Splenectomy – Pediatric

File:Enlarged spleen.png

A splenectomy is a procedure in which the spleen of an individual is removed due to disease or abnormal function.  Conditions that may warrant a splenectomy include (but are not limited to) sickle cell anemia, Hodgkin’s disease, idiopathic thrombocytopenic purpura (ITP), and significant trauma to the spleen.

What is it?

The spleen’s primary functions include removing old or unhealthy red blood cells and ridding the blood of harmful substances.  Although individuals are able to live without a functioning spleen, the organ plays a large role in supporting the immune system and preventing bacterial infections.  If an individual needs to have their spleen removed, a splenectomy may be performed, resulting in the patient living post surgery without a spleen.  A splenectomy may be performed to treat various diseases or trauma to the spleen.  Sometimes, only a part of the spleen is removed. This is called a partial splenectomy.  Today, the most common way to receive a splenectomy is by using laparoscopic surgery.  An open splenectomy may still be performed if the spleen has been severely damaged or has become enlarged due to disease or infection.

What should I do to prepare?

It is common to receive a pneumococcal vaccination to prevent infection as well as blood transfusions to prevent significant blood loss during the procedure.  The patient will undergo various tests before the surgery such as X-rays, MRIs, or CT scans.  Your doctor will also ask you to stop taking most medications before the surgery.  Patients may be on an all-liquid diet leading up to the surgery and may take special medications to help clean the bowels.  You will be asked not to eat or drink after midnight the night before the procedure.

What happens during the process?

Patients will be under general anesthesia for this procedure.  Surgeons will either perform open surgery or laparoscopic surgery.  Laparoscopic surgery will involve three or four small incisions being made in the abdomen.  The surgeon will then insert the laparoscope and other operating tools through the incisions, performing the surgery by watching the video feed from the camera.  Carbon dioxide will also be injected into the patient’s body to give the surgeon room to maneuver the instruments.  After removing the spleen from the surrounding structures, the surgeon takes it out of the body through the largest of the incisions.  A tube may then be left in the abdomen for some time to allow for the carbon dioxide to drain.  Open surgery will involve the abdomen being cut open to allow for a conventional splenectomy.  The surgeon will make larger incisions and cut more tissue to access the spleen and remove it.

What are the risks and potential complications?

  • Excessive bleeding and infection
  • Increased likelihood of contracting bacterial infections
  • Blood clots
  • Damage to nearby tissue
  • Pneumonia


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