how JW's harbor child abusers, consider this: Nobody is perfect. There will always be people who make mistakes, who do wrong things, and who choose to do acts of injustice. You'll find that in every group of people, whether it be a religious group or a national group. Depending on your faith, that may or may not change soon. My faith is solid, that's for sure.
.
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.
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.
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.
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.
"Minimal smoke for improved visibility in the surgical field"
Although I can see how reduced loss of blood can help recovery, I have to question how well the cut parts stick back together when they advertise "minimal smoke" as a selling-point.
"Hey Jonsey, can you clamp this over here... Yeah, thanks. Aww yeah... Do you smell what the doc is cookin'? Anyone up for a trip to Chick-n'-Pig after we finish here?"
Clean shaven makes one a hypocrite? More moronic ramblings from an Internet idiot that thinks they know something about the Bible when they don't. Have you even ever OPENED a Bible? So you're saying Muslims ARE Christians? Better not...you might get the beating of your life from one of them who would find that offensive.
If you're talking about the "Mosaic Laws" then I suggest you brush up on your Bible reading and see if you can conclude that it was abolished by the sacrifice of Jesus Christ. Otherwise I've never seen anything that suggests you can't shave.
I find it funny how idiotic some people on this site are sometimes. As for the blood being part of those same laws...this is true BUT it was mentioned again AFTER the "sacrifice" so it's upheld as something to follow even after the abolishing of these laws just as thou shalt not kill is also retained along with other things.