Bloodless surgery in gynecologic oncology

Bloodless medicine and surgery is an evolving field in the practice of medicine designed to avoid allogeneic transfusions. Although this field has largely developed in response to the growing needs of Jehovah's Witness patients refusing transfusions, all patients may potentially benefit from the avoidance of transfusions. The applications of bloodless techniques and strategies in the field of gynecologic oncology have been limited until recently, in part because of the generally large blood loss associated with gynecologic cancer surgeries. However, as advances in our understanding of bloodless surgery have developed and surgical techniques have been refined, the gynecologic oncology patient can now benefit from the avoidance of allogeneic transfusions. This review outlines bloodless surgery as it applies to gynecologic oncology patients and presents a structured approach to successfully managing these complex patients.