Splenectomy
Introduction
What is it?
Splenectomy is the removal of the spleen via surgery. The spleen is an organ the size of a fist which lies on the upper left side of your abdomen. It is an important part of your immune system as it produces blood cells, but you can survive without it as the liver can take over many of its functions.
A splenectomy is often required to treat blood disorders or if it is damaged by an injury, such as a strong blow to the abdomen. It may also be required in cases where the spleen swells up in size (called “splenomegaly”), to control symptoms and prevent injury to other organs.
Why is it done?
A splenectomy acts as treatment for blood disorders, and it also helps control excessive bleeding if the spleen has been damaged by trauma.
Another benefit of a splenectomy is that it can help with diagnosing the disease in the spleen. For instance, in the case of an enlarged spleen without a known cause, removing the splenectomy allows your doctors to find the cause behind it and then treat that cause.
Will I need any preparation?
If the surgery is planned, you should receive vaccinations for bacteria that could cause infection two weeks before the surgery.
Instead, if it is an emergency surgery, the vaccines should be given two weeks after the surgery.
The recommended vaccinations are:
· S. pneumoniae
· N. meningitidis
· H. influenzae
· Influenza virus
· MMR (measles-mumps-rubella) and varicella, 4-8 weeks apart
· Diphteria, Tetanus, Pertussis (booster if fully vaccinated already, 3-dose if not)
Technique
Anaesthesia
This procedure is usually done under general anaesthetic. This means you’ll be asleep the entire time and shouldn’t feel any pain.
What does it involve?
Most operations to remove the spleen are done by keyhole surgery. This allows the surgeon to operate without having to make large cuts, so you’ll have less scars and recover faster.
The procedure involves:
1. Making some small cuts on your tummy
2. Putting a small probe with a camera on its end into one of the cuts, so the surgeon can see what they are doing
3. Pumping some gas into your tummy so the surgeon has more space to work in
4. Passing thin instruments in through the cuts to cut out and remove the spleen
Open surgery is occasionally done in emergency situations, or if the spleen is too damaged or too big to remove through keyhole surgery. In this case, one large cut will be made on your tummy to remove the spleen.
Post procedure course (follow-up)
You should be able to eat and drink as normal after the operation. You may feel a little sore initially.
You may be able to go home the same day of the surgery, although someone will need to stay with you for 24 hours. Depending on the surgery and the circumstances, you may however be kept in hospital overnight.
You will be given lifelong antibiotics to prevent infections from happening. However, infections could still happen, so you should be aware of any signs of infection (such as fever, cough, or sore throat) and go see your GP immediately if these happen.