What is Laparoscopic Splenectomy

Laparoscopic splenectomy is surgery to remove the spleen. The spleen is an organ in the upper left abdomen, just under the ribs. It filters and cleans blood. It also stores blood cells and destroys cells that are worn out. The spleen is also an important part of the body’s disease-fighting system (immune system).

The spleen may need to be removed if it is damaged due to an injury or certain diseases or conditions, such as:

• A blood disease such as idiopathic thrombocytopenic purpura (ITP).
• A tumor.
• Cancer.
• An enlarged spleen.
• A blood clot (thrombosis) in the blood vessels of the spleen.
• Scarring of the liver (cirrhosis).
• A collection of fluid or pus (cyst or abscess) in the spleen.

Laparoscopic surgery is done using a thin tube that has a light and a camera on the end of it (laparoscope). The camera sends images to a screen in the operating room, and these images are used to help guide the surgery.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Damage to other organs.
• Blood clot.
• Allergic reactions to medicines.

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

Medicines

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
  • Taking over-the-counter medicines, vitamins, herbs, and supplements.
• You may be given vaccinations or antibiotic medicines to help prevent infections. Because the spleen is part of the body’s immune system, not having a spleen may affect your body’s ability to fight infections after you have this procedure.

General instructions

• In some cases, you may receive donated blood or platelets through an IV (transfusions).
• You may be asked to shower with a germ-killing soap.
• Plan to have someone take you home from the hospital.
• Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital. This is important.

What happens during the procedure?

• Ask your health care provider what steps will be taken to help prevent infection. These may include:
  • Removing hair at the surgery site.
  • Washing skin with a germ-killing soap.
  • Antibiotic medicine.
• An IV will be inserted into one of your veins.
• You will be given a medicine that makes you fall asleep (general anesthetic). You may also be given a medicine to help you relax (sedative).
• A small incision will be made in your abdomen.
• Your abdomen will be filled with a gas. This helps your surgeon see your organs more easily and makes room to perform the surgery.
• A laparoscope will be placed through the incision to allow your surgeon to see the area.
• Several other small incisions will be made in your abdomen. Surgical instruments will be placed through these incisions.
• Your spleen and any excess spleen tissue will be removed.
• Your incisions will be closed with stitches (sutures), staples, or adhesive strips.
• A bandage (dressing) will be placed over your incisions.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until you leave the hospital.
• You will be given pain medicine as needed.
• You will be encouraged to do deep breathing exercises to help prevent lung infection (pneumonia).

Summary

• Laparoscopic splenectomy is surgery to remove the spleen through small incisions.
• Before the procedure, you may be given vaccinations or antibiotic medicines to help prevent infections.
• Ask your health care provider about changing or stopping your regular medicines before the procedure.
• You should plan to have someone take you home from the hospital after surgery.

Laparoscopic Splenectomy, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• Mild pain.
• Temporary lack of energy.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.
• Talk with your health care provider about whether you need vaccinations to help prevent infections. Not having a spleen makes certain infections more dangerous because it weakens the body’s disease-fighting system (immune system).

Driving

• Do not drive or use heavy machinery while taking prescription pain medicine.

Incision care

• Follow instructions from your health care provider about how to take care of your incisions. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Check your incision areas every day for signs of infection. Check for:
  • Redness, swelling, or pain.
  • Fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Activity

• Avoid sitting for a long time without moving. Get up to take short walks every 1–2 hours. This is important to improve blood flow and breathing. Ask for help if you feel weak or unsteady.
• Avoid activities that require a lot of energy (strenuous activities). Ask your health care provider what activities are safe for you and when you may return to your normal activities.
• Do not lift anything that is heavier than 10 lb (4.5 kg), or the limit that you are told, until your health care provider says that it is safe.

General instructions

• Drink enough fluid to keep your urine pale yellow.
• Do deep breathing exercises as told by your health care provider. These help to prevent lung infection (pneumonia).
• If you are taking prescription pain medicine, take actions to prevent or treat constipation. Your health care provider may recommend that you:
  • Drink enough fluid to keep your urine pale yellow.
  • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
  • Limit foods that are high in fat and processed sugars, such as fried or sweet foods.
  • Take an over-the-counter or prescription medicine for constipation.
• Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you may take showers. You may only be allowed to take sponge baths.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if you:

• Have pain that does not get better with medicine.
• Have redness, swelling, or pain around an incision.
• Have fluid or blood coming from an incision.
• Notice that an incision feels warm to the touch.
• Have pus or a bad smell coming from an incision.
• Have a fever or chills.
• Have a sore throat.
• Have nausea or vomiting.

Get help right away if you:

• Have trouble breathing.
• Notice that your legs are red, swollen, or painful.
• Suddenly feel very weak or dizzy.
• Have chest pain.

Summary

• Get up to take short walks every 1–2 hours. This is important to improve blood flow and breathing.
• Check your incision areas every day for signs of infection, such as redness or swelling.
• Talk with your health care provider about whether you need vaccinations to help prevent infections.
• You should get help right away if your legs are red, swollen, or painful.