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Laparoscopic Splenectomy

What is the spleen?

The spleen is a delicate fist sized organ that lies under the ribs on the left side of the body, next to the pancreas and colon.

The main function of the spleen is to filter the old blood cells from the circulation, store blood clotting cells (platelets) and contains bloods cells which fight infection.

When is, splenectomy recommended?

Splenectomy may be recommended by a surgeon if the spleen has ruptured, usually because of major trauma to the body. 

Splenectomy performed as an elective procedure is usually recommended by a haematologist (blood specialist) or oncologist (cancer specialist).  Cancers that involve the spleen sometimes require splenectomy and some blood disorders which cause bruising and bleeding require splenectomy.  Some conditions of the spleen cause it to swell, up to the size of a football.

Splenectomy is usually required as part of a distal pancreatectomy operation for pancreatic tumours.

Preparation for splenectomy

Prior to surgery you will need extra vaccinations to prevent some bacterial infections.  These are usually given at least 2 weeks prior to surgery.  If you have a blood clotting disorder, then a short course of steroid medications may be advised by your haematologist.

Laparoscopic or open splenectomy?

Laparoscopic splenectomy, if feasible can be used to remove the spleen using smaller incisions, meaning less pain after the operation.  The size of the spleen and the condition being treated may govern whether laparoscopic splenectomy can be performed.  A football sized spleen, if needed to be removed intact, cannot be removed through a keyhole incision.  Sometimes it is appropriate to break up the spleen, inside a bag before removal, allowing it to be removed via a keyhole.

Open splenectomy if required is performed via up and down incision on the upper abdomen or an incision upper the ribs on the left side. The incision may be more painful so it is important to have good pain relief and to be able to breathe deeply.

Recovering after splenectomy

After splenectomy, it takes most people a couple of days to get back on their feet and to start eating and drinking normally.  A drainage tube is usually placed to the operation site and this is usually removed after 3 days.  If pain is well controlled you may be able to go home on day 3 or 4.  You will receive blood thinning injections to prevent blood clots, which may continue after going home from hospital.  It may take 4-6 weeks to recover fully, but most people will resume ‘normal’ activity or return to work in 3-4 weeks.

Complications of splenectomy

  • Early complications after splenectomy can include
  • Bleeding
  • Wound infection
  • Leakage of pancreatic digestive juice
  • Blood clots (DVT) in the leg or lung

Life after splenectomy

The spleen has an important role in fighting infection, vaccinations against certain bacteria are taken two weeks before or after splenectomy. Regular low doses of antibiotics may be recommended for high risk individuals.  All patients who have had their spleen removed should make their doctor, dentist or nurse, prior to any medical procedure being. 

Further information is available at spleen.org.au