What is an Open Splenectomy

Open splenectomy is a surgery to remove the spleen. The spleen is an organ that is located in the upper left part of the abdomen, just under the ribs. The spleen filters and cleans the blood.

It also stores blood cells and destroys cells that are worn out. The spleen is also important for fighting disease.

The spleen may need to be taken out if it is damaged in a crash or other trauma. It may also need to be taken out if a person has certain diseases or conditions, such as:

• A tumor.
• Cancer.
• An enlarged spleen.
• A blood clot (thrombosis) in the blood vessels of the spleen.
• Chronic liver disease with scarring of the liver (cirrhosis).
• A collection of pus (abscess) in the spleen.
• A blood disease, such as idiopathic thrombocytopenic purpura (ITP).

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.
• Allergic reactions to medicines.
• Damage to other structures or organs.
• A blood clot in the legs, arms, or other big veins. In rare cases, blood clots may travel to the lungs.
• A hernia. This may occur if the incision does not heal correctly, causing a bulge near the incision.

What happens before the procedure?

• 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 before your procedure if your health care provider instructs you not to.
• Follow instructions from your health care provider about eating or drinking restrictions.
• You may have an exam or testing.
• Blood or platelet transfusions may be needed.
• You may be given vaccinations to help prevent infections. These may be needed because not having a spleen makes certain infections more dangerous after you have this procedure.
• You may also be given antibiotic medicine to help prevent infection.
• Ask your health care provider how your surgical site will be marked or identified.
• Plan to have someone take you home after the procedure.

What happens during the procedure?

• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
• An IV tube will be inserted into one of your veins.
• You will be given a medicine to make you fall asleep (general anesthetic).
• The surgeon will make an incision in the middle of your abdomen or under your rib cage.
• The surgeon will remove your spleen and any extra spleen tissue that is found.
• The surgeon may leave a drain in place. This is a small tube that comes out of the skin, near the incision.
• The incision will be closed with stitches (sutures), staples, or skin adhesive strips.
• A bandage (dressing) will be placed on your skin over the incision.

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 often until the medicines you were given have worn off.
• You will be given pain medicine as needed.
• You may be asked to get up and start walking within a day. This helps your intestines start working again. It also helps keep blood clots from forming in your legs.

Open Splenectomy, Care After

Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After the procedure, it is common to have:

• Mild pain.
• Lack of energy.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not drive or operate heavy machinery while taking prescription pain medicine.
• Talk with your health care provider about the need for vaccinations to help prevent infections.

Incision care

• Follow instructions from your health care provider about how to take care of your incision. 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 be 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 area every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.
• Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you can take showers. You may only be allowed to take sponge baths for bathing.

Eating and drinking

• Drink enough fluid to keep your urine clear or pale yellow.
• Return to your normal diet as told by your health care provider.

Activity

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Avoid strenuous activity for 4 weeks or as told by your health care provider.
• Do not lift anything that is heavier than 10 lb (4.5 kg).
• Walk as much as possible.
• Ask your health care provider when it is safe to drive, have sex, or go back to work.

General instructions

• Continue to practice deep breathing as told by your health care provider.
• Always tell your health care providers that you do not have a spleen before you have any procedures. These include medical and dental procedures.
• 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 is not helped by medicine.
• You have more redness, swelling, or pain around your incision.
• You have more fluid or blood coming from your incision.
• Your incision feels warm to the touch.
• You have pus or a bad smell coming from your incision.
• You have a fever or chills.
• You have nausea or vomiting.

Get help right away if:

• Your pain gets much worse.
• Your legs are red, swollen, or painful.
• You have chest pain.
• You have trouble breathing.
• You suddenly feel very weak or dizzy.