What is the spleen and what are its functions?
A splenectomy is the total or partial surgical removal of the spleen.
The spleen is an important part of the body's defense (immune) system that is situated under the left rib cage near the stomach. The spleen contains special white blood cells that can destroy bacteria. It helps the body fight infections and also removes old red blood cells from the body's circulation.
Which patients are considered for splenectomy?
The most common disease-related reason for spleen removal is a blood disorder called idiopathic thrombocytopenic purpura (ITP). This is a condition in which antibodies target blood platelets. Platelets are needed to help the blood to clot, so a person with ITP is at risk for bleeding. The spleen is involved in making these antibodies and removing the platelets from the blood. Removing the spleen can be done to help treat the condition. Other common conditions in which splenectomy can be performed are:
- Patients with a severe injury causing it’s covering to break open or rupture (ruptured spleen can lead to life-threatening internal bleeding).
- Patients with spleen cancer and leukemia
- Diseases that affect blood cells (sickle cell disease)
- Rupture in the spleen's artery
- A blood clot in the spleen's blood vessels
- Cyst or abscess (collection of pus) in the spleen
What is laparoscopic splenectomy?
A splenectomy is the total or partial surgical removal of the spleen. Laparoscopy procedure uses smaller surgical cuts. It usually results in less pain, a faster recovery, less risk of infection, small scars, and a shorter hospital stay. Laparoscopic splenectomy has been performed more frequently in recent years, sometimes called keyhole surgery, which is done with smaller surgical instruments inserted through very short incisions, with the assistance of a tiny camera and video monitor. Not everyone can have laparoscopic surgery. The method is usually decided by the doctor depending on overall health and the size of the spleen.
How long does it take to recover from a splenectomy?
Patients who undergo laparoscopic splenectomy are usually sent home sooner. They are usually placed on intravenous fluids, antibiotics, and pain killers. It will take about four to six weeks to recover from the procedure. Patients are usually advised not to take bath till the wounds are healed (sponge cleaning is advised). Activities such as exercises, walking, and driving are restricted at least for six weeks.
Pancreatitis is inflammation of an organ in the abdomen called the pancreas.
What organ takes over after spleen removal?
After splenectomy, the functions of the spleen are usually taken up by other organs, such as the liver, bone marrow, and lymph nodes. Up to 30% of people have a second spleen (called as accessory spleen), these are usually very small but may grow and function when the main spleen is removed. Rarely, a piece of the spleen may break off due to severe injury, such as after a car accident. If the spleen is removed, this piece can grow and function.
What is the outcome after splenectomy?
The outcome of the procedure varies with the underlying disease or the extent of other injuries. Rates of complete recovery from the surgery itself are excellent, in the absence of other severe injuries or medical problems. Studies of patients with ITP show that 80-90% of children achieve spontaneous and complete remission in 2 to 8 weeks. Small percentages develop chronic or persistent ITP however about 60% showed complete remission by 15 years. No deaths in patients older than 15 years have been attributed to ITP.