Splenectomy
The surgical removal of the spleen, splenectomy helps treat various hematologic disorders. It’s also done as an emergency procedure to stop hemorrhage after traumatic splenic rupture.
The most common reason for splenectomy is hypersplenism—a combination of splenomegaly and cytopenia that occurs in such disorders as hairy cell leukemia, Felty’s syndrome, myeloid metaplasia, thalassemia major, and Gaucher’s disease. In addition, splenectomy is the treatment of choice for such diseases as hereditary spherocytosis and chronic idiopathic thrombocytopenic purpura. Furthermore, it may be performed in a patient with Hodgkin’s disease to establish the stage of the disease and determine the appropriate therapy.
Procedure
After the patient is placed under general anesthesia, the surgeon exposes the peritoneal cavity through a left rectus paramedial or subcostal incision. He ligates the splenic artery and vein and the ligaments that hold the spleen in place. Then he removes the spleen. After carefully checking
for bleeding, he closes the abdomen, often placing a drain in the left subdiaphragmatic space. After the incision site is sutured and dressed, the patient is returned to the postanesthesia care unit.
for bleeding, he closes the abdomen, often placing a drain in the left subdiaphragmatic space. After the incision site is sutured and dressed, the patient is returned to the postanesthesia care unit.
Complications
In addition to bleeding and infection, splenectomy can cause such complications as pneumonia and atelectasis. The reason is that the location of the spleen close to the diaphragm and the need for ahigh abdominal incision restrict lung expansion after surgery. In addition, splenectomy patients are vulnerable to infection because of the spleen’s role in the immune response.
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