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Last updated April 24, 2019

Approved by: Krish Tangella MD, MBA, FCAP

Splenectomy is a surgical procedure that involves a complete removal of the spleen. If a portion of the spleen is removed, then it is called a Partial Splenectomy surgical procedure.

Background Information:

What are the other Names for the Procedure?

  • Spleen Removal

What is Splenectomy surgical procedure?

  • Splenectomy is a surgical procedure that involves a complete removal of the spleen
  • If a portion of the spleen is removed, then it is called a Partial Splenectomy surgical procedure

What part of the Body does the Procedure involve?

A Splenectomy involves the spleen, which is an organ in the abdomen that forms a part of the body’s immune system.

Why is the Splenectomy surgical procedure Performed?

A Splenectomy is performed for the following reasons:

  • Damage to the spleen, resulting in rupture and excessive bleeding
  • The presence of certain blood disorders, such as spherocytosis, thrombocytopenia, or other lymphatic conditions
  • Splenic-vein thrombosis, resulting from esophageal varices
  • Removal of a benign or suspected cancerous tumor within the spleen
  • Abnormal enlargement of the spleen (called splenomegaly)
  • Disease within the liver
  • Leukemia or lymphoma affecting the spleen
  • Abscess formation within the spleen
  • The spleen may undergo auto-splenectomy, which is a non-functioning spleen due to atrophy caused by sickle cell anemia or systemic lupus erythematosus (SLE)
  • Due to idiopathic thrombocytopenic purpura (ITP), thalassemia, hereditary elliptocytosis, hereditary ovalocytosis, and other conditions

What are some Alternative Choices for the Procedure?

Currently, there are no alternatives to the Splenectomy surgical procedure.

What are the Recent Advances in the Procedure?

There have been no recent advances to the Splenectomy surgical procedure.

What is the Cost of performing the Splenectomy surgical procedure?

The cost of Splenectomy procedure depends on a variety of factors, such as the type of health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

  • It is normal for a patient to feel uncomfortable and confused by the information regarding Splenectomy and on what needs to be done
  • If the patient needs further reassurance or a second opinion, a physician will almost always assist and also recommend another physician, if required
  • Also, if the procedure involves multiple surgeries or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently

What are some Helpful Resources?

Complete Guide to Symptoms, Illness & Surgery; Written by H Winter Griffith, M.D.; Revised and updated by Stephen Moore, M.D. and Kenneth Yoder, M.D.; The Berkley Publishing Group, 5th Edition, New York, 2006

Prior to Splenectomy surgical procedure:

How is the Splenectomy surgical procedure Performed?

Any of the following methods for Splenectomy may be adopted by the physician:

  • Laparoscopic splenectomy:
    • Small incisions are made on the abdomen and a laparoscope is inserted through one of the incisions
    • The blood vessels leading to the spleen are ligated (tied) and cut
    • The spleen is separated from the surrounding tissue and removed through a surgical incision
    • The incisions are then sutured (closed)
  • Open splenectomy:
    • An incision is made on the left side of the abdomen
    • The blood vessels leading to the spleen are ligated (tied) and cut
    • The spleen is removed through the incision
    • The abdominal incision is then closed using sutures

Where is the Procedure Performed?

A Splenectomy surgical procedure is performed at a hospital.

Who Performs the Procedure?

A general surgeon performs a Splenectomy procedure.

How long will the Procedure take?

A Splenectomy surgical procedure usually takes about 30 minutes to 2 hours.

What do you need to tell your Physician before the Procedure?

It is very important to provide the following information to your healthcare provider. This enables your healthcare provider in assessing the risks for the Splenectomy procedure and helps avoid unnecessary complications.

  • Provide a complete list of medications you are currently taking to your physician. This information is useful for a variety of reasons. For example, it can help your healthcare provider prevent complications due to a drug interaction
  • If you are allergic to any specific medication or food items
  • If you are taking blood thinners, such as aspirin, warfarin, herbal supplements, or any other such medications
  • If you or your family members have a history of bleeding disorders, or if there is a tendency to bleed more than normal
  • If you have diabetes, high blood pressure, chest pains, or have previously suffered from a heart attack
  • If you have ever been diagnosed with blood clots in your leg (deep vein thrombosis) or lung (embolism of lung)
  • If you have a history of frequent bone fractures (this may affect bone-healing if bones are involved as part of your procedure)
  • A list of all previous surgical procedures you have undergone, like for example: Removal of appendix, gallbladder, or any other part of your body; surgical repair of any body part, such as hernia repair, perforation of bowel wall, etc.

