Laparoscopic Splenectomy

Splenectomy is the surgical procedure where the spleen is removed. The position of the spleen is just under the left rib cage. It is present near the stomach. The main function of the spleen is to combat the infections and filter out the old and damaged blood cells and numerous other functions. Now, you must be thinking that if it is such an important organ then why remove it. Well, the main reason behind spleen removal is when there is a disease involving the spleen, or if the spleen is ruptured due to trauma and is bleeding inside.

This procedure can be done by a keyhole technique called laparoscopic splenectomy.

Why is Laparoscopic Splenectomy done?

The main reasons because of which laparoscopic splenectomy is done are as follows:

• If you somehow get hurt in your abdomen and accidentally rupture your spleen, then doctors usually advise to go for a splenectomy to stop the internal bleeding.
• Sometimes, people experience an abnormal condition in which the spleen enlarges and becomes bigger than its normal size. This causes blood abnormalities and pain. A splenectomy will give you relief from all such problems.
• There are certain blood disorders which can be cured if your spleen is removed. However, spleen removal should be your last option and you should go for it only if all other treatment procedures have failed. Some of those blood disorders include sickle cell anaemia, idiopathic thrombocytopenic purpura & thalassemia.
• Sometimes a large amount of pus accumulates around the spleen leading to an infection which causes inflammation. Splenectomy can treat the condition. There are some cancers which have the probability of being treated on removal of the spleen. Some of those cancers are Hodgkin’s lymphoma, chronic lymphocytic leukaemia, hairy cell leukaemia and non-Hodgkin’s lymphoma.
• Formation of tumours or cysts inside the spleen also requires splenectomy

What happens during a laparoscopic splenectomy?

After you have been given an anaesthesia, the surgeon will insert the laparoscope into your abdomen by making an incision. Through another incision, carbon dioxide gas is inserted into the abdomen so that the surgeon gets some space to work. After that the spleen is disconnected from the neighbouring organs and is removed. After the completion of the process, the incisions are closed. Sometimes a drain tube may be left to allow for drainage of fluid from the surgical site. This is usually removed in a few days.

What are the post-operative precautions after splenectomy?

Laparoscopic splenectomy is generally a safe operation if done for elective indications. In an emergency setting like in a trauma with massive bleeding it is done as a life saving procedure.

The spleen plays an important role in development of immunity. So splenectomy is generally avoided in children unless absolutely essential. The patient is given certain vaccines one week prior to the operation. After the removal of spleen one has to be careful about minor infections like sore throat and fever, these can flare up suddenly. This is usually important in children. In adults the chance of such serious infections is quite rare.