Who Needs a Splenectomy? continued...
Other common reasons a person may need a spleen removal include:
- Hereditary elliptocytosis (ovalocytosis)
- Hereditary nonspherocytic hemolytic anemia
- Hereditary spherocytosis
- Thalassemia (Mediterranean anemia)
Blood vessel problems:
- Aneurysm in the spleen's artery
- Blood clot in the spleen's blood vessels
Leukemia, a blood cancer that affects cells that help the body fight infections.
- Certain types of lymphoma, a cancer that affects cells that help the body fight infections.
- Cyst or abscess (collection of pus) in the spleen
Before a Splenectomy
If your doctor thinks you have a ruptured spleen and you have signs of massive internal bleeding or unstable vital signs, such as low blood pressure, you will likely have spleen surgery right away.
In other cases, a complete physical exam, blood work, and tests to look at your abdominal and chest area will be done before surgery. The exact tests you have depend on your age and condition but may include a chest X-ray, electrocardiogram (EKG), magnetic resonance imaging (MRI) scan, and computed tomography (CT) scan.
You may need to follow a special liquid diet and take medication to clean out your bowels prior to the procedure. You should not eat or drink anything the morning of surgery. Your doctor will give you complete instructions.
Before surgery, you will be given drugs or a vaccine to prevent bacterial infections from developing after the spleen is removed.
How Is a Splenectomy Performed?
You will be given general anesthesia a few minutes before surgery so you are asleep and do not feel pain while the surgeon is working on you.
There are two ways to perform a splenectomy: laparoscopic surgery and open surgery.
Laparoscopic splenectomy is done using an instrument called a laparoscope. This is a slender tool with a light and camera on the end. The surgeon makes three or four small cuts in the abdomen, and inserts the laparoscope through one of them. This allows the doctor to look into the abdominal area and locate the spleen. Different medical instruments are passed through the other openings. One of them is used to deliver carbon dioxide gas into the abdominal area, which pushes nearby organs out of the way and gives your surgeon more room to work. The surgeon disconnects the spleen from surrounding structures and the body's blood supply, and then removes it through the largest surgical opening. The surgical openings are closed using stitches or sutures.