WHAT IS THE SPLEEN?
The spleen is a blood-filled organ located in the upper left abdominal cavity. It is a storage organ for red blood cells and contains many specialized white blood cells which act to filter blood. The spleen is part of the immune system and also removes old and damaged blood particles from your system. The spleen helps the body identify and kill bacteria. The spleen can affect the platelet count, the red blood cell count and even the white blood count.
HOW DO I KNOW IF MY SPLEEN SHOULD BE REMOVED?
There are several reasons why a spleen might need to be removed, and the following list, though not all inclusive, includes the most common reasons.
- Auto-immune thrombocytopenia purpura (ITP)
- Haemolytic anaemia
- Hereditary (genetic) conditions
- Other reasons: Sometimes the blood supply to the spleen becomes blocked (infarct) or the artery abnormally expands (aneurysm) and the spleen needs to be removed. Rarely, the spleen can become infected and is best treated with removal.
- Injury from Trauma
WHAT ARE THE ADVANTAGES OF LAPAROSCOPIC SPLENECTOMY?
Individual results may vary depending on your overall condition and health but the usual advantages are:
- Less postoperative pain
- Shorter hospital stay
- Faster return to a regular, solid food diet
- Quicker return to normal activities
- Better cosmetic results
- Fewer incisional hernias
AM I A CANDIDATE FOR LAPAROSCOPIC SPLEEN REMOVAL?
Most patients can have a laparoscopic splenectomy. Though the experience of the surgeon is the biggest factor in a successful outcome, the size of the spleen is the most important determinant in deciding whether the spleen can be removed laparoscopically. When the size of the spleen is extremely large, it is difficult to perform the laparoscopic technique.
WHAT HAPPENS IF THE OPERATION CANNOT BE PERFORMED OR COMPLETED BY THE LAPAROSCOPIC METHOD?
In a small number of patients, the laparoscopic method cannot be performed. Factors that may increase the possibility of choosing or converting to the “open” procedure may include obesity, a history of prior abdominal surgery causing dense scar tissue, inability to visualize organs or bleeding problems during the operation.
The decision to perform the open procedure is a judgment decision made by your surgeon either before or during the actual operation. When the surgeon feels that it is safest to convert the laparoscopic procedure to an open one, this is not a complication, but rather sound surgical judgment. The decision to convert to an open procedure is strictly based on patient safety.
WHAT COMPLICATIONS CAN OCCUR?
Complications following laparoscopic splenectomy are infrequent, but you should consult your doctor regarding possible complications based on your specific case.
- Possible complications may include:
- surgical site infections,
- internal bleeding
- infection inside the abdomen at the site where the spleen used to be,
- or the pancreas can become inflamed (pancreatitis) or leak fluid after surgery.
Problems that can occur a few months to years later are hernias at the cannula sites or overwhelming infection throughout the entire body. This complication is also infrequent.
Overwhelming infection that occurs after splenectomy is called OPSI or Overwhelming Post-Splenectomy Infection. OPSI is a result of not having a spleen to fight certain bacterial infections. Immunization is usually given before you have your spleen removed and is one method to help the body fight and prevent infection.
Antibiotics, like penicillin, can be given if an infection develops because the bacteria that commonly cause this type of infection are very sensitive to antibiotics. It is important that you tell your physician or any physician that is covering for your doctor that you had your spleen removed.