Table of ContentsView AllTable of ContentsWhat It IsPurposeHow to PrepareWhat to ExpectRecoveryLong-Term Care and Lifestyle
Table of ContentsView All
View All
Table of Contents
What It Is
Purpose
How to Prepare
What to Expect
Recovery
Long-Term Care and Lifestyle
Surgical removal of thespleenis a splenectomy. Partial splenectomy is less common than removal of the whole spleen. These procedures may be done to treat spleen enlargement, anemia, cancer, ruptured spleen, and more.
Emergency surgeryis usually needed as a life-saving treatment after a traumatic spleen rupture.
The spleen does not regenerate itself, nor is it an organ that is transplanted.While the spleen is an important part of yourimmune system, long-term care can allow you to live without it.
SEBASTIAN KAULITZKI / Science Photo Library / Getty Images
What Is a Splenectomy?
A full or partial splenectomy can be scheduled in advance for the treatment of a disease, but an injured spleen must be removed immediately.
There are two ways this surgery can be done:
The laparoscopic procedure is the most common of the two and is typically used whenever possible. Due to its smaller incision size, a laparoscopic approach usually results in less pain during recovery and a lower risk ofinfection.
There are some cases in which the open approach may be necessary:
It is also possible that a spleen removal surgery starts as a laparoscopic procedure but turns into an open procedure while in progress. This may happen if the surgeon discovers that the organ is significantly enlarged while they are operating.
Contraindications
There are no definite contraindications to this surgery. Since emergency splenectomy can be a life-or-death decision in some cases, the pros of the procedure may simply outweigh any risk concerns.
If you are planning to have a splenectomy, your healthcare provider will review your case and determine whether a laparoscopic procedure or an open procedure is better for you.
Surgery will be carefully considered in anyone with blood clotting concerns.
Potential Risks
Splenectomy shares the same general risks associated with anysurgeryand the administration ofanesthesia.
Specific risks associated with splenectomy include:
Splenic Embolization
Splenic embolization is a procedure that may be done in advance of a splenectomy to help mitigate the risk of blood loss associated with the surgery.
Even though a laparoscopic spleen removal poses fewer risks than an open procedure, blood loss remains a notable concern—especially for those with significantly enlarged spleens.
Research shows that when this is done before a laparoscopic or open splenectomy for splenomegaly, splenic embolization can decrease operating time and blood loss.
In some cases, splenic embolization may shrink the spleen to the point that a once-contraindicated laparoscopic procedure is now possible.
Purpose of Spleen Removal Surgery
A splenectomy may done for a number of reasons, the most common of which include:
Surgery may also be used to treatblood disordersthat do not improve through more conservative measures. These disorders include:
Emergency situations aside, the process leading up to splenectomy is not a quick one. You will have several visits with your healthcare providers and need to:
Because of the increased risk of infection when the spleen is removed, it will be recommended that you get certain immunizations, including strep pneumoniae, which can causepneumonia, Haemophilus influenzae, which causes upper respiratory infections (notinfluenza), and N. meningitides, which causes meningitis, if you have not had them already.
If you have a condition that has lowered your red blood cells or platelets, such as ITP, you will needtransfusionsprior to surgery to boost your levels.
How to Keep Yourself Safe Without a Spleen
For many patients who get their spleen removed, there is no opportunity for preparation due to its sudden nature. But if you know you will be having this surgery, there are some things to consider.
Location
The OR will be a large room with an operating table in its center. You’ll see a variety of equipment and instruments, including those used for anesthesia and the surgery itself, as well as lights, monitors, and more.
What to Wear
You may want to wear comfortable clothing that is easy to remove to your procedure. You will need to change into a hospital gown after you are admitted. Leave all valuables, including jewelry, at home.
Food and Drink
Medications
Your healthcare provider may recommend that you stop taking any drugs that thin your blood the week ahead of your surgery. Such drugs include Motrin (ibuprofen), aspirin, and warfarin.
Other drugs and supplements may also need to be stopped, so be sure you tell your surgeon about everything you are taking.
What to Bring
In addition to your insurance card, identification, and any paperwork you were asked to bring, be sure to pack everything you will need for your stay at the hospital.
In addition to personal care items (e.g., a toothbrush, face wash) and practical ones (e.g., a phone charger), bring non-skid slippers to walk in, as well as a comfortable outfit to come home wearing.
Pre-Op Lifestyle Changes
Try to stop smoking, if applicable, as it can impede the healing process post-surgery.
