Splenectomy

A splenectomy, or spleen removal is a surgical procedure that removes the entire spleen.  Surgery can be performed as a traditional open surgery or laparoscopically (minimally invasive keyhole surgery).  If only part of the spleen is removed, this is called a partial splenectomy.

What is the Spleen?

The spleen is a small organ, the size of a fist.  It is located under the left rib cage, near the stomach.  It is an important part of the body’s immune system as it contains special white blood cells that destroy bacteria and help fight infection.  It can also help remove or filter out old red blood cells from the body’s circulation.  Unlike the liver, the spleen cannot regenerate (grow back) once it has been removed.

Reasons for a Splenectomy

A ruptured spleen is life threatening as it causes internal bleeding and will need to be performed as an emergency procedure.  There are a number of other reasons why you may need to have your spleen removed.  These include:

• Damage to the spleen through injury
• Rare blood disorders
• Infection
• Cancer or large cysts of the spleen

Certain conditions can cause the spleen to swell, making it more susceptible to rupture.  Illnesses such as sickle cell disease can cause the spleen to shrivel up and stop functioning.  This condition is caused auto-splenectomy.

Preparing for a Splenectomy

Before your surgery, you will undergo a full physical examination, along with blood tests to look at your abdomen and chest prior to surgery.  You will need to inform your doctor if you are taking any medication and if you may be pregnant.  You may be given certain vaccinations against particular viruses and bacteria as your immune system will be weakened following surgery.  This will prevent infections from developing once your spleen has been removed.

You will undergo tests that will depend on your age and condition, but may include an MRI scan, X-rays, CT scan or Electrocardiogram (EKG).

You may be required to follow a particular liquid diet to clean out your bowels before your procedure.  You should not eat anything after midnight on the day of your surgery, although you can drink water up to 3 hours before your procedure.  This will be fully explained to you at your pre-assessment appointment.

Splenectomy Procedure

Before your surgery, you will be given a general anaesthetic to ensure you are asleep during the procedure and do not feel any pain.  Your surgery will be carried out either laparoscopically or as an open surgery.

Laparoscopic Splenectomy

Laparoscopic, or keyhole surgery is a minimally invasive procedure which is quicker and has a less painful recovery time compared to open surgery.  The surgeon uses an instrument called a laparoscope which is a thin tool with a light and camera on the end of it.  Small incisions, usually 3-4 cuts will be made in your abdomen for the laparoscope to be inserted.  The camera then projects a video of your spleen onto a monitor in the operating theatre.  Different instruments are passed through the other incisions, one of which will blow carbon dioxide into the abdominal area to push the nearby organs out of the way to give the surgeon more room to work.  The surgeon will then remove the spleen with small tools, disconnecting it from surrounding structures and the body’s blood supply.  It is then removed through the largest of the incisions.

Open Splenectomy

Your surgeon may opt for open surgery after viewing your spleen on the monitor.

Traditional open splenectomy involves a larger cut being made down the centre or left hand side of your abdomen, underneath the rib cage.  Once the surgeon has located the spleen, it is disconnected from the pancreas and the body’s blood supply and then removed.  Open surgery is recommended if you are obese, have scar tissue from previous surgeries, or if your spleen has ruptured.

Post-Operative Recovery

Once your surgery is complete, your cuts and incisions will be stitched and dressings applied.  You will be required to stay in hospital; the length of time being dependent on whether or had an open or laparoscopic splenectomy, and any complications you may experience.

Recovery from a splenectomy generally takes between 2-6 weeks, depending on the type of surgery you had.  You will not be able to bathe following surgery, in order for your wounds to heal.  Showering is okay, provided you can keep your dressings dry.

Once you are discharged from hospital, it is important to ensure your home is safe whilst you are recovering, i.e. make sure you cannot trip on anything like rugs or loose wires.  You should arrange for someone to stay with you for the first few days as you will find it difficult to carry out daily chores.

Activities you should avoid include:

• Heavy lifting
• Strenuous activities such as high impact exercising, weightlifting and other activities that make you breathe hard, strain or cause pain or discomfort

Activities you can do include:

• Light housework
• Short walks and slowly climbing the stairs

It is important to remember not to push yourself too hard as this will have a negative impact on your recovery.  Gradually increase your activity levels, and ease off if you feel any discomfort or pain.

Certain symptoms are fairly common when you are recovering from a splenectomy.  These include:

• Nausea and vomiting
• Bruising and redness around the wound which will disappear in time
• Trouble taking deep breaths
• Pain around the incision for a few weeks which will lessen over time
• A sore throat from the breathing tube used during your surgery. You can try soothing your throat by eating ice chips or gargling.

Risks and Complications

Undergoing a splenectomy will leave you with a compromised immune system, meaning you will be more susceptible to infections.  You will likely require annual vaccines and prophylactic antibodies to prevent bacterial infections from occurring.  Related complications from spleen removal include:

• Infection at the incision site
• Inflammation of the pancreas (pancreatitis)
• Collapsed lung
• Injury to the pancreas, stomach and colon
• Hernia at the incision site
• A blood clot in the vein that can carry blood to the liver
• Stroke or heart attack
• Allergic reaction to the anaesthesia

If you experience any of the below symptoms, you should call your doctor or NHS 111 immediately:

• Chills or a fever over 101^oF or 38.5⁰C
• Persistent nausea and vomiting
• Increased swelling of the abdomen
• A cough or shortness of breath
• Bleeding
• Increased redness, pain or discharge at the incision site
• Difficulty eating or drinking
• Persistent pain that does not go away with prescribed medication

Outlook after a Splenectomy

The outlook after a splenectomy can vary largely depending on the type and severity of the illness or injury that resulted in surgery.  The long-term prognosis is good if you are otherwise healthy.

After your spleen has been removed, other organs in your body will take over most of the functions previously performed by it.  Although you can be active without a spleen, you are more at risk of becoming ill or getting infections, with the risk being highest shortly after surgery.  You may also find it more difficult to recover from an illness or injury prior to undergoing a splenectomy.  Your doctor will devise a care plan to help you stay healthy after you have had your spleen removed.

Need Help?

At One Healthcare we can book you in to see a specialist general surgeon, usually within 48 hours, for an initial consultation.  Splenectomy surgery is available at One Ashford Hospital in Kent and One Hatfield Hospital in Hertfordshire.

You can use your private medical insurance or pay for your Splenectomy treatment. We offer competitive, fixed price packages as well as the ability to spread the cost of your treatment over a number of months. If you are using your health insurance, please contact your insurer first for approval and let them know you’d like to be treated at either the One Ashford Hospital or One Hatfield Hospital.

Why One Healthcare

• Modern purpose-built hospital opened in March 2016 (Ashford) December 2017 (Hatfield)
• Fast access to diagnostics including MRI, X-ray and Ultrasound
• Private, spacious, en-suite rooms
• Specialist Physiotherapy and nursing teams
• Little or no waiting time
• ‘Ultra clean air’ theatres
• Freshly prepared food
• Calm, dignified experience

Contact us and find out more

If you live in and around the Kent area and would like to visit our One Ashford Hospital please click here

If you are based in and around Hertfordshire and would like to visit the One Hatfield Hospital please click here.