Splenectomy (Spleen Removal)

What Is a Splenectomy?

A splenectomy is a surgical procedure to remove the spleen, an organ in the upper left abdomen that filters blood and helps fight infection. The spleen isn't essential for survival—other organs take over many of its functions.

Surgical approaches:

• Laparoscopic (primary method): 3-4 small incisions, camera-guided. Completed in 60-120 minutes.
• Open splenectomy: Large incision for emergencies or severe trauma.
• Partial splenectomy: Preserves some immune function, especially in children.

Why It's Done

• Trauma (most common abdominal injury)
• Blood disorders (ITP, hereditary spherocytosis, thalassemia, autoimmune hemolytic anemia)
• Splenic cysts, abscesses, or tumors
• Hypersplenism with enlarged spleen and low blood counts
• Diagnostic purposes in rare disorders

Risks & Complications

Overall short-term complication rates range from 10-20%, with mortality less than 1% for elective cases.

Short-term risks:

• Bleeding: 5-10%
• Infection/abscess: 3-5%
• Organ injury (stomach, pancreas, colon): 1-3%
• Blood clots: 1-5%
• Pancreatic leak: 1-2%
• Wound infection: 2-4%

Long-term risks:

• OPSI (overwhelming post-splenectomy infection): 0.2-0.5% lifetime; up to 50% mortality if untreated
• Reactive thrombocytosis: 30-50% temporarily
• Incisional hernia: Less than 5%

Recovery Timeline

• Hospital stay: 1-2 days (laparoscopic); 3-5 days (open)
• Pain management: Shoulder/left-upper-abdominal pain for several days
• Mobility: Walking same day; light activity in 1 week
• Full activity: 4-6 weeks (longer after open surgery)
• Follow-up: Blood counts checked at 2 weeks, 3 months, and yearly

Important Post-Operative Care

Vaccinations against pneumococcal, meningococcal, and Haemophilus B infections are required before elective surgery or soon after emergency removal.

Lifelong precautions include:

• Seeking immediate care for fever ≥101°F
• Wearing medical alert identification

Surgeon Specialists

General Surgeons, Hepatobiliary (HPB) Surgeons, or Pediatric Surgeons (for children) perform splenectomies. Centers experienced with laparoscopic splenic surgery and trauma management produce optimal outcomes.