A splenectomy surgery is performed as an emergency procedure after severe trauma or injury to the abdomen and as standard treatment for an enlarged spleen, infection, tumor, and many other spleen disorders. The procedure involves the removal of the spleen. If you or a loved one has been recommended for splenectomy surgery, it’s time for you to learn everything you can before surgery to help you prepare.
Review the following questions about having splenectomy surgery at Orange County Robotic General Surgery in California.
- What is a splenectomy?
- What happens before surgery?
- What happens on the day of surgery?
- What complications can occur?
- What should patients expect after surgery?
- When should you call your doctor?
What Is Splenectomy Surgery?
A splenectomy is a surgical procedure that removes the spleen. The spleen is a lymphatic organ located in the left upper portion of the abdominal cavity. This organ is responsible for filtering germs, bacteria, and pathogens from the blood to help keep your immune system healthy. After the spleen is removed, the liver eventually compensates for its loss by taking over many of its functions.
Splenectomy surgery is performed in one of three ways: laparoscopically, robotic-assist, and as an open procedure. Both laparoscopic spleen removal and robotic laparoscopic spleen removal surgeries involve several small incisions and the use of special surgical tools and a tiny camera. Most laparoscopic and robotic splenectomy patients go home the same day of their procedure. Recovery usually takes two weeks.
Open or traditional spleen removal surgery involves a large incision across the stomach and utilizes traditional surgical tools. Open splenectomy surgery patients start their recovery in the hospital before going home. Complete recovery takes six to eight weeks, or longer depending on the patient’s circumstances.
Common Reasons for Spleen Removal Surgery
There are many reasons why spleen removal is medically necessary, including the following:
Rupture: The spleen can rupture from infection and inflammation, injury or trauma sustained from a penetrating wound, or by force from an accident, physical altercation or even sports activity. Rupture can also occur from extreme enlargement/ splenomegaly or from the presence of benign cysts or tumors. A ruptured spleen is a serious medical emergency that can become life-threatening due to internal bleeding.
Auto-immune thrombocytopenic purpura (ITP): Autoimmune thrombocytopenic purpura is a condition that causes the body to make antibodies that trick it into destroying platelets, causing low platelet counts. These platelets play an essential role in clotting activity. Patients with ITP are susceptible to clotting disorders and excessive bleeding.
Splenectomy surgery is usually recommended for ITP patients when all other medical therapies fail to provide significant improvement. Removing the spleen often significantly improves platelet counts and patient outcomes.
Cancerous cells: The spleen normally filters germs and bacteria from the blood. In rare cases, the spleen accumulates these pathogens, excess blood platelets, and cancerous cells, causing it to become enlarged. There are also circumstances where spleen removal is necessary to diagnose or treat certain types of cancer.
Hemolytic anemia: This type of anemia occurs when the spleen destroys healthy red blood cells. Spleen removal is often required for some patients to prevent the need for a blood transfusion.
Hereditary: Some splenectomy patients are born with genetic factors that affect the shape or function of red blood cells causing a normally functioning spleen to target and remove them. Splenectomy surgery is often required to help alleviate symptoms but is not a cure.
Infection: Severe infection and inflammation can cause pus to build up in the spleen, causing it to swell. Infections are usually managed with medications. Spleen removal is necessary for infected spleens that do not respond to other treatments.
Other reasons: Blood cell abnormalities, abdominal aneurysms, and issues that cause the blood supply to the spleen to become blocked can facilitate the need for spleen removal surgery.
There are indirect reasons for spleen removal surgery, such as to aid in the diagnosis of medical conditions or improve treatment efficacy for various spleen disorders.
What Happens Before Surgery?
Before spleen removal surgery is scheduled, there are additional procedures and measures patients are required to complete. These usually include:
- Physical examination
- Lab work
- Additional diagnostic tests
- Medication history review
Before surgery can take place, patients may be required to get certain vaccinations, stop taking certain medications, and make other temporary adjustments. Some medications and health supplements increase the risk of complications and must be stopped within a certain time frame before surgery can occur.
It’s important to discuss your situation with your surgeon to ensure you have a complete understanding of the risks and benefits, and what to expect on the day of surgery and during recovery. It is also necessary to arrange for someone to accompany you to your procedure and to drive you home afterward.
