Surgical removal of the spleen or splenectomy is a procedure performed by a surgeon to remove the spleen, either partially or completely. There are various conditions that make this surgery necessary, including damage to the spleen or enlargement of the spleen.
The spleen is a solid organ about the size of a fist, located under the left rib cage. The role of this organ in the immune system is very important because it contains white blood cells that can fight infection. In addition, the spleen is also responsible for filtering and removing old red blood cells from the body's circulation.
When there is a problem with the spleen that can no longer be treated with medication, surgical removal of the spleen may be recommended by a doctor. To find out more about when spleen surgery needs to be done, see the following description.
When is Spleen Removal Surgery Needed?
The following are some reasons or indications for the need for surgical removal of the spleen:
1. Spleen is damaged (ruptured) due to injury
In patients who have damaged the spleen, for example as a result of a collision in a traffic accident, surgical removal of the spleen should be performed as soon as possible. The reason is, bleeding that occurs in the patient's stomach can threaten his safety.
2. Enlarged spleen
A viral infection, such as mononucleosis, or a bacterial infection, such as syphilis, can cause an enlarged spleen (splenomegaly). An enlarged spleen traps and destroys many blood cells and platelets, including healthy red blood cells, causing their levels to drop.
In addition, an enlarged spleen can cause the spleen to become blocked and its function impaired. This is at risk of causing anemia, infection, bleeding, and even rupture of the spleen which can be life threatening. In these conditions, surgical removal of the spleen is necessary.
3. Certain blood disorders
Your spleen may need to be removed if you have a severe blood disorder that cannot be treated with other treatments, such as sickle cell anemia, hemolytic anemia, idiopathic thrombocytopenic purpura (ITP), and polycythemia vera .
4. Cancer or large spleen cyst
Surgical removal of the spleen is also sometimes recommended in cancers, such as lymphocytic leukemia, non-Hodgkin's lymphoma, and Hodgkin's disease. These cancers can cause the spleen to enlarge and be at risk of rupture.
In addition to cancer, the spleen may also need to be removed due to a cyst or tumor.
5. Infection
Severe infections of the spleen may not improve with antibiotic therapy or other treatments. An infection like this can also cause a collection of pus (abscess) to form in the spleen. To overcome this, the doctor may suggest surgical removal of the spleen.
Types of Spleen Removal Surgery
There are 2 types of surgical removal of the spleen, namely open surgery and laparoscopy. In open surgery, part or all of the spleen is removed through a large incision. While in laparoscopy, removal is done through small incisions with the help of a camera and small tools.
Due to the smaller incision size, laparoscopic surgery minimizes pain during recovery and reduces the risk of infection. However, this operation is sometimes not possible due to variations in the shape and location of the spleen.
An example is in the case of swelling of the spleen. The large size of the spleen does not allow it to be removed through small laparoscopic incisions, so open surgery is preferred.
Likewise in the case of a ruptured spleen due to injury. Through a wide incision, the surgeon can check for injuries to other organs and perform operations more quickly.
After undergoing surgical removal of the spleen, the patient will be more susceptible to infection and his body will not fight off the infection as easily, especially in the first few months after surgery. Therefore, doctors will usually advise patients to receive vaccines to prevent pneumonia and meningitis.
The patient's immunity to infection will gradually increase within 2 years after the surgical removal of the spleen, but it is less likely to return to the condition as before the operation.
So, if you have had surgery to remove your spleen, it is important to always check with your doctor according to a predetermined schedule. If you happen to be sick and go to another doctor, do not forget to tell the doctor that you have had surgery to remove the spleen.
Written by:
dr. Sonny Seputra, M.Ked.Klin, Sp.B, FINACS
(Surgeon Specialist)
