Splenectomy

What is splenectomy and why is it performed?

Splenectomy is a surgical procedure employed to remove the spleen. It is used to treat various diseases and conditions related to spleen.

Spleen is an organ located under the rib cage on the upper left side of the abdomen.

Following are the conditions that where splenectomy may be recommended:

Ruptured spleen:  if there are abdominal injuries the chances of spleen getting ruptured is high. If that happens there may be internal bleeding, the spleen may also get ruptured if there is an enlargement of the spleen and this condition is called splenomegaly.

Enlarged spleen: splenectomy may be recommended if there is enlarged spleen which is painful. In order to relieve the individual from pain the surgery is recommended.

If an individual is suffering from chronic lymphocytic leukemia, Hodgkin’s lymphoma, non-Hodgkin’s lymphoma and hairy cell leukemia then, splenectomy is suggested.

Non-cancerous cysts or tumors that are malignant inside the spleen also require this surgery.

Infections that are severe in nature and due to which there is collection of pus and formation of abscess in the spleen then, to treat these conditions splenectomy is recommended.

Also in cases of idiopathic thrombocytopenic purpura, polycythemia vera and thalassemia splenectomy is performed.

How to prepare for the

procedure?

The doctor will advise a full physical examination before the surgery, to check for any other complication that needs to be addressed before surgery.

Before the surgery blood transfusion is also carried out so that there are enough blood cells in the body of the patient after the removal of spleen.

The doctor will recommend pneumococcal vaccine to prevent infections after the spleen removal.

How is the procedure

carried out?

There are two approaches to remove the spleen, a minimally invasive approach and an open procedure. Depending upon the condition of the individual the surgeon opts for which one to employ.

The surgery is carried out under the influence of general anesthesia. In an open approach the surgeon makes an incision in the middle region of the abdomen, moving the other tissues and muscles aside. Once the spleen is visible surgical instruments go in and the spleen is removed.

In a Laparoscopic approach, once the patient is asleep the process begins by making incisions near the belly button and a small device is inserted which is called a port; it creates an opening that will used be filled with gas (carbon dioxide) in the abdomen region.

Through these incisions a Laparoscope (a Laparoscope is a small instrument with a narrow tube which has light source and camera at the end of the tube) is inserted and using the Laparoscope’s video camera the surgeon is able to locate the affected body part and through the other incisions that are made the damaged/affected (spleen) part is removed with the help of surgical equipment; after this the incisions are sealed using a surgical glue or staples.

How long does it take to recover and what are the guidelines to be followed

during the recovery?

The recovery time for Laparoscopic surgeries is very less and one can return to normal life within days of surgery, but they should avoid heavy lifting. The soreness after the surgery lasts for 48 hours and it can extend up to weeks depending upon the individual. If it’s an open procedure it will take longer for the patient to recover.

Post the surgery, in a life without spleen the functions of the spleen are taken over by the other parts of the body.

For a few weeks after the surgery the patient has to be in a highly sanitized area because he is susceptible to infections.

The patient will be discharged from the hospital in 6 to 8 days after the laparoscopic procedure and if it’s an open procedure the call to discharge will be taken by the doctor based on the condition of the patient.

The doctor will recommend vaccines against pneumonia, influenza, Haemophilus influenzae type b (Hib) and meningococci after surgery.

If the pain in the incisional area persists the doctor will advise bed rest for a week.

One might feel nauseated post-surgery, this might be due to anesthesia administered for the purpose of the surgery.

Post-surgery one might feel shoulder pain because of the gas that was pumped in during the surgery, which will go away within 48 hours.

When to call a doctor if complications

occur post-surgery?

If one feels nauseated, develops fever, bleeding occurs through the incisions, inability to urinate etc; under these circumstances it is better to get in touch with the doctor who performed the operation.

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