Mobile Platform Estimates Real-Time Surgical Blood Loss

Intraoperative blood loss can now be inferred through the use of an iPad app that calculates blood loss and hemoglobin mass on surgical sponges.

The Triton Fluid Management System is based on sophisticated computer algorithms used in combination with cloud storage technology. Using an iPad camera, the system scans surgical sponges that are covered in blood, and sends the images to the cloud, where feature extraction technology (FET) is used to automatically filter out nonsanguineous components—such as saline irrigation, ascites, and amniotic fluid—which can modify the spatial appearance of the sample. FET estimates the amount of blood contained in the sponge, and sends it back to the operating room in real time.


During a surgical procedure, a team member unfurls and points the wet sponge at the iPad, pressing a pedal to take an image. Once processed, an estimate of the amount of blood in the wet sponge is added to a running tally. The system also offers accurate, real-time Hemoglobin loss estimation and rapid scanning and sponge counting for retained foreign object vigilance. The Triton Fluid Management System is a product of Gauss Surgical (Los Altos, CA, USA), and has been approved by the US Food and Drug Administration (FDA). The system is fully Health Insurance Portability and Accountability Act (HIPAA) compliant.

“We identified a critical unmet need for a fast and accurate way to estimate blood loss on sponges in the operating room,” said Siddarth Satish, founder and chief technology officer of Gauss Surgical. “By leveraging the power of mobile devices in combination with our proprietary software we’re fulfilling that need with the potential to reduce unnecessary transfusions and the associated costs and complications.”

“Blood loss in surgery has always been estimated and in situations of large blood loss, erroneous,” said Aryeh Shander, MD, chief of the department of anesthesiology, critical care medicine, hyperbaric medicine, and pain management at Englewood Hospital and Medical Center (NJ, USA). “Over or under estimation of blood loss may lead to wrong clinical decisions. This new technology avails us the ability to more accurately account for blood loss with the potential to not only improve patient outcomes but also conserve healthcare resources.”

Clinical studies show that the use of blood products beyond a level deemed medically necessary can increase complication rates, intensive care unit (ICU) stays, and overall length of hospitalization. Overuse can also substantially increase the cost of care, since the cost of a single unit of red blood cells (RBCs) can reach as high as USD 1,100 (when administration and supply costs are included).

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