Splenectomy the surgical removal of the spleen may be necessary to protect or restore health. Whether it’s due to trauma, blood disorders, or autoimmune conditions, this procedure can often be life saving or drastically improve a person’s quality of life.

The human body has many vital organs, each performing specific functions to maintain overall health. One such organ is the spleen, located in the upper left side of the abdomen, just beneath the rib cage. While the spleen isn’t as commonly discussed as organs like the heart or liver, it plays a significant role in supporting the immune system and filtering blood. However, in certain medical conditions, a splenectomy the surgical removal of the spleen becomes necessary.

What is Splenectomy?

Splenectomy is a surgical procedure in which the spleen is partially or completely removed. The surgery may be performed as an emergency or elective procedure depending on the underlying condition. A complete splenectomy removes the entire spleen, while a partial splenectomy involves removing only a portion of the spleen, preserving some of its function.

Why is a Splenectomy Performed?

A splenectomy is typically recommended when the spleen is damaged, enlarged, overactive, or affected by disease. Common reasons for undergoing a splenectomy include :-

Trauma or Injury :- In cases of severe abdominal trauma, such as from a car accident or sports injury, the spleen may rupture and bleed internally. This is a medical emergency that often requires immediate removal of the spleen to prevent life-threatening blood loss.
Blood Disorders :- Certain blood disorders cause the spleen to overwork or become enlarged. Conditions such as hereditary spherocytosis, sickle cell anemia, and thalassemia may necessitate splenectomy to improve symptoms and reduce complications.
Cancers and Tumors :- Malignancies like lymphoma, leukemia, or metastatic cancer may involve the spleen. A splenectomy might be done to manage disease progression or to obtain a tissue sample for diagnosis.
Hypersplenism :- In hypersplenism, the spleen becomes overactive, destroying blood cells at an abnormally high rate. This leads to low levels of red blood cells, white blood cells, or platelets. Removing the spleen can help restore normal blood cell counts.
Autoimmune Conditions :- In diseases like idiopathic thrombocytopenic purpura (ITP), the immune system destroys platelets. When medication fails, a splenectomy can help by removing the source of platelet destruction.

Types of Splenectomy Procedures

There are two primary approaches to performing a splenectomy :-

Laparoscopic Splenectomy :- This is a minimally invasive procedure where the surgeon makes small incisions in the abdomen and inserts a laparoscope (a tiny camera) and surgical tools. The camera projects images onto a screen, guiding the surgeon during the procedure. Laparoscopic splenectomy is preferred when the spleen is not massively enlarged and there is no trauma. Recovery time is usually quicker, with less postoperative pain.
Open Splenectomy :- In cases where the spleen is very large, ruptured, or cancerous, an open splenectomy may be necessary. This involves a single large incision in the abdomen to access and remove the spleen directly. Though recovery is longer, this method may be safer in complex situations.

Preparing for a Splenectomy

Before the procedure, your doctor will conduct several tests, including blood tests, imaging scans, and sometimes a physical examination of the spleen. You may also need vaccinations against certain bacteria (like pneumococcus, meningococcus, and Haemophilus influenzae type B) because the spleen plays a key role in fighting off these infections. These vaccinations are typically given at least two weeks before a planned splenectomy or soon after emergency surgery.

Recovery After Splenectomy

Recovery time can vary depending on the type of procedure performed and the individual’s health. Patients who undergo laparoscopic surgery may return to normal activities within 2 to 4 weeks, while recovery after open surgery can take 4 to 6 weeks or longer.

Hospital stay is generally shorter for laparoscopic splenectomy (1 to 2 days), while open splenectomy might require a longer stay. Pain, swelling, and fatigue are common in the initial days following surgery, but they improve with time and proper post operative care.

It’s important to follow your surgeon’s instructions, take all prescribed medications, and avoid strenuous activities until fully healed.

Life After Splenectomy: What to Expect?

Living without a spleen requires certain lifestyle changes and precautions. Since the spleen helps the body fight infections, individuals without a spleen are at a slightly higher risk for serious infections, especially from encapsulated bacteria.

Preventive Measures Include :-

Routine vaccinations to protect against bacterial infections
Prompt medical attention for fevers or signs of infection
Prophylactic antibiotics in certain cases, especially in children or those with compromised immunity
Wearing a medical alert bracelet stating the absence of the spleen

Most people live a normal, healthy life after splenectomy, especially with proper preventive care and regular medical check ups.

Risks and Complications

As with any surgery, splenectomy carries certain risks. These may include :-

Bleeding during or after the procedure
Infection at the surgical site
Injury to nearby organs such as the stomach or pancreas
Blood clots in the veins of the legs or lungs
Overwhelming post-splenectomy infection (OPSI) a rare but serious complication that can occur without a spleen

Discussing these risks with your surgeon can help you make an informed decision about your treatment options.

Conclusion

A splenectomy is a significant surgical procedure often performed to treat trauma, blood disorders, or specific cancers. While the spleen plays an important role in immune function, the body can usually adapt to its absence. Thanks to advancements in surgical techniques, most splenectomy procedures today are safe and have favorable outcomes.