Once you and your doctor have prepared for your bloodless procedure, you are ready to undergo surgery. Keep in mind that some blood loss is expected. However, a bloodless surgeon uses specialized instruments and techniques in order to minimize the blood loss and avoid the need for a transfusion of donor blood.

Here's what you can expect during your bloodless surgery:

  • Anesthesia Techniques Your anesthesiologist will employ a number of techniques to ensure a safe and successful surgery:
    • Body temperature - Carefully maintaining your body temperature to avoid dropping too low. When patients have a below-normal body temperature, they are more likely to lose blood.
    • Blood pressure - Maintaining your blood pressure at the optimal rate for a successful surgery is a delicate procedure requiring a highly skilled anesthesiologist. Hypotensive anesthesia lowers your blood pressure, which results in slower blood loss; however, it is important that your blood pressure does not drop too low or it poses a risk to your organs.
  • Hemodilution This is a technique to conserve your blood during surgery.
    • During hypervolemic hemodilution, doctors will infuse extra fluid into your blood to minimize the loss of red blood cells when you bleed.
    • During normovolemic hemodilution, or closed-system hemodilution, your blood is drawn and, in its place, you receive an equal amount of intravenous fluid. The volume remains the same but the blood flowing throughout your body is less concentrated. When you experience the inevitable blood loss, you are losing this less concentrated blood. At the end of the surgery, the more concentrated blood that had been drawn is returned to your body.
  • Interventional Radiology This technique can open closed blood vessels or close off bleeding vessels through very small holes in the skin.
  • Meticulous Hemostasis Your surgery team will pay close attention to even the smallest amount of bleeding and work quickly to stop it.
  • Minimally Invasive Surgery Your surgeon will choose the most minimally invasive procedure that will result in less blood loss.
  • Patient Position Certain positions, such as the Trendelenburg position, where the patient is on his or her back with feet higher than the head, have been shown to decrease the amount of bleeding, as well as increase the blood and oxygen delivery where the body needs it most.
  • Pulse Oximeter – Instead of needing to draw blood to check your oxygen level, this device uses infrared technology to estimate the amount of oxygen in your blood.
  • Selective Embolization/Embolotherapy – Embolization is the use of very high heat to cauterize or cut off the blood volume by burning. For example, if a patient has a vascular tumor, our bloodless surgeons would selectively embolize and then use gel foams. Without selective embolization, the blood loss would be greater.
  • Specialized Instruments Your surgeon will make use of the most innovative devices, which result in much less blood loss.
    • Harmonic scalpel: This scalpel cuts the tissue and seals the bleeding vessels at the same time.
    • CyberKnife: Used for brain surgery; utilizes a powerful form of radiation.
    • Laser surgery: Cuts through tissue using the energy from light
    • Cryosurgery: Destroys abnormal tissues by freezing them.
    • Stereotactic surgery/stereotaxic surgery: Pinpoints the exact site which needs treatment so surgeons can cut precisely where needed and avoid unnecessary cutting.
    • Argon beam: Causes the blood to clot at the bleeding site.
    • Electro cautery: Uses heat to stop bleeding.
    • Blood salvaging (Cell Saver®): When blood spills during surgery, it is collected using a Cell Saver machine. The blood is then filtered and reinfused back into the patient.
  • Volume Expanders – Another technique used by bloodless surgeons in which non-blood fluids are used to enhance your circulation.

Learn More about the Bloodless Medicine and Surgery Program at MedStar Georgetown:

Make an Appointment

For more information or to schedule an appointment with a bloodless medicine specialist, call


Bloodless Medicine Specialists

  • James Malatack, MD, Co-Director
  • Hiep Dao, MD, Co-Director
  • Mike Hofmann, Bloodless Medicine and Surgery Program Coordinator
  • Richard Verstraete, RN, Nursing Coordinator

Program Brochure

We are the only Bloodless Medicine and Surgery Program in the area. Learn more.

Related Resources

Join our Mailing List

To receive our quarterly newsletter, please email [email protected].