Abstract
<h3>Study Objective</h3> To determine the utility of the Triton quantitative blood loss (QBL) system (Gauss Surgical, Inc, Los Altos, CA) in more accurately measuring blood loss during gynecologic surgery. <h3>Design</h3> Gynecologic surgery was performed with no changes in standard practice. Estimated blood loss (EBL) was determined by the surgeon, and the Triton system was then used to measure QBL. Surgeon was blinded to QBL values. <h3>Setting</h3> All cases were performed by the minimally invasive gynecologic surgery division at a tertiary care facility. <h3>Patients or Participants</h3> All cases were eligible. 59 cases were assessed as part of this study. 38 cases were laparoscopic, 20 cases were laparotomies, and 1 case was vaginal. <h3>Interventions</h3> QBL was recorded in addition to the surgeon's EBL with no other changes in standard care. Surgeon, procedure, operative time, pre-operative hemoglobin, post-operative hemoglobin, and blood transfusions were also recorded. <h3>Measurements and Main Results</h3> QBL was on average 204 mL higher for all cases, with 218 mL for laparoscopic cases, and 190 mL for open cases. Coefficient for EBL vs QBL was 1.47 (p<0.05) with a R<sup>2</sup> of 0.663. Coefficient for operative time vs EBL was 2.74 (p<0.05) with a R<sup>2</sup> of 0.344, while time vs QBL was 4.18 (p<0.05) with a R<sup>2</sup> of 0.244. Coefficient of QBL vs. the difference between QBL and EBL was 0.55 (p<0.05) with a R<sup>2</sup> of 0.746. Among those cases with post-operative hemoglobin (n=25), coefficient for EBL vs. hemoglobin extrapolated blood loss was 0.688 (p<0.05) with a R<sup>2</sup> of 0.374, while QBL vs. hemoglobin extrapolated blood loss was 0.407 (p<0.05) with a R<sup>2</sup> of 0.463. The difference between these two R<sup>2</sup> values was not statistically significant (p=0.33). <h3>Conclusion</h3> QBL showed higher blood loss measurement than EBL, suggesting that EBL is underestimating blood loss. Size of difference between EBL and QBL was strongly associated with QBL values suggesting EBL is more inaccurate with higher blood loss.
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