Splenectomy

(Spleen Removal; Removal, Spleen)

Definition

Splenectomy is the surgical removal of the spleen. The spleen is an organ in the upper left part of the abdomen. It lies beneath the ribs and behind the stomach.

The spleen filters blood. It removes items that can cause infection such as bacteria or parasites. It also removes old and damaged blood cells.

Spleen

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Reasons for Procedure    TOP

You may need to be treated by having a splenectomy if you have:

Possible Complications    TOP

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

Factors that may increase the risk of complications include:

  • Obesity
  • Diabetes
  • Smoking
  • Poor nutrition
  • Recent or chronic illness
  • Advanced age
  • Heart or lung disease
  • Bleeding or clotting disorders

What to Expect    TOP

Prior to Procedure

Your doctor may do the following:

  • Physical exam
  • Blood and urine tests
  • Review of your current medications
  • ECG
  • Other tests to evaluate the cause of the spleen enlargement
  • Studies to determine rate of destruction of red blood cells and/or platelets

Imaging tests to evaluate the abdomen and spleen may include:

Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.

Anesthesia

General anesthesia will be used. You will be asleep during the procedure.

Description of Procedure    TOP

The spleen can be removed through an open incision or through laparoscopic surgery.

Open Incision

An incision will be made in the abdomen over the spleen. The skin and muscles will be pulled back. The blood vessels to and around the spleen will be tied off. This will free the organ. Moist sponges may be placed in the abdomen. The sponges will absorb some of the blood and fluid. The spleen will be removed. The sponges will then be removed.

The muscles and skin will be closed with stitches or staples. A gauze dressing will be placed over the wound.

Laparoscopic Removal

A small incision will be made in the abdomen. A thin, lighted tube with a small camera will be inserted through the incision. It allows the doctor to see inside your body. Carbon dioxide gas will be passed into the abdomen. This puffs up the abdomen. It will give the doctor more room to work.

Two or three more small incisions will be made. Special tools will be inserted through these incisions. Blood vessels to the spleen will be cut and tied off. The spleen will then be rotated and removed. The incisions will be closed with stitches and covered with surgical tape.

Immediately After Procedure    TOP

The removed spleen is sent to the lab for testing.

You will be taken to a recovery room and monitored. You may need a blood transfusion if you lost a lot of blood.

How Long Will It Take?    TOP

About 45-60 minutes

Will It Hurt?    TOP

Anesthesia prevents pain during the procedure. There will be some pain and discomfort until you have healed. Medicine can help to manage discomfort.

Average Hospital Stay    TOP

The usual length of stay is 2 to 4 days. The stay may be longer if there are complications.

Post-procedure Care    TOP

Complete recovery may take up to 6 weeks. Some activities will be limited until you heal. Do not return to full activity or do any heavy lifting until your doctor says it is okay. Arrange for help at home for a couple of days.

You may be given specific exercises to do at home. It will help with healing and let you maintain strength. Pain can be managed with medicine. Do not take aspirin.

The spleen is part of the immune system. Without it, you will have a higher risk of certain infections. Vaccines can boost your protection against infections. Recommended vaccines may include:

Your doctor may also recommend daily antibiotics.

Always let your doctor(s) know that you do not have a spleen. Carry a national splenectomy card. When traveling, take special precautions against malaria and other infections.

Call Your Doctor    TOP

It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
  • Increasing pain or swelling in your abdomen
  • Cough, shortness of breath, chest pain, or severe nausea or vomiting
  • New or unexpected symptoms

If you think you have an emergency, call for emergency medical services right away.

RESOURCES:

Family Doctor—American Academy of Family Physicians
https://familydoctor.org
National Institute of Diabetes and Digestive and Kidney Diseases
https://www.niddk.nih.gov

CANADIAN RESOURCES:

Caring for Kids—Canadian Paediatric Society
http://www.caringforkids.cps.ca
The College of Family Physicians of Canada
http://www.cfpc.ca

References:

Cadili A, de Gara C. Complications of splenectomy. Am J Med. 2008;121(5):371-375.
Sabiston DC Jr. Textbook of Surgery. 17th ed. Philadelphia, PA: WB Saunders Co.; 2004.
Splenectomy. The Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/articles/splenectomy-spleen-removal. Accessed September 19, 2013.
Splenomegaly—differential diagnosis. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated June 5, 2017. Accessed September 5, 2017.
10/9/2009 DynaMed Plus Systematic Literature Surveillance http://www.dynamed...: Renzulli P, Hostettler A, Schoepfer AM, Gloor B, Candinas D. Systematic review of atraumatic splenic rupture. Br J Surg. 2009;96(10):1114-1121.
Last reviewed September 2017 by EBSCO Medical Review Board Donald W. Buck II, MD
Last Updated: 7/11/2018

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