The last twenty years have witnessed a surge of interest in bloodless surgery, for a variety of reasons. Jehovah's Witnesses reject blood transfusions on religious grounds; others may be afraid of bloodborn diseases, such as hepatitis and AIDS.

Surgery may involve the use of techniques such as cell salvage, a device which recycles and cleans blood from a patient during an operation and redirects it into the patient's body.

Other methods include the use of blood substitutes, which at present do not carry oxygen but expand the volume of the blood to prevent shock. Blood substitutes which do carry oxygen are also under development.

Laser or sonic scalpels work by minimizing the bleeding during an operation.

Doctors may also use noninvasive techniques as well.

Further information about bloodless surgery

• Time Magazine Special Report (http://www.time.com/time/reports/heroes/bloodless.html)
• Outline of techniques used (http://www.bloodlessmed.com/Pages/alternatives.htm)
• Report on a conference in Moscow concerning bloodless surgery (Jehovah's Witness website) (http://www.watchtower.org/library/g/1999/4/22a/article_01.htm)
• Bloodless surgery helps save lives - Imperial College, London (http://www.imperial.ac.uk/P3731.htm)
• noblood.org - A 'virtual community' for healthcare professionals and others who wish to discuss bloodless medicine (http://www.noblood.org/)