A splenectomy is a surgical procedure that involves the total or partial removal of the spleen. The spleen plays an important role in the body's immune system, helping it fight off germs and infections. The spleen also helps filter the blood and regulates the blood supply to the liver. If the spleen becomes damaged or diseased, a splenectomy may be necessary.
Splenectomies are performed under general anesthesia, which means the patient is asleep. A laparoscopic splenectomy involves the use of a thin instrument with a camera and light at the end called a laparoscope. The surgeon inserts the laparoscope through a small cut in the abdomen, while the surgical tools are inserted through other small cuts. Patients who have a laparoscopic splenectomy generally recover more quickly than those who have an open splenectomy.
An open splenectomy involves a large incision across the center of the abdomen or on the left side of the abdomen below the ribs. The surgeon removes the spleen through the incision before stitching it closed. Patients who need a splenectomy due to cancer of the spleen often have open splenectomies so that the surgeon can examine the lymph nodes in the stomach for signs of cancer. Infected lymph nodes may also be removed during the procedure.
If the entire spleen is not damaged or diseased, the surgeon may only remove part of the spleen. This helps lower the risk of infection, since the spleen helps the immune system fight germs in the body. Patients with enlarged spleens often find pain relief after a partial splenectomy.
The most common splenectomy risk is the development of an internal bacterial infection that can spread throughout the body. After the spleen is removed, the body's ability to filter bacteria out of the blood and fight viruses is lowered. Children have a greater risk of infection than adults do, and the risk is highest during the first two years following the procedure. The risk of infection can be minimized by receiving vaccinations before the procedure to lower the risk of certain infections.
Other splenectomy complications include reactions to the anesthesia, breathing problems, blood clots, significant blood loss, and infection. Patients can minimize the risk of infection by eating a healthy diet before and after surgery, refraining from tobacco and alcohol, and caring for the surgical wound properly. The procedure can cause damage to nearby organs, such as the stomach, pancreas, and colon. The risk of damage to other organs is minimized when an experienced surgeon performs the procedure.
Full splenectomy recovery usually takes four to six weeks. Most patients spend less than one week in the hospital following the surgery. Patients should refrain from heavy lifting or any movement that pulls on the incision until it is fully healed. Surgeons give splenectomy patients detailed instructions on how to take care of the surgical incision, including washing and changing the dressing.