For many people, blood and surgery may seem like they go together hand in hand, but at San Ramon Regional Medical Center, physicians realize that in some cases, significant blood loss is not a viable option for patients.
That's why the hospital offers a series of blood conservation -- or bloodless medicine -- programs for many of its procedures.
For more than 20 years, San Ramon Regional has offered programs that include surgical techniques, medications and technology aimed at minimizing blood loss during procedures for patients who need to avoid blood transfusions due to religious beliefs or medical concerns.
"Bloodless surgery is beneficial to the patient as it prevents the necessity of the added risk associated with receiving a blood transfusion. Having performed over 10,000 spine surgeries in my career, I have been able to reduce blood loss during spine surgery to a minimum despite a practice that sometimes involves major deformity correction (scoliosis, kyphosis, fractures)," said Dr. Robert A. Rovner, an orthopedic spine surgeon at San Ramon Regional.
Hospital officials say they have a dedicated staff skilled in blood conservation techniques that replace the traditional necessity of replacing blood lost during surgery with banked blood from donors.
"It is quite rare for us to require a blood transfusion," Rovner said. "We are very meticulous with controlling the bleeding and have a cell saver available for the rare case where there is atypical bleeding."
In addition to conducting minimally invasive surgery when possible, methods used at San Ramon Regional to increase blood conservation include:
* Blood salvaging, or recycling blood through a machine that cleans blood and returns it to a patient's body.
* Specialized surgical devices such as the harmonic scalpel, argon beam coagulator and electrocautery -- also known as thermal cautery -- that seal blood vessels and minimize bleeding.
* Certain medications can be used to regulate the clotting and control bleeding. The genetically engineered hormone EPO (erythropoietin) for example can be used to have a patient's body replace lost blood at a faster pace.
* Conservation techniques can also be used in the laboratory, where both before and after surgery physicians can conduct blood tests using a minimal amount of blood through a process called "micro-sampling."
* Stressing the importance of good nutrition, patients can be proactive in ensuring their blood and bodies are as ready as possible for surgery by asking physicians about proper nutritional measures leading up to their procedures.
Hospital officials say San Ramon Regional is a destination hospital for patients seeking bloodless surgery. While the techniques have developed for people who need bloodless surgery mainly for religious reasons, many of the practices have become standard procedure.
"These procedures make us better surgeons," said Dr. Murali Dharan, a cardiothoracic surgeon at San Ramon Regional. "We have done hundreds of bloodless surgeries and procedures with excellent results."
Speaking as to why patients needed bloodless surgery in the first place, Dharan said "The main reasons typically include religious beliefs or medical concerns, such as risk of infection. However, blood products are screened very well and the risk is extremely low."
"At San Ramon Regional Medical Center, we respect and care about our patients and their individual values, beliefs and preferences," chief Strategy Officer Pam Yoo said. "People travel to our hospital for our bloodless medicine program, as well as the experts and compassionate care we provide."