A splenectomy is the surgical removal of the spleen. It is the most common major operation used to treat certain conditions of the spleen. The spleen is an organ located in the upper abdomen. It is a part of the lymphatic system and helps the body in filtering out and destroying certain types of bacteria.
Splenectomy may be performed for conditions such as spleen enlargement (splenomegaly), spleen tumors, blood disorders that affect the spleen, and infection of the spleen. Rarely, damage to the spleen caused by injury may require a splenectomy.
The main goal of a splenectomy is to prevent and treat infections by removing the spleen and its potentially harmful bacteria. After the surgery, the body will still be able to fight infections, but the risk of life-threatening infection is increased.
Overview of Splenectomy
Splenectomy may be performed for a variety of reasons. It can be used to remove a large or diseased spleen, reduce the risk of infection, and treat certain blood disorders. It may also be used to help diagnose diseases, such as certain types of leukemia and lymphoma.
Splenectomy is typically performed under general anesthesia by a team of specialists, such as general surgeons, gastroenterologists, hematologists, and oncologists. The entire surgery usually takes approximately two to three hours and may be done either through open surgery or minimally invasive laparoscopic surgery.
In open surgery, a long incision is made along the midline of the abdomen. The surgeon then removes the spleen and checks for any other affected organs, such as the stomach or nearby lymph nodes. In laparoscopic splenectomy, small incisions are made in the abdomen and the spleen is removed with a laparoscope and instrument. This method of splenectomy usually requires shorter hospital stays and quicker healing times.
Benefits of Splenectomy
Splenectomy is a beneficial treatment option for numerous medical conditions. The main benefit of the procedure is the removal of diseased and/or enlarged spleen. It can also reduce symptoms associated with the condition, including pain, infection, and hemolytic anemia. It can also improve other conditions associated with the spleen, such as abnormal blood clots.
Other potential benefits of splenectomy include:
• Improved shortness of breath
• Reduced risk of infection, as the spleen no longer filters out bacteria
• Better quality of life due to a reduction in symptoms
• Reduced risk of organ damage
• Improved symptom management of organ dysfunction
Expected Results of Splenectomy
After a splenectomy, many of the symptoms associated with the condition, such as pain and infection, will be reduced. Most people can expect to have a quicker recovery and improved quality of life.
However, the body’s ability to fight infections is reduced after this procedure. Because of this, it is important to protect against infection by receiving immunizations and taking antibiotics before and after surgery. Additionally, recovery from splenectomy also requires close monitoring of the body’s lymphatic system as well as lifestyle changes.
It is important to talk to a doctor before and after surgery to assess the benefits and risks of splenectomy and to determine if the procedure is right for you.
Preventing Infection After Splenectomy
After splenectomy, it is important for patients to protect themselves from infection. To do this, patients should take proper precautions to avoid potential infections, including:
• Receiving recommended vaccinations before and after surgery to protect against infections
• Taking antibiotics before and after surgery to protect against infections
• Eating foods with high nutritional value to maintain a healthy immune system
• Washing hands regularly to reduce the spread of infections
• Avoiding contact with individuals with contagious illnesses
To summarize, splenectomy is a surgical procedure used to remove an enlarged or diseased spleen. It can be used to treat a variety of conditions, such as blood disorders, spleen tumors, and infection. The main benefit of the procedure is the removal of potentially harmful bacteria.
It is important to talk to a doctor before and after splenectomy to assess the benefits and risks associated with the procedure and to determine if it is the right option for you. After splenectomy, it is important to take precautions to reduce the risk of infection, such as receiving vaccines and taking antibiotics before and after surgery.
التعريف والنظرة العامة
Splenectomy is a procedure that removes a ruptured spleen usually due to an injury to the abdomen. The spleen, an organ located under the ribcage, is responsible for fighting infections and filtering out damaged blood cells and other unnecessary materials inside the body.
Due to technological advances in the field of medicine, this spleen removal procedure can now be performed using minimally invasive techniques, which reduce the risks associated with open surgery and shorten the patient’s recovery period.
