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.
Copyright © Nucleus Medical Media, Inc.
Reasons for Procedure
You may need to be treated by having a splenectomy if you have:
- Trauma to the spleen
- Splenic rupture due to tumor, infection, inflammatory condition, or medications
- Enlargement of the spleen—splenomegaly
-
Certain
blood disorders when other treatments are not working, including:
- Idiopathic thrombocytopenia purpura
- Hereditary spherocytosis
- Thalassemia
- Hereditary elliptocytosis
- Some types of leukemia or lymphoma
- Tumor or abscess in the spleen
- Liver disease—cirrhosis
- Abnormal formation of fibrous tissue in the bone marrow
- Damage in the blood vessels of the spleen
- Diseased spleen, due to disorders like HIV infection
Possible Complications
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
- Infection
- Bleeding
- Hernia formation at incision site
- Blood clots
- Damage to other organs
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
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
- Give certain vaccines to boost immune system after surgery
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 1 week before the procedure.
Anesthesia
General anesthesia will be used. You will be asleep during the procedure.
Description of Procedure
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 3 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
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?
About 45 to 60 minutes
Will It Hurt?
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
The usual length of stay is 2 to 4 days. The stay may be longer if there are complications.
Post-procedure Care
Complete recovery may take up to 6 weeks. Some activities will be limited during recovery.
The spleen is part of the immune system. There is a higher risk of some infections after it is removed. Vaccines can boost protection against the infections. The type will depend on individual needs.
Call Your Doctor
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, 2019.
Splenomegaly—differential diagnosis. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T270052/Splenomegaly-differential-diagnosis. Accessed September 5, 2019.
10/9/2009 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T116823/Splenic-injury-and-rupture: 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 2019 by EBSCO Medical Review Board Donald W. Buck II, MD Last Updated: 10/9/2020