What is the Spleen?
The spleen is a lymphatic organ situated behind the lower ribs at the upper left side of the abdomen. It lies near the tail (tip) of the pancreas, beneath our diaphragm and at the back of the stomach.
Do I Need My Spleen?
The spleen plays a vital role as an organ of the immune system and lymphatic system. It aids in immunity by filtering bacteria, platelets, and dying red blood cells from the blood. As an organ of the lymphatic system, it acts as a regulator, controlling the blood flow to the liver. It is also responsible for storing certain blood cells in the body, including platelets.
What is a Splenectomy?
Splenectomy is a surgical procedure done to facilitate the removal of a diseased/ damaged/ overactive or tumor-invaded spleen. It is also indicated for individuals with hematological disorders, splenic abscesses, and non-cirrhotic portal hypertension with GI (gastrointestinal) bleeding.
Why Undergo a Splenectomy?
A splenectomy or surgical removal of the gallbladder is performed for assessment or treatment of certain diseases. It is also done to control signs and symptoms of some ailments like pain or bleeding from a traumatic injury. Other indications of splenectomy can be any of the following:
- Treatment of disorders such as idiopathic thrombocytopenia purpura (ITP) and other auto-immune diseases
- Diagnosis or treatment of certain cancers or lymphomas
- Treatment of some blood disorders
- Treatment from certain rupture or bleeding secondary to spleen trauma
- Pain management
What Happens Before a Splenectomy?
To be certain of the diagnosis and the need for spleen removal, your physician will perform a physical exam and request diagnostic testing. You can help your care staff prepare for your surgery by informing them if you have other medical conditions or if you are taking any medications.
What Happens During a Splenectomy?
You will be assisted to the operating room and will be placed under general anesthesia. Currently, there are three different methods to perform a splenectomy.
- Open Splenectomy – This is done by creating a vertical incision along the abdomen. Then, the surgeon will separate the spleen from the other organs and the attached blood vessels. After removing the spleen, the incision will be closed with sutures or staples.
- Laparoscopic Splenectomy – Unlike open surgeries, laparoscopic splenectomy involves the creation of 3-4 tiny holes/incisions in the abdomen. Specialized surgical instruments are then used to visualize the abdominal area and remove the spleen. Once the procedure is completed, sutures will be used to close the small incisions.
- Hand-Assisted Laparoscopic Splenectomy – This procedure is performed like the laparoscopic method. However, aside from the tiny incisions made for laparoscopy instruments to be inserted into the abdominal cavity, a large incision is also created to allow removal of a very large spleen.
Possible Risks of a Splenectomy
All surgical procedures have possible risks and complications. Splenectomy is not an exemption. The following risks and complications may occur during or after surgical removal of the spleen:
- Injury to the bowel or other abdominal contents
- Pancreatic leak
- Sepsis (Blood infection)
What Happens After a Splenectomy?
The anesthesia and the procedure itself may cause you to feel sore or uncomfortable for a few days. After your splenectomy, you may experience:
Pain – Pain on the surgical site may be felt once the effects of the anesthesia are gone. The characteristic of pain may be different from one person to another. However, it is normal and is common to any surgical procedures because of the tissue damage from the creation of incision.
Your surgeon will prescribe pain medications and will recommend non-pharmacologic methods of pain management. Some people need 1 to 3 doses of pain-relieving pills and others need more. Also, it is essential that you inform your surgeon if the medication doesn’t help in controlling your pain. In general, your pain should improve each day after your operation.
Constipation – This is pretty common among post-splenectomy patients. Constipation may occur as a side-effect of pain medication. Your doctor may recommend the use of a stool softener, as well as modifications to your diet. Vegetable, grains, and fruits may help you manage constipation because these foods are high in fiber.
Life Without a Spleen
Recovery – You will be advised to do deep breathing and, in some cases, move or exercise as tolerated. Deep breathing and exercise can help prevent complications after surgery, such as pneumonia, blood clots, or fluid pooling in the lungs.
Wound Care – Avoid touching the incision site if your hands are soiled. Be sure to wash your hands before and after touching the skin near the incision. Don’t soak in a bathtub until the stitches or staples are removed. You may take a shower two days after you were sent home unless you are advised not to.
Home Medications – Be sure to ask your physician about the medications you need after your operation. Aside from pain relievers, your surgeon might prescribe stool softeners if you are constipated, as well as antibiotics to keep at home in case you become ill from infections.
Immunizations/Vaccines – Because the human spleen works as part of our immune system, your defense system against some infections may be compromised once the spleen is removed. Although you may still be able to ward off some infections, there are chances that certain diseases may develop quickly. Immunizations might be helpful to prevent these infections such as Influenza, Meningococcal, and Pneumococcal.
Travel – Talk to your physician before traveling out of the country because special precautions may be necessary. If you are regularly spending time outdoors like camping or trekking, you may be more susceptible to rare infections like malaria and babesiosis. Wearing long sleeves and trousers may help you protect yourselves to cover exposed skin. If you become ill while on a camping trip, seek medical help promptly.
Splenectomy at Pine Creek Medical Center
If you were advised to undergo splenectomy due to a hematologic disease, splenic tumor or cysts, and other conditions, talk to your physician or book with one at Pine Creek Medical Center. You can entrust your splenectomy to our highly-skilled and board-certified surgeons and physicians.