Definition Spleen removal, or splenectomy, involves surgically removing the spleen from the body. The spleen produces red blood cells and white blood cells in the body. It also stores blood. The spleen also filters out bacteria and old red blood cells from the blood. It is located to the upper left side of the abdomen, just in front of the stomach.
Who is a candidate for the procedure? A spleen removal is usually done on a person with a diseased or damaged spleen. Reasons for a removal include:
How is the procedure performed? The removal of a spleen is done under general anaesthesia. This means that the person is put to sleep with medication. An incision, or cut, is made in the abdomen. The blood vessels supplying blood to the spleen are tied off and cut. The surgeon then turns the spleen and lifts it out of the body. The surgeon also checks the other organs in the abdomen, looking for injury, tumours, or other conditions. The abdomen and its blood supply are rechecked for bleeding. The other organs are put back in place, and the muscles are sutured where necessary. The incision is closed with sutures, staples, or clips.
What happens right after the procedure? The person will be in the surgery recovery room for a few hours to monitor the blood pressure, heart rate, and breathing. He or she will also be watched for any problems with bleeding or any reaction to the analgesia. The person will not be able to drink anything for at least 4 to 5 hours. Then small sips of clear fluids can be taken. An intravenous line, or IV, will usually be left in a vein in the arm or hand to give fluids so the person doesn't get dehydrated. The IV will usually be left in place at least 24 hours. It is taken out when the person is able to eat and any pain is under control. Pain medication can be given into the IV line or injected into muscle. A person may also be given antibiotics to lower the risk of infection.
There are usually a few tubes that are left near the incision to drain fluids and blood from the site. These tubes can be removed once the draining stops. A nasogastric tube may also be in place to drain fluids from the stomach, which is called gastric suction. Oxygen is given if needed. For the next few days the person will be encouraged to do deep breathing. This helps to clear the lungs and prevent pneumonia. The person will also be encouraged to walk. This lowers the risk of blood clots. The person will be in the hospital usually 5 to 7 days.
What happens later at home? Following a spleen removal, the person will be taught how to care for the incision. Activity at home will be based on how the person is feeling. The person can slowly increase activity as his or her strength comes back. It may be a few weeks to several weeks before a person can drive, return to work, or participate in strenuous activity.
What are the potential complications after the procedure? There are possible side effects with any surgery. These include bleeding, infection, and allergic reactions to the anaesthesia.
A person who has his or her spleen removed may also be more prone to bacterial infection. Common infections are streptococcus pneumonia and haemophilus influenza. The body loses some of its ability to fight infection when the spleen is removed. After a short time, other organs, such as the liver, increase their infection fighting ability. The increased risk of infection is not lifelong. Children are at higher risk for this complication. Avoiding exposure to others with known infection may reduce the risk of contacting these illnesses.
Author: Eileen McLaughlin, RN, BSN Reviewer: eknowhow Medical Review Panel Editor: Dr John Hearne Last Updated: 21/09/2004 Contributors Potential conflict of interest information for reviewers available on request
