Spleen removal (splenectomy) is surgery to remove a diseased or damaged spleen. This organ is in the upper part of your belly, on the left side. It helps your body fight germs and infections. It also helps filter your blood.
Why The Procedure Is Performed ?
Some conditions that may require spleen removal are:
- Trauma to the spleen
- Blood clot (thrombosis) in the blood vessels of the spleen
- Diseases or disorders of blood cells, such as idiopathic thrombocytopenia purpura (ITP), hereditary spherocytosis, thalassemia, hemolytic anemia, and hereditary elliptocytosis. These are all rare conditions.
- Sickle cell anemia
- Abscess or cyst in the spleen
- Lymphoma, Hodgkin's disease, and leukemia
- Other tumors or cancers that affect the spleen
- Cirrhosis of the liver
- Splenic artery aneurysm (rare)
Risks for any surgery are:
- Blood clots in the legs that may travel to the lungs
- Breathing problems
- Infection, including in the surgical wound, lungs (pneumonia), bladder, or kidney
- Blood loss
- Heart attack or stroke during surgery
- Reactions to medicines
Before The Procedure
You will have many visits with your doctor and several tests before you have surgery.
Some of these are:
- A complete physical exam
- Screening blood tests, special imaging tests, and other tests to make sure you are healthy enough to have surgery
- Transfusions to receive extra red blood cells and platelets, if you need them
- Immunizations, such as pneumococcal (Pneumovax), meningococcal vaccine, Haemophilus vaccine, and flu vaccine
If you smoke, you should stop smoking several weeks before this surgery. Spleen removal is major surgery, and smoking will increase your risks of problems.
You will have a general anaesthetic, and will be asleep for the whole operation. A cut is made in the skin between your breast bone and your tummy button. The spleen is taken out. The cut in the skin is then closed up. You will need some treatment for a year or more to ward off infections. Plan to go home 7 days after the operation. That is, unless there is a need for you to go back to a medical ward for extra treatment from the haematology specialist. You will be told about this at the time. You will need to take antibiotics and have vaccinations for a year after the operation.
The surgeon locates and isolates the spleen, rotates it and brings it out of the wound. Its attachments to other organs are gently cut. In children, following traumatic injury and splenic disruption, a healthy fragment of the spleen may be reimplanted. Such fragments provide continued splenic function.
Complications are unusual but are rapidly recognised and dealt with by the nursing and surgical staff. Chest infections may arise, particularly in smokers. Co-operation with the physiotherapists to clear the air passages is important in preventing the condition. Do not smoke. Wound infection is a rare problem and settles down with antibiotics in a week or two. Aches and twinges may be felt in the wound for up to 6 months. Occasionally there are numb patches in the skin around the wound which get better after 2 to 3 months. In the longer term there is a risk of you getting infections readily. We will arrange for you to take antibiotics for a year or longer just in case. You may need antibiotics and booster injections to prevent this. The haematologist or your GP will advise you.
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