Splenectomy / Splenic salvage procedures - Khobragade Multispeciality Hospital

What is Splenectomy and Splenic Salvage?

Splenectomy is a surgical procedure to remove the spleen, an important organ located in the upper left abdomen, just below the ribcage. The spleen plays a vital role in filtering blood, fighting infection, and managing red blood cells and platelets. This procedure may be partial or total, depending on the severity of the condition.

Splenic salvage procedures, on the other hand, aim to preserve all or part of the spleen when possible. These techniques are often preferred in cases of trauma or specific diseases where maintaining spleen function is beneficial, especially in children and younger adults.

Symptoms That May Indicate the Need for Splenectomy

Splenectomy or splenic salvage may be considered if the patient experiences:

Frequent infections or sepsis due to spleen dysfunction
Chronic or severe pain in the upper left abdomen
Fatigue or anemia
Unexplained weight loss
Low platelet or red blood cell count (due to splenic sequestration)
Enlarged spleen (splenomegaly) causing pressure on surrounding organs
Trauma to the spleen causing internal bleeding

Common Conditions That May Require a Splenectomy or Splenic Salvage

Splenic rupture (due to accident or trauma)
Hematologic diseases like idiopathic thrombocytopenic purpura (ITP), sickle cell anemia, or hereditary spherocytosis
Certain cancers, including lymphoma or leukemia
Abscess, cyst, or tumors of the spleen
Hypersplenism (overactive spleen)
Autoimmune disorders

Procedure / Treatment

1. Splenectomy

Splenectomy can be performed using:

Laparoscopic surgery (minimally invasive): Involves small incisions, faster recovery, and less postoperative pain.
Open surgery: Used in emergencies or if the spleen is significantly enlarged or damaged.

The patient is usually given general anesthesia. The surgeon removes the spleen, controls bleeding, and closes the incision. Postoperative care includes vaccinations and antibiotics to prevent infections.

2. Splenic Salvage Procedures

These include:

Partial splenectomy: Only the damaged part is removed.
Splenorrhaphy: Surgical repair of the spleen using sutures, mesh, or topical agents.
Embolization: Blocking blood flow to a part of the spleen to stop bleeding or reduce its size without removal.

These procedures aim to maintain immune function and reduce the risk of life-long infections associated with total splenectomy.

Prevention and Postoperative Care

While some spleen issues are not preventable (especially trauma), managing underlying diseases early can reduce risks. After splenectomy:

Vaccinations (against pneumococcus, meningococcus, and Haemophilus influenzae) are crucial before or shortly after surgery.
Antibiotics may be prescribed for several months post-surgery or longer in children.
Regular follow-ups are important to monitor blood counts and immune function.

Benefits of Splenectomy and Splenic Salvage

Relief from chronic pain or symptoms caused by spleen disorders
Prevention of life-threatening internal bleeding
Improved blood count levels in patients with hematologic disorders
Preservation of immune function through splenic salvage
Reduced risk of postoperative complications with laparoscopic techniques