Splenectomy is surgery to remove the entire spleen, which is a delicate, fist-sized organ that sits under your rib cage on the upper left side of your abdomen.

June 3, 2022

Splenectomy is surgery to remove the entire spleen, which is a delicate, fist-sized organ that sits under your rib cage on the upper left side of your abdomen.

Some facts about Splenectomy:

  • The spleen helps fight infection and filters unnecessary material, such as old or damaged blood cells from your blood.
  • A ruptured spleen, which is often caused by an abdominal injury can be treated by a Splenectomy.
  • Other conditions, such as splenomegaly in which an enlarged spleen causing discomfort, some blood disorders, certain cancers, infection, and noncancerous cysts or tumors can also be treated by a Splenectomy.
  • A tiny video camera and special surgical tools will be used to perform a Splenectomy.
  • A second spleen called an accessory spleen may grow and function when the main spleen is removed in some cases. 
  • Splenectomy is required when you have an injury that damages the organ as  ruptured spleen can lead to life-threatening internal bleeding.
  • Car accidents and severe blows to the abdomen during contact sports, such as football or hockey are common injury-related causes of a ruptured spleen.
  • A splenectomy may also be done if you have cancer in and around the spleen or certain diseases that affect blood cells.
  • A blood disorder called idiopathic thrombocytopenic purpura (ITP) is the most common disease-related reason for a spleen removal
  • The spleen does not regenerate after it is removed.
  • You will likely have spleen surgery immediately if you have a ruptured spleen and you have signs of massive internal bleeding or unstable vital signs, such as low blood pressure.

Preparation for Splenectomy:

  • A complete physical exam, blood test, and tests to look at your abdominal and chest area will be done before surgery.
  • Chest X-ray, electrocardiogram (EKG), magnetic resonance imaging (MRI) scan, and computed tomography (CT) scan may be performed depending on your age and condition.
  • You may need to clean out your bowels prior to the procedure by following a special liquid diet and taking medication. 
  • Quit smoking a few weeks before the surgery, make sure all other health conditions are well-managed before surgery, inform your doctor about any other supplements, prescriptions, and over-the-counter medications you are taking and about any possibility of pregnancy, if it is a scheduled surgery.
  • Any history of bleeding disorders or are taking any blood-thinning (anticoagulant) medicines, aspirin, or other medicines that affect blood clotting should be informed to your healthcare provider as you may need to stop taking these medicines before your surgery.
  • Take your medicine with a small sip of water to avoid drinking too much liquid if you do have to take any medications
  • Drugs or a vaccine will be given prior to surgery to prevent bacterial infections from developing after the spleen is removed.

Procedure for Splenectomy:

  • The procedure is called a partial splenectomy if only part of the spleen is removed.
  • General anesthesia will be given a few minutes before surgery so you are asleep and do not feel pain during the procedure.
  • Laparoscopic surgery and open surgery are two ways to perform a splenectomy.
  • An instrument called a laparoscope with a light and camera on the end will be used to perform Laparoscopic splenectomy.
  • Three or four small cuts will be made by the surgeon in the abdomen, and the laparoscope will be inserted through one of them so that the doctor can look into the abdominal area and locate the spleen.
  • Various medical instruments will be passed through the other openings.
  • Carbon dioxide gas will be delivered through this instrument into the abdominal area, which pushes nearby organs out of the way and gives your surgeon more room to work.
  • The spleen will be removed through the largest surgical opening after disconnecting the spleen from surrounding structures and the body's blood supply.
  • Stitches or sutures will be used to close the surgical openings.
  • The surgeon may have to switch to the open procedure sometimes during laparoscopic splenectomy when you have bleeding problems during the operation.
  • A larger surgical cut is required in open splenectomy than the laparoscopic method.
  • An incision will be made by the surgeon across the middle or left side of your abdomen underneath the rib cage.
  • The spleen will be removed after locating it and disconnecting it from the pancreas and the body's blood supply.
  • The procedure for Laparoscopy is less invasive than open surgery, and usually results in a faster recovery, less pain and a shorter hospital stay.
  • However, the method you and your doctor choose for Splenectomy depends on your overall health and the size of your spleen.
  • Laparoscopic surgery is not possible in all cases as it can be hard to remove a very large or swollen spleen using a laparoscope.
  • Laparoscopic surgery is also not possible in patients who are obese or who have scar tissue in the spleen area from a previous operation