Splenectomy Procedure
Overview
A splenectomy involves the removal of the spleen, an organ found beneath the rib cage on the upper left side of the belly. The spleen plays a key role in protecting the body from infection and helps get rid of old or damaged blood cells.
Common Reasons for Spleen Removal:
- Ruptured spleen after an injury
- Large spleen causing pain or discomfort
- Blood disorders
- Certain cancers
- Infection or benign cysts
Laparoscopic splenectomy is a common technique, where doctors use a small camera and specialized tools to remove the spleen. This method often shortens hospital stays, and many patients can go home the same day. Full recovery usually takes about two weeks.
Main Reasons for Spleen Removal
Doctors perform splenectomy for several medical reasons. They may remove the spleen when it is injured, enlarged, or not working properly. Common causes for splenectomy include:
- Severe Injury or Rupture: Trauma, such as an accident, can cause the spleen to rupture and result in dangerous internal bleeding.
- Enlarged Spleen (Splenomegaly): An enlarged spleen can cause pain and discomfort. When it becomes too large or causes symptoms, surgery might be needed.
- Blood Disorders: Certain blood problems can make the spleen work too hard or stop working right. Conditions like idiopathic thrombocytopenic purpura, hemolytic anemia, and thalassemia are sometimes treated with a splenectomy after other treatments do not work.
| Condition | Why Splenectomy Helps |
|---|---|
| Enlarged spleen (splenomegaly) | Relieves pain, discomfort, or fullness. |
| Blood disorders | Reduces breakdown of blood cells; helps control symptoms. |
| Trauma or injury | Prevents life-threatening bleeding. |
| Cancer (like leukemia, lymphoma) | Removes cancerous or affected tissue. |
| Infections or abscess | Removes infected tissue if antibiotics do not work. |
| Cysts or tumors | Removes growths that cannot be treated in other ways. |
Doctors sometimes remove the spleen to treat cancers such as chronic lymphocytic leukemia, Hodgkin’s lymphoma, non-Hodgkin’s lymphoma, or hairy cell leukemia. In other cases, when medicine does not resolve a severe infection or abscess, they may recommend splenectomy.
Large cysts or tumors inside the spleen, whether cancerous or not, can also prompt this surgery. Doctors may also suggest this procedure when they need tissue from the spleen to help diagnose certain illnesses, especially when the spleen is enlarged and the cause is unknown.
Possible Complications
After a splenectomy, the body becomes less effective at fighting certain bacteria, increasing the risk of infections like pneumonia and meningitis. To reduce this risk, doctors typically recommend vaccinations against specific bacteria, including:
- Pneumococcus
- Haemophilus influenzae type b (Hib)
- Meningococcus
- Influenza
Doctors may also prescribe preventive antibiotics, especially for individuals with additional health concerns. It’s important to stay alert for any signs of infection following spleen removal.
Steps Before Surgery
Diet and Medicine Guidelines
Patients are usually advised to stop eating and drinking several hours before surgery. Some medications, such as blood thinners and certain supplements, may need to be paused. Always follow your healthcare provider’s guidance about which medicines are safe to take. In some cases, antibiotics or corticosteroids are started in advance.
Safety Steps to Take
Doctors may suggest blood tests or a blood transfusion if needed. They often give vaccines, like the pneumococcal shot and other booster shots, weeks before surgery to help protect against infection after they remove the spleen.
What You Can Expect
Before the operation starts, the anesthesia team gives the patient general anesthesia through a mask to breathe in a gas or as a liquid injected into a vein. This ensures the patient is fully asleep and does not feel pain during the surgery.
Doctors and nurses carefully check the patient’s vital signs using a heart monitor and blood pressure cuff. They place the monitors on the chest and upper arm to track the patient’s condition during the procedure.
What Happens in the Operating Room
After the patient becomes unconscious, the surgeon begins the operation using one of two main techniques: minimally invasive (laparoscopic splenectomy) or open surgery.
- Laparoscopic Splenectomy:
- The surgeon makes several small cuts in the patient’s abdomen—usually four.
- A thin tube with a small camera goes in through one of these openings.
- Special medical tools are inserted through the other incisions to help remove the spleen.
- The camera sends live images to a screen, so the surgeon can see and work on the spleen without a large cut.
- After the surgeon removes the spleen, the incisions are closed.
- This method is not always possible for everyone, especially in cases where the spleen is very large or has ruptured.
Open Splenectomy:
- The surgeon makes a bigger cut in the middle of the abdomen.
- Muscle and tissue are gently moved to reach the spleen.
- The surgeon carefully removes the spleen and closes the wound.
- Sometimes, if there are complications or the spleen is too large, the surgeon may switch from a laparoscopic to an open method.
What Follows After Surgery
After the procedure, the patient is taken to a recovery room for monitoring. If the surgery was laparoscopic, most people can go home the same day or the next day. In contrast, an open splenectomy typically requires a hospital stay of two to six days.
Before discharge, doctors will provide clear instructions for home care and recovery. Recovery tends to be quicker after laparoscopic surgery, with most patients resuming normal activities within two weeks. For open surgery, full recovery may take up to six weeks.
Regardless of the surgical method, follow-up care is essential. Patients without a spleen are at higher risk for infections, so ongoing monitoring and preventive steps are important for long-term health.
Outcomes
After spleen removal, other organs take on most of the spleen’s jobs. Most people return to a regular life, but their risk of serious infections increases, especially soon after surgery. The immune system weakens, so people get sick more easily and take longer to recover.
Key risks after spleen removal include:
- Higher chance of severe infection.
- Slow or difficult recovery from illness or injury.
Steps to Lower Infection Risk
| Prevention Step | Description |
|---|---|
| Vaccination | Vaccines for pneumonia, influenza, Hib, and meningococcal bacteria are important. |
| Preventive Antibiotics | Doctors sometimes prescribe these for children under 5 or others at high risk. |
| Watch Signs of Infection | Notify a doctor if fever (above 100.4°F/38°C), chills, sore throat, or redness appear. |
| Medical Identification | Wear a medical alert bracelet so caregivers know about spleen removal. |
People need to stay aware of changes in their health. Act quickly if symptoms like high fever, lasting cold, chills, or sore throat occur. Anyone involved in their care should know about the absence of the spleen.
