Splenic Surgery

What is the spleen?

  • It is a solid organ situated in the upper left side of the abdomen, just below the ribs

 

How big is it?

  • A normal spleen would be between 9-11 cm in length

 

What is Hypersplenism?

  • Abnormal destruction of blood cells by the spleen which result in abnormality and a lowering in the number of these cells Lower red blood cells: anaemia. Lower platelets: bruising and bleeding.

 

Splenic diseases

  • Hereditary spherocytosis : abnormal blood cells are collected by the spleen causing it to enlarge.
  • Idiopathic thrombocytopenic purpura (ITP) : Abnormal antibodies attack the platelets destroying them
  • Thrombotic thrombocytopenic purpura (TTP) : A haematological disease which leads to spleen enlargement.
  • Haemolytic anaemia : abnormal destroyed blood cells collected by the spleen causing it to enlarge.
  • Lymphoma : cancer which can affect the spleen.
  • Acute or chronic leukaemia : cancer which affects the blood cells , these cells are then collected by the spleen causing it to enlarge.

 

How are these diseases treated?

  • The first treatment for all these diseases is medical. If this treatment fails then patients are considered for splenectomy.

 

What is a splenectomy?

  • It is the surgical removal of the spleen which can be done with open surgery or with keyhole surgery. It involves controlling the blood vessels which bring the blood to and from the spleen then mobilising the spleen from the organs to which it is attached (stomach, colon, pancreas and diaphragm).

 

Can I live without my spleen?

  • Most adults live normally without the spleen. Children may be more affected without their spleen due to their immature immune system.
    A vaccination against bacterial infection is given before splenectomy to reduce the risk of infections

 

What is the recovery after surgery?

  • If open surgery is performed the average hospital stay is 4-5 days and you can return to full physical activity in 4 to 6 weeks.
    If keyhole surgery is performed the hospital stay is 1-2 days and you can return to full physical activity in 2-3 weeks

 

What are the advantages of keyhole splenectomy?

  • In addition to the shorter hospital stay and a quicker recovery, there will be less pain and better cosmetic results, both of which are clear advantages.