Splenectomy can be either full or partial. It is important to note that the spleen does not regenerate or grow back after a surgical removal of the entire organ or part of it—unlike in other organs such as the liver. Research shows that there are some individuals with a smaller, second spleen known as an “accessory spleen” which usually takes over the functions of the removed organ.
من يجب أن يخضع للنتائج المتوقعة
Splenectomy is often performed on patients with abdomen injury that caused the spleen to rupture or break open, which increases the risk of internal bleeding that can threaten the patient’s overall health. Common causes of injury to the spleen include the following:
- Car accidents
- Engaging in contact sports—including hockey, rugby, or football—and suffering blows to the abdomen
The abnormal enlargement of the spleen can also result in rupture.
Other conditions that might require splenectomy include:
Cancer, especially the types that directly affect the spleen or the blood, such as chronic lymphocytic leukemia, Hodgkin’s and non-Hodgkin’s lymphoma, and hairy cell leukemia.
Blood disorders, which can include sickle cell فقر دم, polycythemia vera, idiopathic thrombocytopenic purpura, and الثلاسيميا. However, it is important to note that a spleen removal procedure is not the first line of treatment for patients with blood disorders. The doctor will only recommend a splenectomy when all other forms of treatment have failed to improve the patient’s condition.
Cysts or tumors in the spleen that are diagnosed as benign growths but require immediate removal to prevent serious complications in the future.
A severe infection in the spleen, which has resulted in inflammation and formation of pus in the organ. Again, spleen removal is not the first line of treatment in this situation but will be recommended if the infection did not respond to other forms of treatment.
Splenectomy can also be performed as a diagnostic procedure especially in patients with an enlarged spleen that cannot be explained by other types of diagnostic techniques.
كيف يتم إجراء العملية؟
Splenectomy can be performed as an emergency or a non-emergency procedure. Typically, as soon as the doctor determines that the patient has a ruptured spleen (typically by observing symptoms such as unstable vital signs, abnormally low blood pressure, and signs of serious internal bleeding), the patient will be recommended for an immediate spleen removal procedure.
In non-emergency cases, the doctor will first perform a complete physical exam, including blood tests and other laboratory and imaging procedures to determine if the patient is an ideal candidate for the procedure. The doctor will also place the patient on a special diet (mostly consisting of liquids) and provide medication to clean out the bowels before the operation. Vaccines can also be prescribed to prevent the onset of infection.
The surgery, which is performed under general anaesthesia, can be performed using either traditional open surgery or by using minimally invasive methods.
Open surgery – This requires a rather large incision on the left side of the abdomen to access the part of the ribcage where the spleen is located. The organ’s blood supply is then cut before it is disconnected from the pancreas. As soon as the spleen is successfully removed, the surgeon will close the incision using small sutures.
Laparoscopic splenectomy – This is a minimally invasive procedure and is performed using a special instrument called a laparoscope, which is a thin, elongated tool with a camera and light attached on one end. This requires three to four small incisions in the abdomen where the laparoscope and other small surgical tools are inserted. Carbon dioxide is introduced into the abdominal area to efficiently and safely locate the spleen. The organ is then disconnected from the pancreas and removed through one of the incisions. These small incisions are closed using small sutures or surgical staples.
المخاطر والمضاعفات المحتملة
Splenectomy is generally safe, but like other types of surgical procedures, it comes with the possibility of risks and complications, including the following:
- Internal bleeding
- Formation of blood clots that can possibly get into the patient’s bloodstream
Injury or perforation of nearby organs, including the pancreas, stomach, and colon
There is also the possibility of long-term infections due to the absence of the spleen, which actively fights infection. To reduce the risk of serious or even life-threatening infections, doctors typically recommend vaccines against influenza, Haemophilus influenza type B, meningococci, and التهاب رئوي. Preventive antibiotics can also be prescribed for those who are vulnerable to serious infections.
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Lee MH, Phillips EH. Laparoscopic splenectomy. In: Cameron JL, Cameron AM, eds. Current Surgical Therapy. 11th ed. Philadelphia, PA: Elsevier Saunders; 2014:1345-1349.
Shelton J, Holzman MD. The spleen. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 57.