Splenectomy

Splenectomy is a surgical procedure that removes the spleen. The spleen is an organ that is part of the lymphatic system and is located on the left side of the body just under the ribcage. The function of the spleen is to filter the blood and help fight germs and infections. As a filter, the spleen can remove damaged blood cells from the blood.1-3

In several kinds of blood cancer, the spleen can become enlarged. Because of its location right next to the stomach, an enlarged spleen can press on the stomach, making someone feel not hungry, or they may get full after just a small amount of food. This can lead to weight loss. An enlarged spleen may also be painful.2,4

Reasons why a splenectomy is performed

The most common reason people have a splenectomy is to remove a ruptured spleen after an injury to the abdomen. In someone with blood cancer, including leukemia and lymphoma, the spleen may be removed to relieve symptoms, such as pain and changes in appetite. Removing the spleen can also potentially improve blood cell counts and reduce the need for blood transfusions. Because the spleen filters out damaged blood cells, an enlarged spleen can become overactive in its filtering, causing lowered red blood cells or platelets. A splenectomy can help improve blood counts in these patients.2,4,5

How a splenectomy is performed

A splenectomy may be performed as an open procedure or as a laparoscopic procedure. For either procedure, the patient is given general anesthesia, a type of sedative and pain medication.1,3 The anesthetic may be given as a gas that is inhaled through a mask over the nose and mouth, or it may be injected into a vein.2

In an open splenectomy, the surgeon makes an incision in the belly, removes the spleen, and closes the incision with stitches or staples.1

In a laparoscopic splenectomy, three or four small cuts are made in the belly, and instruments are inserted into these cuts. One of the instruments is a laparoscope, which allows the surgeon to view the internal structures. The surgeon inflates the abdomen with a harmless gas to allow room to view the structures and move the instruments. The spleen is removed using the instruments, and the incisions are closed using stitches or staples.1

A laparoscopic procedure may give the patient a faster and less painful recovery, but in some cases where the spleen is very large, an open procedure may be more appropriate. Patients should talk to their surgeons about which procedure is best for them and why.1,2

After an open surgery, the patient remains in the hospital for a few days. With a laparoscopic procedure, the patient may go home the same day or the next day after surgery. With either procedure, normal activities can usually be resumed after six weeks, but each patient should talk to their doctor about their recovery expectations.2

Potential risks of a splenectomy

A splenectomy is usually a safe procedure, but as with any surgery, there are potential risks, such as bleeding, blood clots, infection, or injury to nearby organs. A splenectomy increases the long-term risk of infections, including serious infections. People who have a splenectomy may be given preventive antibiotics and/or vaccines to prevent pneumonia, influenza, and meningococcal infections.2

After surgery

After surgery, other organs in the body take over most of the tasks that were handled by the spleen. People who have had a splenectomy are at an increased risk of infection, and they may experience a harder or longer time recovering from infections or injuries. Any sign of infection, including a fever, chills, redness or sore spots on the body, sore throat or a cold that lasts longer than usual should be brought to the attention of a doctor.2

Written by: Emily Downward | Last reviewed: February 2018
View References
  1. Spleen removal. MedlinePlus, U.S. National Library of Medicine. Available at https://medlineplus.gov/ency/article/002944.htm. Accessed 2/14/18.
  2. Splenectomy, Mayo Clinic. Available at https://www.mayoclinic.org/tests-procedures/splenectomy/about/pac-20395066. Accessed 2/15/18.
  3. Uranüs S, Sill H. Splenectomy for hematological disorders. In: Holzheimer RG, Mannick JA, editors. Surgical Treatment: Evidence-Based and Problem-Oriented. Munich: Zuckschwerdt; 2001. Available at https://www.ncbi.nlm.nih.gov/books/NBK6913/. Accessed 2/14/18.
  4. Surgery for chronic lymphocytic leukemia, American Cancer Society. Available at https://www.cancer.org/cancer/chronic-lymphocytic-leukemia/treating/surgery.html. Accessed 2/15/18.
  5. Laparoscopic splenectomy, Medscape. Available at https://emedicine.medscape.com/article/1829873-overview#a2. Accessed 2/15/18.