What is a Splenectomy (Spleen Operation)?
The spleen is a very important organ of the lymphatic and immune systems located below the left side of the rib cage. It is known for conducting several crucial functions that include the purification of old or damaged red blood cells, storing platelets, and producing white blood cells to fight infections. Although the spleen is a comparatively small organ in the body, it plays a very key role in the maintenance of blood health and immune defense. But due to some disease conditions like rupture of the spleen in case of trauma, enlarged spleen, hypersplenism, blood cancer, idiopathic thrombocytopenic purpura, thalassemia, or spherocytosis, removal of the spleen becomes a very necessary step, through a spleen operation and procedure called splenectomy. It is the most common surgical procedure that involves the spleen, which usually involves partial or complete removal of the spleen, depending on the patient’s disease condition.
Types of Spleen Operation
Splenectomy is conducted depending on the medical condition that is being treated, and on which type of splenectomy that is being done, which is one of the following:
- Total splenectomy is the complete removal of the spleen. It is carried out when the spleen is completely damaged, or is affected by tumors, or in cases of certain blood diseases.
- Partial splenectomy is a type where only a part of the spleen is removed. This helps in keeping intact at least some type of immune functionality while treating localized diseases or injuries.
- Laparoscopic splenectomy is a minimally invasive splenectomy technique that is conducted using small cuts and a camera to remove the spleen. This results in recovering faster and leads to less post-operative pain.
- Open splenectomy is another subtype of splenectomy where the cut made for the operation is larger, especially in the abdominal region. Open splenectomy is first choice preference in cases of trauma, large spleen, or in case of extensive bleeding or cases where there are complications.
| Procedure Name | Spleen Operation |
|---|---|
| Type of Surgery | Minimally invasive or keyhole surgery in the case of Laparoscopic splenectomy, and traditional surgery in the case of an Open splenectomy |
| Type of Anesthesia | General anesthesia |
| Procedure Duration | Laparoscopic splenectomy takes 1-2 hours, Open splenectomy takes 1-5 hours, depending on the severity and how complex the case is |
| Recovery Duration | Laparoscopic splenectomy, the patient can go home the same day or stay for 1-2 days. Full recovery takes two to 4 weeks. Open splenectomy, patients need to stay in the hospital for 2-6 days. Full recovery usually takes 4-6 weeks. |
Spleen Operation: Pre-Op & Post-Op Care
Splenectomy requires extensive pre-operative care, intra-operative care, and post-operative care to make the patient safe and immune to long-term infection and diseases. Because of the importance of the spleen as an organ, especially in the maintenance of immunity and the immune system, post its removal, a patient needs to take necessary precautions lifelong.
Before The Start Of Splenectomy
Pre-operative care for splenectomy focuses on examination of the patient, education, and vaccination to avoid infections after surgery.
Evaluation and optimization involve a complete physical examination of the patient, blood tests, and imaging of the patient’s overall health. Any disorders related to blood are taken care of before surgery. Management of medicines involves blood thinners like aspirin, and the patient is either instructed to fix the dose or completely avoid them.
Vaccination before splenectomy surgery is the most important step, especially in elective splenectomy, which is the removal of the spleen in non-emergency cases.
Patients receive vaccines against the pneumococcus bacteria that cause pneumonia, Haemophilus influenzae type B, Meningococcus that causes meningitis, and annual influenza and COVID-19 vaccine shots.
For surgeries that are planned previously, vaccines are given several weeks before to build immunity.
The healthcare team then educates the patient on the procedure, the recovery process, and the lifelong risk of the infection. Patients are usually advised to quit smoking for ease of recovery and better healing.
Intra-operative Care – Splenectomy Procedure
During the splenectomy surgery, care is taken that the technique is conducted with proper focus, controlling hemorrhage, and not causing any harm or damage to the nearby organs. A splenectomy can be performed as both open and laparoscopic surgery.
General anesthesia is then given, and a nasogastric tube and a Foley catheter may be placed. Prophylactic antibodies are administered to the patient within the first hour of incision.
For laparoscopic surgery, small incisions are made for both the camera and the surgical instruments. The abdomen is then inflated with the gas, the splenic artery and vein are sealed and divided, along with other ligaments that hold the spleen in position.
For open surgery, which is carried out in more complex cases, namely massive splenomegaly or trauma, larger incisions are made to remove the spleen.
Complications like bleeding are controlled by carefully tying blood vessels, and surgeons then conduct the procedure very carefully to avoid causing any harm to surrounding organs like the pancreas. The surgeon also searches for and removes any accessory spleen content to avoid recurrence of underlying conditions.
After the Splenectomy Procedure
Post-operative care focuses on monitoring the patient for any immediate complications, and discussion between the doctor and patient on how to live normally post-splenectomy.
In-hospital recovery involves monitoring the patient for any bleeding, infection, and other problems
Pain management treatment is done, with importance being placed on trying to bring the patient to oral medicines as soon as possible.
As soon as the patient is fit to walk, mobilization is encouraged to increase blood circulation and prevent problems like pneumonia and blood clots.
Post-surgery patients are encouraged to take a liquid diet and then switch to small but frequent meals.
Lifelong infection prevention post-splenectomy involves revaccination, because severe infection can occur anytime, so booster doses are recommended by the doctor periodically.
A medical alert bracelet should be worn by a patient to indicate they are asplenic.
Patients are always advised to have an emergency supply of antibiotics and know when to use them, especially in cases of fever where the temperature rises above 38°C or higher.
Wound care involves keeping the incision area clean and dry and following specific instructions for bathing. Also, the patient is advised not to lift any heavy weights.
Splenectomy patients are usually monitored for two conditions, namely portal vein thrombosis (PVT), where blood clotting is monitored, and anticoagulant medications are prescribed. The second condition is overwhelming post-splenectomy infection (OPSI), where the doctor makes the patient and family aware of the symptoms of this very rare but fatal complication.
Benefits of Spleen Operation at Yashoda Hospitals
- Treatment of Idiopathic Thrombocytopenic Purpura (ICT)
- Treatment of Hemolytic Anemia
- Treat Cancer
- Spleen ruptured due to injury
- Treatment of Hypersplenism
- Symptom relief for splenomegaly
- Less post-operative pain in laparoscopic splenectomy
- Shorter hospital stay in laparoscopic splenectomy
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