What you need to know about:

Splenectomy

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Average Cost:

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Recovery Period:

2-3 days in hospital

Permanence:

Depends on patient condition

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Time it takes:

2-4 hours

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Anesthetize:

General Anesthesia

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Overview of

Splenectomy

in Thailand

A splenectomy is the removal of the entire spleen. Surgery to remove just part of the spleen is called a partial splenectomy. The spleen is a fist-sized organ located under the diaphragm on the left side of the body, close to the stomach. It plays an important part in the body’s immune system. The spleen contains special white blood cells that destroy bacteria and help the body fight infection. Furthermore, the spleen is responsible for producing red blood cells and removing or filtering old red blood cells from circulating through the body.

Goals of

Splenectomy

A splenectomy is done to treat different diseases and symptoms. Your doctor may recommend this procedure to you if experience any of the following: -Rupture of the spleen due to severe injury to the abdomen that can lead to life-threatening internal bleeding. A ruptured spleen must be removed. -Severe blood disorders may require a splenectomy, such as idiopathic thrombocytopenic purpura (ITP), polycythemia vera, thalassemia, and sickle cell disease. Other treatment options will be considered first, but when they do not work, a splenectomy may be required. -Certain types of cancer affect the spleen, such as chronic lymphocytic leukemia (CLL), Hodgkin’s lymphoma, and non-Hodgkin’s lymphoma. A patient may need a splenectomy if cancer is found in the spleen or due to an enlarged spleen caused by cancer. Furthermore, hairy cell leukemia is usually treated with a splenectomy. Severe infection or excessive pus in the spleen that already has severe abscesses that do not respond to other treatment may require a splenectomy. -A non-cancerous cyst or tumor in the spleen that is too large or difficult to remove may lead to a splenectomy. Your doctor may recommend the removal of your spleen if it is enlarged and no cause is found through laboratory tests or imaging tests. This is a rare occurrence.

Price of

Splenectomy

Average Cost

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Pros and cons of

Splenectomy

Pros

-Removing your spleen is a major surgery and leaves you with a compromised immune system. For these reasons, it’s only performed when truly necessary. The benefits of a splenectomy are that it can resolve several health issues such as blood diseases, cancer, and infection that could not be treated any other way. Having a ruptured spleen removed can save your life.

Cons

-One of the biggest threats to patients who have undergone splenectomies are infections. Infections after spleen removal usually develop quickly and make the person severely ill. They are referred to as overwhelming post-splenectomy infections, or OPSI. Such infections cause death in almost 50% of cases. Children under age 5 and people who have had their spleen removed in the last two years have the greatest chance for developing these life-threatening infections.

How it works:

Splenectomy

A splenectomy is done under general anesthesia so the patient is asleep during the procedure. An anesthesiologist will deliver the medication through a mask or intravenously. The medical team will closely monitor the patient’s heart rate, blood pressure, and blood oxygen saturation during the surgery. The doctor will begin the procedure only when the patient is unconscious. The doctor may choose a minimally invasive procedure (laparoscopic splenectomy) or an open splenectomy. Laparoscopic splenectomy- This type of surgery is minimally invasive and has a quicker and less painful recovery time than open surgery. In a laparoscopic splenectomy, your surgeon makes just a few small cuts in your abdomen. Then, they use a small camera to project a video of your spleen onto a monitor. Your surgeon can then remove your spleen with small tools. They’ll then stitch up the small incisions. Your surgeon may decide an open surgery is necessary after viewing your spleen on the camera. Open splenectomy - A traditional open surgery involves making a cut down the center of your abdomen. The surgeon then moves aside other tissues to remove your spleen. The incision is then closed with stitches. Open surgery is preferred if you have scar tissue from other surgeries or if your spleen has ruptured.

Preparation before

Splenectomy

Pre - treatment

If the procedure is not an emergency, the following should carried out before the splenectomy: Treat any problems with blood clotting and the number of red blood cells and/or platelets. Treat any infection. Manage the immune system. Patients normally receive vaccinations about two weeks before the procedure, including Pneumovax or Pnu-Imune 23 (to prevent pneumococcal infection) and Menomune-A/C/Y/W-135 to prevent meningococcal infection.

Recovery after

Splenectomy

Post - treatment

After the procedure the patient will be moved to the recovery room to be monitored for any complications from the surgery and the anesthesia. The patient will likely stay in the hospital for two to six days. Please talk to the doctor before leaving the hospital regarding the recommendations for activity. The doctor may recommend the patient stay home and avoid driving for at least one week after the procedure, but this may be longer, depending on the type of surgery. Minimally invasive surgery often has a shorter recovery period.

Risks & side effects

Normally a splenectomy is a safe procedure, but all surgery carries risks, including: Excessive bleeding Blood clots Infection Injury to nearby organs, such as stomach, pancreas, and the intestines

FAQs:

Splenectomy

What is Life Without a Spleen like?

After the spleen is removed, other organs will take over the function of the spleen and most people without spleens can live normal lives. However, without the spleen the patient is more susceptible to serious infection when compared with a person with a spleen so the doctor may recommend the patient be vaccinated for pneumonia and the flu to prevent life-threatening illness. In some cases prophylactic antibiotics may be prescribed, especially if the patient has other medical conditions making them susceptible to infection. Always let medical personnel know if you do not have a spleen and wear a medical identification bracelet so others are aware of this.

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What are the recommendations for travel for this procedure?

If you are taking any blood-thinning medication/anticoagulant, please let your doctor know as some may need to be stopped before you travel for the procedure. Travelers to Thailand should plan to stay in the country for at least two to five days after the procedure, depending on their condition after surgery, or for the entire duration of treatment. If you plan to return home after the procedure, please speak to your doctor before making travel arrangements. There are no restrictions for air travel. During your follow-up appointment your medical team will assess your health and your incision and you will receive documents detailing your medical and treatment history and your "Fit to Fly" certificate (if needed).

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What are the Long-Term Risk of Infection once I have a splenectomy?

A person without a spleen is at risk of severe or life-threatening infection. The doctor will recommend that person be vaccinated for pneumonia and the flu every year. In some cases prophylactic antibiotics may be prescribed, especially if the patient has other medical conditions making them susceptible to infection.

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What kinds of patients need splenectomies?

You may need to have your spleen removed if you have an injury that damages the organ, causing its covering to break open, or rupture. A ruptured spleen can lead to life-threatening internal bleeding. Common injury-related causes of a ruptured spleen include car accidents and severe blows to the abdomen during contact sports, such as football or hockey. A splenectomy may also be recommended if you have cancer involving the spleen or certain diseases that affect blood cells. Certain conditions can cause the spleen to swell, making the organ more fragile and susceptible to rupture. In some cases, an illness, such as sickle cell disease, can cause the spleen to shrivel up and stop functioning. This is called an auto-splenectomy.

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