A splenectomy is surgery to remove the entire spleen, a delicate, fist-sized organ that sits under the left rib cage near the stomach. The spleen is an important part of the body's defense (immune) system. It contains special white blood cells that destroy bacteria and help the body fight infections when you are sick.
Your spleen is a small organ located on the left side of your abdomen under the rib cage. This organ is part of your immune system and helps to fight off infections while also filtering damaged and old cells out of your bloodstream. If your spleen needs to be removed, you’ll undergo a surgical procedure called a splenectomy.
Undergoing a spleen removal leaves you with a compromised, or weakened, immune system. Since infections can be more dangerous without a spleen, you may need yearly vaccines and prophylactic antibiotics. Prophylactic antibiotics are used to prevent a bacterial infection from occurring. They aren’t used to treat an existing infection.
There are several reasons that your doctor may recommend that you have your spleen removed. These include having:
• a spleen that’s damaged from injury
• an enlarged spleen or ruptured spleen, which can occur from trauma
• certain rare blood disorders
• cancer or large cysts of the spleen
Your spleen may need to be removed if you have a severe blood disorder that doesn’t respond to other treatments. Blood disorders of this type include:
• sickle cell anemia
• hemolytic anemia
• idiopathic thrombocytopenic purpura (ITP)
• polycythemia vera
• sickle cell anemia
A viral infection, such as mononucleosis, or a bacterial infection, such as syphilis, can cause your spleen to become enlarged.
An enlarged spleen traps an excessive amount of blood cells and platelets. Eventually it traps and destroys healthy red blood cells as well. This is called hypersplenism, and it leads to a large reduction of healthy blood cells and platelets in your bloodstream. Your spleen becomes clogged, which then begins to interfere with its functioning. An enlarged spleen can cause anemia, infection, and excessive bleeding. It may eventually rupture, which is life-threatening.
If your spleen has ruptured, you may need a splenectomy immediately because of life-threatening internal bleeding. A rupture may be caused by a physical injury, such as being hit by a car, or by an enlargement of your spleen.
Certain cancers such as lymphocytic leukemia, non-Hodgkin’s lymphoma, and Hodgkin’s disease affect the spleen. These can cause your spleen to enlarge, which can lead to a rupture. The spleen may also need to be removed because of the presence of a cyst or tumor.
A severe infection in your spleen may not respond to antibiotics or other treatments. This type of infection can lead to a more serious abscess or an inflammation and a buildup of pus. Your spleen may need to be removed to resolve the infection.
A splenectomy may be performed as a traditional open surgery or as a laparoscopic, or minimally invasive, procedure. You will be under sedation for either procedure.
A traditional open surgery involves making a cut down the center of your abdomen. The surgeon then moves aside other tissues to remove your spleen. The incision is then closed with stitches. Open surgery is preferred if you have scar tissue from other surgeries or if your spleen has ruptured.
This type of surgery is minimally invasive and has a quicker and less painful recovery time than open surgery. In a laparoscopic splenectomy, your surgeon makes just a few small cuts in your abdomen. Then, they use a small camera to project a video of your spleen onto a monitor. Your surgeon can then remove your spleen with small tools. They’ll then stitch up the small incisions. Your surgeon may decide an open surgery is necessary after viewing your spleen on the camera.
Removing your spleen is a major surgery and leaves you with a compromised immune system. For these reasons, it’s only performed when truly necessary. The benefits of a splenectomy are that it can resolve several health issues such as blood diseases, cancer, and infection that could not be treated any other way. Having a ruptured spleen removed can save your life.
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