What to Expect the Day of Surgery
Going in for any major surgery can be nerve-wracking, even if you know that it’s needed and may help improve a health condition you’ve been dealing with for some time.
If you’ve got a splenectomy on your schedule, this look at what happens from start to finish may help you feel more prepared for what’s to come.
Before the Surgery
You will check-in for your surgery and be asked to change into a hospital gown.
A nurse will likely meet with you soon after that to review your food/drink intake, medications, and other information (even if just to confirm what you’ve already noted on the forms).
Your vital signs will be checked and recorded. Once you are wheeled to the operating room, you will be hooked up to a heart monitor and a blood pressure cuff will be placed. A cannula will be placed in your nose to deliver oxygen during the procedure.
During the Surgery
An open spleen removal surgery is very similar to a laparoscopic approach and proceeds as follows:
What Is an Accessory Spleen?An accessory spleen is splenic tissue that exists outside of the organ itself. About 10 to 30% of people have one. If discovered, the accessory spleen will also be removed during a splenectomy.This is because the tissue functions as if it were part of the normal spleen. Without its removal, symptoms will persist.
What Is an Accessory Spleen?
An accessory spleen is splenic tissue that exists outside of the organ itself. About 10 to 30% of people have one. If discovered, the accessory spleen will also be removed during a splenectomy.This is because the tissue functions as if it were part of the normal spleen. Without its removal, symptoms will persist.
After the Surgery
You will still be asleep when you are taken to a post-op recovery area for monitoring.
When you wake up, you will feel some pain on the left side of your abdomen.
Because the spleen is so prone to bleeding when injured, you may require a blood transfusion after the procedure. This will depend on the amount of blood loss before, during, and after the procedure, and is only done as needed.
The average patient is able to go home from the hospital 48 to 72 hours after surgery if the splenectomy was performed laparoscopically. An open procedure may require a longer stay, often up to a week, before you can be discharged.
Your medical team will make this call based on your condition and whether or not you have any signs of complications.
Recovering after splenectomy surgery varies widely. It depends on the surgical approach used, as well as your overall health, and the reason you had the surgery. Regardless, it will be a bit before you are feeling up to doing everything for yourself; it can be helpful to have someone stay with you during this time.
If you were not immunized as recommended prior to surgery, this may be recommended to you again two weeks post-op.
Wound Care
The increased risk of infection that you face will remain throughout your life, but it is especially high right after spleen removal. It is extremely important that you are diligent about your incision care.
Washing yourself:
If you have a wound dressing:
Caring for Your Incision After Surgery
Infection Checks and Prevention
Your incision(s) should be inspected for signs of infection on a daily basis or more often.
When to Call Your Healthcare ProviderContact your healthcare provider right away if you experience:101 degrees F fever or higher (take your temperature daily for the first week)Incision site that is red, hot, or bleedingFoul-smelling, thick, or discolored discharge from the incisionSwelling/hardening of the incisionShakes, chillsUnmanageable painInability to eat or drink
When to Call Your Healthcare Provider
Contact your healthcare provider right away if you experience:101 degrees F fever or higher (take your temperature daily for the first week)Incision site that is red, hot, or bleedingFoul-smelling, thick, or discolored discharge from the incisionSwelling/hardening of the incisionShakes, chillsUnmanageable painInability to eat or drink
Contact your healthcare provider right away if you experience:
It is best to stay home for the couple of weeks after surgery to protect yourself from outside germs. If you live with others, ask them to be diligent about hand-washing; leaving hand sanitizers around the house can also be helpful.
Activity
Most patients are able to resume their normal activities four to eight weeks after surgery.Of course, if damage to the spleen was only part of the impact of a trauma, your overall recovery may take longer as you heal from other injuries.
Light activity, like a short walk, a trip upstairs, or small chores, is OK—ifyou feel up for it. (It can even help ease belly pain.)But pushing yourself too much, too fast can impact recovery.
Avoid strenuous activities of all kinds until your surgeon clears you to resume them.
Coping With Recovery
Your healthcare provider will give you pain medication to take. Use it as directed. Taking it on time can not only keep symptoms well-managed but reduce the risk of accidental overdose.
You may be prescribed narcotic pain medicine, which is appropriate to use if your pain calls for it. That said, given the risks of using these drugs, you may want to ask your healthcare provider whether you can take (or at some point switch to) Motrin (ibuprofen) or another pain reliever instead. Never take aspirin, as it can increase your risk of bleeding.
