Surgeons perform splenectomy during general anesthesia, so you won't be awake during the procedure. The anesthesiologist or anesthetist gives you an anesthetic medication as a gas — to breathe through a mask — or injects a liquid medication into a vein. The surgical team monitors your heart rate, blood pressure and blood oxygen throughout the procedure with a blood pressure cuff on your arm and heart-monitor leads attached to your chest. After you're unconscious, your surgeon begins the surgery using either a laparoscopic or open procedure.
Minimally invasive (laparoscopic) splenectomy. During laparoscopic splenectomy, the surgeon makes four small incisions in your abdomen. A tube with a tiny video camera is inserted into your abdomen through one of the incisions. Your surgeon watches the video images on a monitor in the operating room as special surgical tools are inserted through the other incisions in your abdomen and your spleen is removed. The incisions are then closed.
Laparoscopic splenectomy isn't appropriate for everyone. A ruptured spleen usually requires open splenectomy. In some cases your surgeon may begin with a laparoscopic approach and find it necessary to make a larger incision because of scar tissue from previous operations or other complications.
- Traditional (open) splenectomy. During open splenectomy, your surgeon makes an incision in the middle of your abdomen. Muscle and other tissue are moved aside to reveal your spleen. Your surgeon then removes the spleen, and closes the incision.
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- In the hospital. After surgery, you're moved to a recovery room where the health care team watches for complications from the surgery and anesthesia. A hospital stay of two to six days is usually required after splenectomy.
- After you go home. Talk to your doctor about how long to wait until resuming your normal daily activities. Doctors usually recommend staying home from work or school and not driving for at least one week after surgery, but it may be longer depending on your situation. Full recovery from splenectomy typically takes from four to six weeks.
- Splenomegaly. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/hematology_and_oncology/spleen_disorders/splenomegaly.html. Accessed May 15, 2012.
- Landaw SA, et al. Approach to the adult patient with splenomegaly and other splenic disorders. http://www.uptodate.com/index. Accessed May 15, 2012.
- Hoffman R, et al. Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2009. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-443-06715-0..X5001-8--TOP&isbn=978-0-443-06715-0&uniqId=230100505-56. Accessed May 15, 2012.
- Maurus CF. Laparoscopic versus open splenectomy for nontraumatic diseases. World Journal of Surgery. 2008;32:2444.
- Townsend CM Jr, et al. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 19th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.mdconsult.com/das/book/body/208746819-6/0/1565/0.html. Accessed May 15, 2012.
- Patient information for laparoscopic spleen removal (splenectomy) from SAGES. Society of American Gastrointestinal and Endoscopic Surgeons. http://www.sages.org/publications/publication.php?id=PI12. Accessed May 15, 2012.
- Cadili A, et al. Complications of splenectomy. The American Journal of Medicine. 2008;121:371.
- Mesa RA (expert opinion). Mayo Clinic, Rochester, Minn. June 4, 2012.