Splenectomy

The spleen is a fist-sized organ situated high up in the left side of the abdomen, under your rib cage. Splenectomy is a procedure where the surgeon removes the spleen. Splenectomy is ideally suited to a laparoscopic (minimally invasive) approach as it can be a very inaccessible organ to extract and the subcostal incision used for open surgery tends to be quite painful.

When is a splenectomy done?

Despite the spleen being well protected by the ribcage, the most common indication for splenectomy these days is blunt abdominal trauma. In this setting, it is mostly done with open surgery (laparotomy).

Other indications for splenectomy / spleen surgery includes:

• Idiopathic thrombocytopenic purpura (ITP) unresponsive to medical therapy
• Hereditary spherocytosis, when you have a shortage of red blood cells (anaemia)
• Thalassemia major, when you lack globin genes
• Certain stages of Hodgkin's disease. This is a blood cancer that develops in the lymphatic system

How is splenectomy done?

Before the spleen surgery, you will be given a general anaesthetic. After you are under anaesthetic Dr Cooper will perform either a minimally invasive (laparoscopic) or open (traditional) procedure depending on the size of your spleen.

• Laparoscopic splenectomy
  During this procedure, Dr Cooper will make 3 small incisions in your abdomen and place 3 ports. A tube that has a tiny video camera, called a laparoscope is then passed through one incision. He will then observe the video images on a monitor while performing the procedure. The surgeon will then pass the necessary surgical tools through the other ports and remove the spleen through a separate small incision. The incisions are then sutured close.
• Open splenectomy
  During this procedure, Dr Cooper will make a larger incision in the middle of your abdomen or below the left lower edge of the rib cage depending on the size of the spleen and then move aside muscles and tissues to access the spleen. He will then remove the spleen and stitch close the incision.

After splenectomy, you can be more prone to contract certain infections. It is, therefore, standard practice to vaccinate against infections such as pneumococcus, H. influenza and meningococcus pre-operatively.