Are Routine Blood Group and Save Samples Needed for Laparoscopic Day Case Surgery?

Area of Science:

• Minimally Invasive Surgery
• Surgical Safety
• Health Economics

Background:

• Laparoscopic day case procedures generally have low complication rates.
• Routine pre-operative group and save (G&S) is standard practice for these procedures.
• The cost of G&S is a significant financial consideration.

Purpose of the Study:

• To evaluate the necessity of routine pre-operative G&S for common laparoscopic day case procedures.
• To assess the clinical indication for G&S in this patient population.

Main Methods:

• Retrospective review of patients undergoing laparoscopic cholecystectomy, inguinal hernia repair, and diagnostic laparoscopy.
• Analysis of hospital coding and transfusion department records.
• Identification of patients who underwent G&S or cross-match and received peri-operative transfusions.

Main Results:

• Zero patients received transfusions for bleeding complications following 532 procedures.
• The total cost for G&S over two years was £7558.
• One patient received a transfusion for pre-existing anemia, not a bleeding complication.

Conclusions:

• Pre-operative G&S is not clinically indicated for laparoscopic day case surgery due to 0% transfusion rates for bleeding complications.
• Discontinuing routine G&S can result in substantial cost savings.
• This practice change is clinically justified and financially beneficial.