Surgeons are familiar with intraoperative cell salvage (ICS) but use it sparingly during liver resections for cancer due to concerns about tumor cell contamination, indicating a need for more robust oncological outcome data.

• 26 hepatopancreatobiliary surgeons reported moderate to high familiarity with ICS (23/26) and occasional use (23/26), but only 10 used it during liver cancer operations.
• Most cited oncologic safety as a barrier, and 20/26 expressed that long-term outcome data would boost their confidence in using ICS.

Surgeons are willing to participate in trials to assess ICS safety, highlighting a potential path forward in its adoption if safety concerns are addressed.