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Splenectomy

(Spleen Removal; Removal, Spleen)

by Editorial Staff and Contributors

Home | Health Information Center | Procedure & Surgery Fact Sheets | Article

Definition

Reasons for Procedure

Possible Complications

What to Expect

Call Your Doctor

En Español

Definition

Splenectomy is the surgical removal of the spleen. The spleen is an organ in the upper left part of the abdomen. It lies beneath the ribs and behind the stomach.

The spleen filters blood. It removes items that can cause infection such as bacteria or parasites. It also removes old and damaged blood cells.

Spleen

Reasons for Procedure

You may need to be treated by having a splenectomy if you have:

Trauma to the spleen
Splenic rupture due to tumor, infection, inflammatory condition, or medications
Enlargement of the spleen—splenomegaly
Certain blood disorders when other treatments are not working, including:
- Idiopathic thrombocytopenia purpura
- Hereditary spherocytosis
- Thalassemia
- Hereditary elliptocytosis
Some types of leukemia or lymphoma
Tumor or abscess in the spleen
Liver disease—cirrhosis
Abnormal formation of fibrous tissue in the bone marrow
Damage in the blood vessels of the spleen
Diseased spleen, due to disorders like HIV infection

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

Infection
Bleeding
Hernia formation at incision site
Blood clots
Damage to other organs

Factors that may increase the risk of complications include:

Obesity
Diabetes
Smoking
Poor nutrition
Recent or chronic illness
Advanced age
Heart or lung disease
Bleeding or clotting disorders

What to Expect

Prior to Procedure

Your doctor may do the following:

Physical exam
Blood and urine tests
Review of your current medications
ECG
Other tests to evaluate the cause of the spleen enlargement
Studies to determine rate of destruction of red blood cells and/or platelets
Give certain vaccines to boost immune system after surgery

Imaging tests to evaluate the abdomen and spleen may include:

Talk to your doctor about your medications. You may be asked to stop taking some medications up to 1 week before the procedure.

Anesthesia

General anesthesia will be used. You will be asleep during the procedure.

Description of Procedure

The spleen can be removed through an open incision or through laparoscopic surgery.

Open Incision

An incision will be made in the abdomen over the spleen. The skin and muscles will be pulled back. The blood vessels to and around the spleen will be tied off. This will free the organ. Moist sponges may be placed in the abdomen. The sponges will absorb some of the blood and fluid. The spleen will be removed. The sponges will then be removed.

The muscles and skin will be closed with stitches or staples. A gauze dressing will be placed over the wound.

Laparoscopic Removal

A small incision will be made in the abdomen. A thin, lighted tube with a small camera will be inserted through the incision. It allows the doctor to see inside your body. Carbon dioxide gas will be passed into the abdomen. This puffs up the abdomen. It will give the doctor more room to work.

Two or 3 more small incisions will be made. Special tools will be inserted through these incisions. Blood vessels to the spleen will be cut and tied off. The spleen will then be rotated and removed. The incisions will be closed with stitches and covered with surgical tape.

Immediately After Procedure

The removed spleen is sent to the lab for testing.

You will be taken to a recovery room and monitored. You may need a blood transfusion if you lost a lot of blood.

How Long Will It Take?

About 45 to 60 minutes

Will It Hurt?

Anesthesia prevents pain during the procedure. There will be some pain and discomfort until you have healed. Medicine can help to manage discomfort.

Average Hospital Stay

The usual length of stay is 2 to 4 days. The stay may be longer if there are complications.

Post-procedure Care

Complete recovery may take up to 6 weeks. Some activities will be limited during recovery.

The spleen is part of the immune system. There is a higher risk of some infections after it is removed. Vaccines can boost protection against the infections. The type will depend on individual needs.

Call Your Doctor

It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:

Signs of infection, including fever and chills
Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
Increasing pain or swelling in your abdomen
Cough, shortness of breath, chest pain, or severe nausea or vomiting
New or unexpected symptoms

If you think you have an emergency, call for emergency medical services right away.

RESOURCES:

Family Doctor—American Academy of Family Physicians
https://familydoctor.org

National Institute of Diabetes and Digestive and Kidney Diseases
https://www.niddk.nih.gov

CANADIAN RESOURCES:

Caring for Kids—Canadian Paediatric Society
http://www.caringforkids.cps.ca

The College of Family Physicians of Canada
http://www.cfpc.ca

References:

Cadili A, de Gara C. Complications of splenectomy. Am J Med. 2008;121(5):371-375.

Sabiston DC Jr. Textbook of Surgery. 17th ed. Philadelphia, PA: WB Saunders Co.; 2004.

Splenectomy. The Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/articles/splenectomy-spleen-removal. Accessed September 19, 2019.

Splenomegaly—differential diagnosis. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Accessed September 5, 2019.

10/9/2009 DynaMed Plus Systematic Literature Surveillance http://www.dynamed...: Renzulli P, Hostettler A, Schoepfer AM, Gloor B, Candinas D. Systematic review of atraumatic splenic rupture. Br J Surg. 2009;96(10):1114-1121.

Last reviewed September 2019 by EBSCO Medical Review Board Donald W. Buck II, MD
Last Updated: 10/9/2020

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