Splenectomy

What is a splenectomy?

A splenectomy is the surgical removal of the spleen. The spleen is an organ located under the ribs on the left side of the body. It filters your blood and helps your body fight infections. The spleen is part of the lymphatic system, which also includes the lymph nodes, lymph vessels, lymphatic fluid, the tonsils, thymus, and lymphoid tissue of the digestive tract. Your doctor may perform a splenectomy because your spleen has been damaged or diseased by certain types of cancer, infection, or blood disorder, such as immune thrombocytopenic purpura (ITP).

Once your spleen is removed, other organs will take over the majority of the spleen’s former functions. However, the absence of a spleen puts you at increased risk of infection. If you have a splenectomy, you will need to work with your doctor to make sure you receive the right vaccinations, antibiotics, and other medications to bolster your immunity.

A splenectomy is a major surgery with serious risks and potential complications. You may have less invasive treatment options and should consider getting a second opinion about all your treatment choices before having a splenectomy.

Why is a splenectomy performed?

Splenectomy is a major surgical procedure that your doctor may recommend to treat certain diseases and conditions of the blood and lymphatic system. Your doctor may only consider a splenectomy for you if other treatment options that involve less risk of complications have been ineffective. Talk with your doctor about all your treatment options and consider getting a second opinion.

Your doctor may recommend a splenectomy for damage or disease of the spleen and blood caused by:

• Benign tumor of the spleen, a noncancerous tumor
• Blood disorders, including hereditary spherocytosis, hereditary elliptocytosis, immune thrombocytopenic purpura (ITP), hemolytic anemia, and thalassemia
• Cancers that affect the spleen, including leukemia, non-Hodgkin lymphoma, and Hodgkin's disease (Hodgkin’s lymphoma)
• Cirrhosis of the liver, which occurs when an underlying disease or condition, such as alcoholism, causes scar tissue to form in the liver
• Cyst or abscess of the spleen, which can occur as a complication of trauma or other process
• Injury to the spleen or other abdominal organs
• Ruptured spleen, which can be due to severe trauma
• Sickle cell anemia, a disorder in which the body makes abnormally sickle-shaped red blood cells

How is a splenectomy performed?              

A gastrointestinal surgeon will lead a surgical team and perform your splenectomy in a hospital. A gastrointestinal surgeon is a physician who specializes in conditions of the gastrointestinal tract and abdomen. Your surgeon will perform the procedure by making an incision or series of incisions in the upper left abdomen. He or she then cuts out the spleen and its attachments to other organs.

Surgical approaches to splenectomy

Your doctor will perform a splenectomy using one of the following approaches:

• Minimally invasive surgery is a procedure performed by inserting special instruments and a laparoscope through small incisions in the abdomen. The laparoscope is a thin, lighted instrument with a small camera that transmits pictures of the inside of your body to a video screen. Your surgeon sees the inside of your abdomen on the video screen as he or she performs the surgery. Minimally invasive surgery generally involves a faster recovery and less pain than open surgery. This is because it causes less trauma to tissues and organs. Your surgeon will make small incisions instead of a larger one used in open surgery. He or she can then thread surgical tools around muscles and other tissues instead of cutting through or displacing them as in open surgery.
• Open surgery is performed by making a large incision in the abdomen. Open surgery allows your surgeon to directly view and access the surgical area. Open surgery generally involves a longer recovery and more pain than minimally invasive surgery. This is because it causes more trauma to tissues. Open surgery requires a larger incision and more cutting and displacement of muscle and other tissues than minimally invasive surgery. Despite this, open surgery may be a safer or more effective method for certain patients.