How do you prepare for Splenectomy?

• Your doctor may ask you to stop taking blood thinning medicines like aspirin or other medications containing aspirin for at least two weeks prior to surgery.
• You will be asked to stop eating anything after midnight before the scheduled surgery.
• You will undergo several  blood tests, X-rays, MRI, EKG, and anesthesia clearance tests in order to determine your health condition

What happens during Splenectomy?

After your doctors have evaluated your symptoms, the surgical team will prep you for the procedure.

Your surgeon may decide to perform either of the following procedures-

• Total splenectomy

• Partial splenectomy

The surgical team will put you under general anesthetic in the form of a gas or injection. They also keep an eye on your vitals during the spleen removal surgery.

As per the size of spleen enlargement, your surgeon will choose either of the following procedures.

• Laparoscopic splenectomy

First, the surgeon will cut out four incisions in your stomach. He/she will insert a tube with a small camera through one incision. The team will fill the space with gas to ensure visibility. This is mostly because surgeons will have to move a lot of muscles and tissues.

Second, your surgeon uses the other incisions to locate specific tools towards the spleen. The video feed on a monitor helps surgeons navigate during the procedure. He/she will cut out the spleen completely and immediately place it in a separate bag.

Lastly, the surgical team will pull this bag out of the biggest incision in your stomach. The laparoscopic splenectomy ends with your surgeon stitching close all the incisions.

• Open splenectomy

In this type of spleen removal surgery, your surgeon will only cut one large incision in the middle of your stomach. The team will follow the same procedure as above except with general tools.

What can you expect after Splenectomy?

• The surgical team will monitor your recovery for a period of time. This may require you to stay back 2-6 days at the hospital.
• Your doctors may have performed the spleen removal surgery to treat other conditions. The team will, therefore, require a specific follow up recovery before you leave.
• You can expect to fully recover by 4-6 weeks after the spleen removal surgery.

What are some of the risks associated with Splenectomy?

Your doctors and surgeon will always ensure your spleen removal surgery is safe. Yet, there can be a few things you should be careful about. The possible complications associated with spleen removal surgery include-

• Infection
• Pneumonia
• Pancreatitis
• Flu
• High fever
• Malaria
• Bleeding
• Blood clots
• Serious harm to nearby organs like the stomach, pancreas and colon

Alwaysinform your doctor immediately if you experience any of the symptoms above.

What are some of the lifestyle changes after Splenectomy?

Your doctor will give you a timeline on how and when you can resume your normal routine. They usually advice not to be strenuous 1 week after the spleen removal surgery. This time can increase depending on how you recover from the procedure.

Key Terminology:

• Spleen. There is an organ called the spleen in the upper left side of your stomach. It is fist-shaped and filters blood flow to the liver. The spleen continuously assists in the defence against infection, stores extra amounts of blood cells and transports the same to the liver.
• Hypersplenism. Here, there is over functioning of the spleen which enlarges the size (splenomegaly). It kills or stores abnormal blood cells/platelets.

• Primary cancer. Like chronic lymphocytic leukemia, hodgkin lymphoma, non-hodgkin lymphoma and hairy cell leukemia.

• Idiopathic thrombocytopenic purpura. The condition where antibodies destroy platelets.

• Ruptures. Trauma or injury can cause ruptures, usually in the stomach area. The rupture can be directly on the spleen or an artery (splenic artery rupture). It is very dangerous for life due to the excessive internal bleeding that occurs.

• Abscess. When infection causes pus collection and an inflamed spleen.

• Sickle cell disease. A blood disorder where the RBCs are sickle-shaped and not disc-shaped.

• Thalassemia. Blood disorders that are inherited and lead to insufficient hemoglobin production.

Hereditary spherocytosis. This is an inherited condition. There is an absence of a protein called ankyrin. The symptoms include growth of unusually-shaped red blood cells called spherocytes. These spherocytes are hard to move. They can stay very long in the spleen and enlarge it.