Splenectomy

Why is this procedure done?

Your spleen is an organ in the upper left part of your belly under your ribs. It has many jobs to keep you healthy. The spleen is part of your immune system and helps to fight infections. It acts as a filter and removes old blood and other dead cells from your body. The spleen also acts as a storage center for some healthy parts of your blood like platelets and white blood cells. The doctor may remove your spleen if it is not working the right way or is injured. ‚
Splenectomy is the surgery to remove all or part of the spleen. It may be removed through several small cuts in the belly by using long instruments and a tiny camera inserted through tubes. This is laparoscopic surgery. The spleen may also be removed by using one longer cut on your belly without a camera. This is open surgery. It may be recommended by your doctor when: ‚

Your spleen is damaged due to injury and cannot be repaired
You have a growth or cancer in the spleen
The spleen is much larger than normal
The spleen is destroying healthy parts of the blood

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What will the results be?

All or part of your spleen will be removed to help control your illness. ‚

What happens before the procedure?

Your doctor will take your history. Talk to your doctor about:
- All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
- Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin, ibuprofen, Aleve (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
- How often you smoke.
- When you need to stop eating or drinking before your procedure.
Your doctor will do an exam and may order:
- Lab tests
- X-ray
- CT scan
- Ultrasound
Your immune system will not be as strong without any spleen. You will need certain vaccine shots 2 weeks or more before your surgery. This will help prevent some infections. You may need to get the shots after you have an emergency surgery.
Your doctor may want you to clean out your colon before your surgery. If so, your doctor will tell you to take drugs that will cause watery loose stools. These may be liquids, pills, or both.
You will not be allowed to drive right away after the procedure. Ask a family member or a friend to drive you home.

What happens during the procedure?

Once you are in the operating room, the staff will put an I.V. in your arm to give you fluids and drugs. You will be given a drug to make you sleepy. It will also help you stay pain free during the surgery.
Your doctor will put a tube in your bladder to drain urine.
If you have laparoscopic surgery, the doctor will make 3 to 4 small cuts on your belly and side. The doctor will put a tube with a camera at the tip and small tools into the cuts. The doctor will make one cut larger, about 4 inches, to remove the spleen.
If you have open surgery, the doctor will make a cut on your belly. Some body parts like muscles and blood vessels are moved out of the way. The spleen is then taken out.
The doctor will close the cut with stitches or staples and cover the wound with a clean bandage.

What happens after the procedure?

You will go to the Recovery Room and the staff will watch you closely. You may have to stay in the hospital for about a week if you have an open surgery. If you have a laparoscopic surgery, you may go home sooner.
Your doctor may leave a tube in your bladder to drain your urine overnight.
You will have some pain after the surgery. This may become more painful when the anesthesia wears off. Your doctor will order drugs for this.
Your doctor may have placed a drain through your surgical cut. Keep this in place. Your doctor may remove this after about 1 day.
You may need a blood transfusion if you lost too much blood.
You will start with clear liquids after your stomach is working again. Later you will start to eat more solid foods.

What care is needed at home?

Ask your doctor what you need to do when you go home. Make sure you ask questions so that you understand everything the doctor says. This way you will know what you need to do.
Take your drugs as ordered by your doctor.
Your doctor may teach you deep breathing exercises to prevent infection.
Talk to your doctor about how to care for your cut site. Ask your doctor about:
- When you should change your bandages
- When you may take a bath or shower.
- If you need to be careful with lifting things over 10 pounds
- When you may go back to your normal activities like work, driving, or sex
Be sure to wash your hands before and after touching your wound or dressing. You may use soap and water to wash your wound, but do not soak it. Gently towel-dry the wound afterwards.
Keep your legs above the level of your heart when in bed. Your doctor may also tell you to wear compression stockings. This is to help with your bodys blood flow and decrease the chance of blood clots.
Your bowel movements may be delayed for a day or two. You may need to begin stool softeners after surgery to prevent constipation.

What follow-up care is needed?

Your condition needs close monitoring. Your doctor may ask you to make visits to the office to check on your progress. Be sure to keep these visits.
If you have stitches or staples, you will need to have them taken out. Your doctor will often want to do this in 1 to 2 weeks.
Your wounds will likely heal after 4 to 6 weeks.
Your doctor will tell you if you need other tests, vaccines, drugs, or follow up visits.

What lifestyle changes are needed?

You will be more likely to get infections if your spleen is taken out. You need to be aware of the early signs of an infection.
Use good hand washing to help prevent the spread of germs. Wash your hands often with soap and water for at least 15 seconds, especially after coughing or sneezing. Alcohol based hand sanitizers also work to kill germs.
You may need to take a small dose of antibiotics each day to prevent infections.
You may be asked to keep antibiotics with you at all times.

Will physical activity be limited?

You may slowly increase your activity over time. Talk to your doctor about the right amount of activity for you. ‚

What problems could happen?

Bleeding
Infection
Poor wound healing
Bulge in the belly, called a hernia.
Irritated pancreas or pancreatitis

When do I need to call the doctor?

Signs of infection. These include fever of 100.4 ‚ °F (38 ‚ °C) or higher, chills.
Signs of wound infection. These include swelling, redness, or warmth around the wound; too much pain when touched; yellowish, greenish, or bloody discharge; foul smell coming from the cut site; or cut site opens up.
Bleeding problems
Trouble breathing
Very bad pain or swelling in the belly
Not able to eat or drink
Throwing up

Helpful tips

Hold a pillow on your belly when you cough to help with the pain. ‚

Where can I learn more?

Platelet Disorder Support Association ‚
http://www.pdsa.org/treatments/conventional/splenectomy.html ‚
Society of American Gastrointestinal and Endoscopic Surgeons ‚
http://www.sages.org/publication/id/PI12/ ‚

Consumer Information Use and Disclaimer

This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚

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