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Routinepre-operative cross matching of two units of packed red cells (PRC) is currentpractice in our unit for patients undergoing elective laparoscopic colorectal surgery (LCS). This study aimed to determine the usage of PRC in patients undergoing elective LCS and its cost implications.Retrospective analysis of 116 consecutive laparoscopic colorectal resections under the care of two consultant surgeons.Surgicalprocedures were anterior resection (31.9%; n = 37), right hemicolectomy (22.4%; n = 26), sigmoid colectomy (22.4%; n = 26), subtotal colectomy (7.8%; n = 9), APR (4.3%; n = 5), panproctocolectomy (3.4%; n = 4), completionproctectomy (1.7%, n = 2), left hemicolectomy (0.9%, n = 1), total colectomy (0.9%; n = 1) & resection rectopexy (0.9%; n = 1). The median age was 65 years, 58% female. The medianpre-operative haemoglobin was 131 g/1, median blood loss 100 mls and median post operative haemoglobin 111.5 g/1. Eleven cases were converted. Three patients required perioperative blood transfusion, two of whom underwent open conversion. The cost of carrying out a group & save (G&S) in our hospital is £40.60 excluding laboratory staff labour cost. A two unit crossmatch costs £294.60. There is potential for substantial cost savings with change ofpractice to G&S only.Group and save is sufficient to allow safe & cost-effective operativepractice in laparoscopic colorectal surgery.