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Ann R Coll Surg Engl. 2009 April; 91(3): 266–267.
PMCID: PMC2765021
Technical Notes and Tips
Bruce Campbell, Section Editor

Pelvic Surgery: Water or Saline Wash?

Major pelvic surgery may be associated with significant bleeding. Deep in the pelvis, small bleeding vessels are often difficult to identify. Washouts with normal saline or water are often used to aid clarity of the surgical field. To the naked eye, water and normal saline are both clear in a transparent bottle. However, water remains clear when in contact with blood, thus aiding the identification of individual bleeding small vessels (Figs 1 and and2).2). This effect is not observed with normal saline which gives a cloudy appearance. Furthermore, water has the theoretical benefits of tumour cell lysis by osmosis during the wash.1

Figure 1
Operative field after water lavage.
Figure 2
Operative field after saline lavage.


1. Huguet EL, Keeling NJ. Distilled water peritoneal lavage after colorectal cancer surgery. Dis Colon Rectum. 2004;47:2114. [PubMed]

Articles from Annals of The Royal College of Surgeons of England are provided here courtesy of The Royal College of Surgeons of England