Splenectomy (Spleen Removal): Surgery, Recovery, Complications (original) (raw)

How should I prepare for this procedure?

Splenectomies are either medical emergencies or elective procedures (ones you can schedule ahead of time). If you’re having an elective splenectomy, preparation may involve:

• Vaccinations. If the timing allows, you’ll need to get up to date on all vaccinations to prevent infections. You’ll usually start getting shots 10 to 12 weeks before surgery so you’re fully vaccinated at least two weeks before surgery. This timeline optimizes your body’s immune response, so you’re protected from infection once your spleen’s gone. If you don’t get vaccinated before surgery, then you’ll need vaccination two weeks after the surgery.
• Quitting smoking. Your body can’t heal itself as quickly if you smoke or use tobacco products. If you smoke, your provider will work with you on quitting.
• A physical exam, blood tests and imaging. Your healthcare provider will examine you and order blood tests to ensure you’re in good shape for surgery. They may order imaging to help plan for surgery.

Follow your provider’s guidance on if you need to fast or stop taking certain medicines, like blood thinners, before surgery.

What happens during a splenectomy?

Your surgeon can remove your spleen using one of two procedures: laparoscopy or open surgery. For both procedures, you’ll receive general anesthesia, so you’ll be asleep.

Laparoscopic surgery

In most cases, your provider can perform a splenectomy laparoscopically. Laparoscopic surgery is minimally invasive. It requires smaller cuts than traditional open surgery, which makes for a faster recovery than open surgery.

During laparoscopy, your surgeon will:

1. Inflate your abdomen with a safe carbon dioxide gas to provide a better view of the operating area.
2. Make three or four small cuts (incisions). They’ll insert a thin rod with a camera at one end (laparoscope) into one of the cuts. A laparoscope records images of the operating area and sends them to a video monitor your surgeon uses as a guide to operate.
3. Insert tiny operating instruments into the other incisions to perform the operation.
4. Remove your spleen.
5. Prepare your spleen to be sent to a lab for testing (to diagnose conditions affecting it, if needed).

Afterward, your surgeon will use stitches, staples or surgical glue to seal the wound.

Open surgery

You may need open surgery if your spleen is too large to remove with laparoscopy. Your surgeon may also use an open approach if you have out-of-control bleeding. It’s always possible that a laparoscopy may need to be converted to open surgery if there’s an issue.

The steps for an open surgery are similar to laparoscopy. The biggest difference is that instead of operating through a few small incisions, your surgeon operates through a larger single abdominal incision.

What happens after a splenectomy?

Once you’re able to tolerate a regular diet, move around without difficulty and your pain is under control, you’ll be discharged home. This usually occurs within two to three days with the laparoscopic technique and five to seven days with an open incision.

Before you’re discharged, your care team will ensure you understand how to navigate life without a spleen. This includes:

• Getting regular vaccinations. You’ll need to stay up to date on vaccines to prevent viral and bacterial infections.
• Understanding what antibiotics you’ll need. You may need to take antibiotics daily if you belong to a high-risk group. People more likely to develop life-threatening infections include children under 5 and people who are immunocompromised. Regardless of your risk factors, you’ll need emergency antibiotics you can take in case you experience symptoms of an infection.
• Knowing when to visit the ER. You should know the symptoms of an infection (like fever, vomiting, chills) so you can get to an ER (emergency room) immediately if they start.
• Understanding travel precautions. You should understand the risks associated with traveling. For example, traveling to areas with high instances of malaria or babesiosis can be especially risky without a spleen. Schedule a visit with your healthcare provider 12 weeks before traveling to discuss precautions and get any needed shots.
• Having a medical ID on you. You should carry a card or wear a medical ID bracelet so that all providers and potential caregivers know you don’t have a spleen.

What vaccinations will I need after a splenectomy?

Getting vaccinated or continuing a vaccination series is one of the most important things you’ll do after a splenectomy. You’ll need:

Your vaccination schedule depends on your previous vaccination history and other treatments (for example, if you’re receiving chemotherapy). Generally, the vaccine schedule looks like this:

• Before surgery: You’ll receive three shots to strengthen your immune system.
• After surgery: You’ll receive the shots at two weeks, four weeks and eight weeks.
• Booster shots: You’ll receive booster shots at one year, two-and-a-half years, and five years after surgery.