Why is blood not spilling out if the surgeon is operating on for example stomach.
In: Biology
Ob/Gyn here:
1. Entry. When we enter the abdomen or pelvis, we are careful to avoid any major blood vessels that would cause the patient to bleed out if damaged.
2. Damage control. Minor blood vessels can be easily cauterized with monopolar electrocautery. Larger bleeding vessels often need to be tied off with suture, or clamped and sealed with bipolar electrocautery. We can also use chemical hemostatic agents made from gelatin, cellulose, starch, etc. When we are done we close up layer-by-layer and make sure nothing is still bleeding.
3. Pressure. The body has its own methods of controlling bleeding. Sometimes all you need to do is hold pressure and allow the blood to clot by itself.
4. Manual evacuation. Sometimes its not enough and you just need to get the blood out of the way to focus on the source of the bleeding. We use suction and sponges.
5. Last resorts. If someone is bleeding too much and is beyond repair, we can remove the organ itself or large parts of it. Cesarean hysterectomies and splenectomies are good example of this.
6. Resuscitation. Sometimes blood is literally spilling out. This is is why you plan (if possible) major surgeries in a place where the patient can be resuscitated with major amounts of blood products.
Hope this helps! Interesting fact: Pregnant women routinely lose up to 1/5 of their pregnancy blood volume after a C-section, and about 1/10th after a vaginal delivery. Thankfully pregnant women have about that much extra blood (4-5L vs about 3-4L depending on size of person), which has been made hyper-coagulable, accumulated during the pregnancy.
Another interesting fact is the legendary Iranian hero Rostam from the Shahnameh (Book of Kings) was born via Caesarean section, which is (historically) called a Rostamineh, not a cesarean section because why would Iranians care about Rome or Caesar lol. According to the poem/legend, Rostam’s dad Zal got instructions from the simorgh (iranian phoenix) on how to do it on his pregnant wife Rudaba, and was able to save both the baby and mom on his first try! What a great teacher that bird was! Which I had him for residency
Here are some hilariously gruesome pictures of the surgery, from across the medieval Persianate world:
[https://pbs.twimg.com/media/DPwORwzX0AAWRRk?format=jpg&name=900×900](https://pbs.twimg.com/media/DPwORwzX0AAWRRk?format=jpg&name=900×900)
[https://s01.sgp1.digitaloceanspaces.com/inline/929881-12.jpg](https://s01.sgp1.digitaloceanspaces.com/inline/929881-12.jpg)
[https://i.pinimg.com/474x/9a/6b/e1/9a6be16a8eeac1228bee73571b3fd82c.jpg](https://i.pinimg.com/474x/9a/6b/e1/9a6be16a8eeac1228bee73571b3fd82c.jpg)
[https://media.gettyimages.com/photos/the-birth-of-rostam-picture-id167070846?s=594×594](https://media.gettyimages.com/photos/the-birth-of-rostam-picture-id167070846?s=594×594)
[https://www.bl.uk/learning/images/story/shah/birth%20of%20rostam-st.jpg](https://www.bl.uk/learning/images/story/shah/birth%20of%20rostam-st.jpg)
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