Controlling Post-Surgery Pain
Whether or not you need additional treatments after splenectomy depends on why you had the surgery. For example, additional treatment is likely in cases of cancer.
Your resistance to infection will likely improve within two years of your surgery, but it is unlikely that it will ever return to preoperative levels.
To protect yourself from infection:
If you are seeing a new healthcare provider or being treated for an unrelated problem, be sure to let the healthcare provider know that you are “asplenic”—i.e., that you do not have a spleen. It is also a good idea to wear amedical ID braceletthat states this.
Keeping Yourself Safe When You Don’t Have a Spleen
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Health Resources & Services Administration. U.S. Government Information on Organ Donation and Transplantation.What Can Be Donated.Feldman L.Laparoscopic Splenectomy: Standardized Approach.World J Surg. 2011;35(7):1487-1495. doi:10.1007/s00268-011-1059-xYi SL, Buicko JL.Splenectomy. [Updated 2020 Jul 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-.U.S. National Library of Medicine. MedlinePlus.Open spleen removal in adults-discharge.Wu Z, Zhou J, Pankaj P, Peng B.Comparative treatment and literature review for laparoscopic splenectomy alone versus preoperative splenic artery embolization splenectomy. Surg Endosc. 2012 Oct;26(10):2758-66. doi:10.1007/s00464-012-2270-zMount Sinai.Spleen removal.Mayo Clinic.Splenectomy.Bajwa SA, Kasi A.Anatomy, Abdomen and Pelvis, Accessory Spleen. [Updated 2020 Aug 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-.
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Health Resources & Services Administration. U.S. Government Information on Organ Donation and Transplantation.What Can Be Donated.Feldman L.Laparoscopic Splenectomy: Standardized Approach.World J Surg. 2011;35(7):1487-1495. doi:10.1007/s00268-011-1059-xYi SL, Buicko JL.Splenectomy. [Updated 2020 Jul 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-.U.S. National Library of Medicine. MedlinePlus.Open spleen removal in adults-discharge.Wu Z, Zhou J, Pankaj P, Peng B.Comparative treatment and literature review for laparoscopic splenectomy alone versus preoperative splenic artery embolization splenectomy. Surg Endosc. 2012 Oct;26(10):2758-66. doi:10.1007/s00464-012-2270-zMount Sinai.Spleen removal.Mayo Clinic.Splenectomy.Bajwa SA, Kasi A.Anatomy, Abdomen and Pelvis, Accessory Spleen. [Updated 2020 Aug 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Health Resources & Services Administration. U.S. Government Information on Organ Donation and Transplantation.What Can Be Donated.Feldman L.Laparoscopic Splenectomy: Standardized Approach.World J Surg. 2011;35(7):1487-1495. doi:10.1007/s00268-011-1059-xYi SL, Buicko JL.Splenectomy. [Updated 2020 Jul 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-.U.S. National Library of Medicine. MedlinePlus.Open spleen removal in adults-discharge.Wu Z, Zhou J, Pankaj P, Peng B.Comparative treatment and literature review for laparoscopic splenectomy alone versus preoperative splenic artery embolization splenectomy. Surg Endosc. 2012 Oct;26(10):2758-66. doi:10.1007/s00464-012-2270-zMount Sinai.Spleen removal.Mayo Clinic.Splenectomy.Bajwa SA, Kasi A.Anatomy, Abdomen and Pelvis, Accessory Spleen. [Updated 2020 Aug 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-.
Health Resources & Services Administration. U.S. Government Information on Organ Donation and Transplantation.What Can Be Donated.
Feldman L.Laparoscopic Splenectomy: Standardized Approach.World J Surg. 2011;35(7):1487-1495. doi:10.1007/s00268-011-1059-x
Yi SL, Buicko JL.Splenectomy. [Updated 2020 Jul 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-.
U.S. National Library of Medicine. MedlinePlus.Open spleen removal in adults-discharge.
Wu Z, Zhou J, Pankaj P, Peng B.Comparative treatment and literature review for laparoscopic splenectomy alone versus preoperative splenic artery embolization splenectomy. Surg Endosc. 2012 Oct;26(10):2758-66. doi:10.1007/s00464-012-2270-z
Mount Sinai.Spleen removal.
Mayo Clinic.Splenectomy.
Bajwa SA, Kasi A.Anatomy, Abdomen and Pelvis, Accessory Spleen. [Updated 2020 Aug 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-.
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