What Happens on the Day of Surgery?
The actions you take on the day of spleen removal surgery are critical to the outcome. Adhere to all preoperative instructions so you know when to avoid beverages and foods. This includes taking medications with water without Dr. Abtin Khosravi’s approval. If you eat or drink on the day of your procedure, it will need to be rescheduled.
Showering and bathing are allowed on the day of surgery. However, you should not wear lotions, creams, makeup, and skincare products. Shaving is also not allowed. Leave all jewelry and accessories at home. You should arrive at the clinic in loose-fitting, comfortable clothing.
What Complications Can Occur?
Spleen removal surgery does come with complication risks that patients should be aware of. Many of these complications are common with most surgical procedures, especially splenectomy.
- Injury to abdominal organs
- Respiratory issues
- Blood clots
- Hernia at the surgical site
- Increased vulnerability to serious and potentially life-threatening infections
These complications apply to both laparoscopic and open spleen removal surgeries.
What Should Patients Expect After Surgery?
It may seem as if not having a spleen (asplenia) is dangerous to your health, but it’s not. Many people with asplenia live healthy and normal lives. Not having a spleen is not an immediate risk to overall health, but it does, however, interfere with your ability to fight off infections and illnesses. Because of the heightened risk of illness, a short five-to-seven-day stay in the hospital is likely if you had open surgery.
On the other hand, laparoscopic spleen removal patients are allowed to go home shortly after their operation, usually within two to three days. Prior to discharge home, patients must show they can eat, move, and void urine and that their pain is manageable.
Regardless of how your procedure is performed, the surgical staff will monitor your vitals and watch for potential signs of infection and complications. During this time, you’ll receive a regimen of fluids and medication.
Due to the overwhelming risk of post-splenectomy infection, patients receive vaccines before, and shortly after, and a series of booster vaccines several months later to help boost and stabilize their immune system.
Recovering From Spleen Removal Surgery
The average recovery time for spleen removal patients is four to six weeks. During that time, some pain, fatigue, and overall weakness may persist before gradually going away. It’s necessary for you to take all prescribed medications and follow all post-operative instructions provided by your surgeon to improve your health and help your strength return while you heal from surgery.
Bathing and showering are permitted. Driving is not permitted until patients no longer experience pain with movement or that requires the use of narcotic medications to manage. Rest is encouraged. Do not rush to return to normal activities right away. Follow all postoperative restrictions and gradually build up to your normal level of activity as your body and surgical wound allow.
When Should You Call Your Doctor?
Spleen removal patients should stay current on all vaccinations to lower their risk of infection. Pneumonia, haemophilus influenzae type b (Hib), meningococci, and the flu vaccinations are vital in shoring gaps in immunity due to the absence of the spleen.
Splenectomy surgery patients should develop healthy dietary and lifestyle habits, avoid or limit their exposure to sick people and environments where the risk of infection or illness is high, and monitor their health.
They should also inform their doctor at the first sign of illness, especially if symptoms include a fever of 101°F, chills, blood, pus, or fluid leaking from incisions, abdominal swelling, shortness of breath, coughing, nausea, vomiting, spreading redness or tenderness near the incision, or intolerable pain.
It’s not the end of the world if you’ve recently learned you may need a splenectomy. Surgery is the safest and most effective treatment measure for various conditions, including splenomegaly, certain blood disorders, genetic irregularities, etc.
Although the spleen plays a vital role in fighting infection and keeping you healthy, it is quite normal and possible to live a happy, healthy, and productive life without one. Knowing the risks and preventive measures in addition to developing good health and lifestyle practices and staying on top of all vaccination and medical needs are paramount to shoring up any gaps in immunity and preventing complications.
To learn more about splenectomy or to set up a consultation for spleen removal surgery, contact Dr. Abtin Khosravi, MD, at Orange County Robotic General Surgery clinic in California or call 714-541-4996.
To find out if inguinal hernia repair surgery is right for you, Contact Orange County General Robotic Surgery at (714) 706-1257 for a consultation with Dr. Abtin H. Khosravi.