Splenectomy

A splenectomy is a surgical procedure where the spleen is removed.

Before we explain the procedure, let’s talk about the structure of the spleen. The spleen has two jobs; one is to protect the body from dangerous microorganisms and the other is to filter waste and unwanted things from the blood. For example, the spleen removes old and damaged cells from the blood. It is located at the left side of the abdomen, under the ribs.

The most common reason for having a splenectomy is a ruptured spleen caused by trauma. However, any disease or disorder that can cause a dysfuntion in the spleen or enlarge the spleen (splenomegaly) could justify the need for a splenectomy. Some of these include:

• Blood disorders
• Cancers
• Infections
• Non-cancerous cysts or tumors

Reasons for prescribing a splenectomy

Below is a more detailed explanation of why a doctor would prescribe a splenectomy.

• Ruptured/enlarged spleen: You might wonder why a doctor doesn’t treat the spleen rather than removing it or why a large spleen is dangerous. The answer to the first question is that a lot of blood flows into the spleen, and a person whose spleen has been ruptured would bleed to death very quickly. In addition, splenectomy can help alleviate symptoms of an enlarged spleen such as pain and feeling heavy and full.
• Blood disorders: A splenectomy can treat blood disorders such as ITP, polycythemia, and thalassemia. In these cases, a splenectomy is the last resort after you’ve tried all other treatments.
• Cancer: Cancers treatable through splenectomy: chronic lymphocytic leukemia, Hodgkin and non-Hodgkin lymphomas, and hairy cell leukemia.
• Infections: If a spleen is suffering from severe infection or abscess and is not responding to treatment, it must be removed.
• Benign tumor: A splenectomy is necessary if a benign tumor in the spleen is so large that it cannot be removed separately.

Paraclinical testing before a splenectomy

Your doctor may order an ultrasound, CT scan and/or MRI to help with the diagnosis. Many types of blood testing can also help identify blood disorders.

Preoperative care, the procedure, and postoperative care

Before the procedure

In non-emergency situations you must get the required vaccines 2 weeks before the procedure. Consult your doctor about taking your medication. Ask your doctor about when you should stop eating before the surgery. If you are having the surgery in a non-emergency situation, blood with the appropriate blood group will be readied in case you need a transfusion during the surgery. You will wear the hospital gown, lie on your back on the operating table and be taken to the operating room.

The splenectomy procedure

Before the surgery begins, you will be put under general anesthesia. This means that you will be unconscious throughout the surgery and won’t feel anything. An IV line will be started to administer drugs or any other liquids when needed. The surgical staff will attach heart monitors to your chest and a blood pressure cuff on your arm to monitor your condition throughout the procedure. They will also attach a device to your finger that assesses your blood oxygen levels.

Now it is time for the surgery to begin. If you will be undergoing a laparoscopy, 4 small incisions will be made and a camera along with the required tools will be inserted through them. Otherwise, there will only be one big incision. The surgeon will remove the spleen and then close the incision(s).

After procedure

First, you’ll be taken to the recovery room until you become conscious and then you’ll be taken to your room in the ward.

Talk to your physician to know how long it will take until you can return to your normal day-to-day life. It may be 2 weeks if you had a laparoscopic procedure or 6 weeks if you had an open surgery.

Important notes regarding the splenectomy procedure

Immediately notify your doctor if you experience the following after the procedure:

• 38°C+ fever
• Sore throat
• Shaking and shivering due to chills
• Swelling or redness somewhere on the body
• A cold that lasts longer than normal

Duration of hospitalization

The duration of hospitalization varies depending on the way the procedure was performed. If you had a laparoscopy, you may have to stay for only one day but if you had an open surgery, it might be 2-6 days before you can leave.