In healthy people, the spleen plays a role in immunity against bacterial infections. The spleen is in the uppermost area of the left side of the abdomen, just under the diaphragm. It typically has attachments to the stomach, left kidney, and colon.

If the surgery is elective (planned) rather than an emergency, your doctor will give you vaccines against certain bacteria prior to removing the spleen. If the operation is an emergency, you should get the vaccines after the operation.

The spleen is removed while the patient is under general anesthesia. The surgeon makes an incision in the abdomen, locates the spleen, and separates it from its attachments to the surrounding organs. The surgeon then divides the blood supply to the spleen and removes it from the abdomen. After a careful check for bleeding, the abdominal incision is closed.

Some patients may be able to undergo laparoscopic surgery (also known as "keyhole" or "telescopic" surgery) to remove the spleen. This operation is done with several tiny incisions instead of a single large one, and recovery is typically faster. Some patients, however, are not suited to laparoscopic surgery.

Some conditions which may require spleen removal include:

EMERGENCY:

• Trauma to the spleen with uncontrolled bleeding
• Spontaneous rupture (extremely rare)

ELECTIVE:

• Idiopathic thrombocytopenia purpura (ITP)
• Congenital or acquired hemolytic anemia
• Thrombosis (clot) of the splenic blood vessels
• Portal hypertension and hypersplenism
• Hereditary spherocytosis
• Lymphoma, leukemia with a markedly enlarged spleen

Risks for any anesthesia include the following:

• Reactions to medications
• Breathing problems, pneumonia
• Heart problems
• Blood clots in the legs

Risks for any surgery include the following:

• Bleeding
• Infection

Additional risks include the following:

• Injury to surrounding organs
  • Pancreas
  • Stomach (rare)
  • Colon (rare)
• Increased risk for infection after splenectomy (post-splenectomy sepsis or other infections; children are at higher risk than adults for this complication)

The outcome varies with the underlying disease or the extent of other injuries. Complete recovery from the surgery itself should be anticipated, in the absence of other severe injuries or medical problems.

All patients undergoing splenectomy should be vaccinated against pneumococcal pneumonia. Consult your physician regarding an appropriate vaccination regimen. In addition, some physicians recommend vaccinations against other types of bacteria, and, especially in the case of children, long-term treatment with antibiotic drugs to prevent post-splenectomy sepsis. Long-term antibiotic use is usually not necessary in adults.

However, any patients who have had a splenectomy should seek medical attention for even seemingly minor illnesses, such as sinus infections or sore throats, as the health care provider may wish to prescribe antibiotics.