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Splenectomy

Splenectomy is a procedure that consists of the removal of the spleen and it is recommended in certain hematological disease cases and for post-traumatic spleen rupture. The spleen is a delicate organ that is situated under the left rib cage that helps the body fight infections and filter damaged blood cells. Splenectomy is rarely performed for diagnosis, especially if there aren’t other clinical manifestations or tests to indicate the primary disease. 

The laparoscopic splenectomy is frequently used and represents the extirpation of the spleen laparoscopically, using special surgical tools and a tiny video camera.

The indication of removing the spleen can be made in the following cases:

• Diseases associated with the destruction of platelets or red blood cells in the spleen (thrombocytopenia or autoimmune hemolytic anemia)
• Splenic lymphoma
• Spleen rupture
• Spleen abscess
• Splenic cysts
• Large splenic hemangiomas
• Some forms of cirrhosis with a large spleen modifying the figurative elements of the blood

The doctor may also proceed to remove the spleen in order to diagnose a condition, especially if it is enlarged.

The removal of the spleen can be done using several methods:

• Classic surgery (involves cutting the abdomen)
• Laparoscopic surgery (the surgeon does not need to cut the abdomen, the procedure is performed through small holes)
• Partial surgical splenectomy (the removal of a single part of the spleen in order to avoid the side effects of the whole spleen removal)
• Splenic artery embolization (a kind of nonsurgical splenectomy: the spleen is not removed but it is not functional anymore)
• The risks that splenectomy implies are usually reduced but according to the general health of the patient severe postoperative complications can appear, including death.

Any procedure that disturbs the function of an organ or which implies its removal can be accompanied by several side effects. Therefore, undergoing a splenectomy can lead to:

• High risk of infections
• An increase in the number of leukocytes
• A decrease in the response to vaccination
• High risk of thrombosis
• Low tolerance to effort

The results of laparoscopic surgery can vary depending on the procedure and the general health state of the patient.

However, the usual advantages are:

• Less postoperative pain
• Less hospitalization
• Quicker resumption of normal alimentation
• Quicker resumption of normal activities
• Better cosmetic results

Most of the patients can undergo a laparoscopic splenectomy. Even though the experience of the surgeon is the most important aspect in order to achieve a favorable result, the dimension of the spleen is the factor that helps the doctor decide whether to remove the spleen laparoscopically or not, as an extremely big spleen would make this procedure impossible.