What Preparations are needed, prior to the Procedure?

It is very important to provide the following information to your healthcare provider. This enables your healthcare provider in assessing the risks for the Splenectomy procedure and helps avoid unnecessary complications.

  • The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient including information related to the medications that are being currently taken
  • Some medications increase a person’s chances of bleeding and it may be recommended to discontinue them for a period of time, before the procedure is performed
  • Blood tests may be performed to determine if there is a bleeding tendency or any other medical conditions that prevents the person from undergoing the procedure
  • Normally local anesthesia is not used; however, do inform the physician if you are allergic to any local anesthetics, lidocaine, etc.
  • Avoid application of any cosmetics, deodorant, or topical medicines on the area, prior to the procedure
  • It is advisable to quit smoking and the use of any nicotine based products, for a while, before the surgery
  • Consumption of alcoholic drinks must also be avoided for a period of time, as instructed
  • The patient must avoid eating or drinking at least 8 hours prior to the surgical procedure, depending on when the procedure is arranged (2 weeks prior or 2 weeks after emergency procedure)
  • For persons suffering from diabetes, it is important that the blood sugar stays within the normal range; if not their diabetologist may have to control blood sugar by recommending insulin and/or a combination of oral medicines
  • Streptococcus haemophilus vaccine to prevent infection with pneumococcal and meningococcal bacteria
  • Bowel preparation before elective surgery

What is the Consent Process before the Procedure?

A physician will request your consent for Splenectomy procedure using an Informed Consent Form.

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied by the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What Tests are needed, before the Splenectomy surgical procedure?

Before a Splenectomy procedure, the patient should undergo certain tests such as:

  • Physical examination
  • Routine blood and urine analysis
  • Abdominal X-ray
  • Ultrasound imaging scan
  • Electrocardiography (ECG)
  • Computerized tomography (CT scan) scan
  • MRI scan of the abdomen

What are some Questions for your Physician?

Some of the basic questions that you might ask your physician are as follows:

  • What is a Splenectomy?
  • Why is this procedure necessary? How will it help?
  • How soon should I get it done? Is it an emergency?
  • Who are the medical personnel involved in this procedure?
  • Where is the procedure performed?
  • What are the risks while performing the procedure?
  • What are the complications that might take place during recovery?
  • How long will it take to recover? When can I resume normal work?
  • How many such procedures have you (the physician) performed?
  • Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
  • What are the costs involved?

During the Splenectomy surgical procedure:

What kind of Anesthesia is given, during the Procedure?

General anesthesia by injection and inhalation is administered prior to the Splenectomy surgical procedure.

How much Blood will you lose, during the Procedure?

  • The blood loss during a Splenectomy surgical procedure is usually minimal
  • However, depending on the reason for the procedure, blood loss can be significant

What are the possible Risks and Complications during the Splenectomy surgical procedure?

There are general factors that increase the risk of getting complications during surgery and they include:

  • Obesity: Generally greater the degree of obesity, greater is the surgical risk
  • Smoking: Longer the smoking history (in pack years smoked), greater the surgical risk
  • Advancing age
  • Poorly controlled diabetes, as evidenced by a high hemoglobin A1c and a high fasting glucose
  • Poorly functioning kidney, as evidenced by increased BUN (blood urea nitrogen) and blood creatinine
  • Poorly functioning liver, as evidenced by increased blood liver function tests
  • Hypertension (increased blood pressure), especially if it is poorly controlled
  • Poor nutritional status (malnutrition with mineral and vitamin deficiencies)
  • Poor lung function, as evidenced by abnormal lung function tests
  • History of bleeding disorders
  • Longstanding illness, such as autoimmune disorders, chronic infections
  • Poor immune system due to a variety of causes

The possible risks or complications that may arise during the surgery are:

  • Excessive bleeding, which may require a blood transfusion
  • Infection within the surgical wound
  • Anesthetic complications

What Post-Operative Care is needed at the Healthcare Facility after the Splenectomy surgical procedure?

  • After the Splenectomy procedure, the patients are sent to an area of the hospital called the postoperative recovery area (or PACU)
  • The patient’s blood pressure, heart rate, and respiration cycle shall be closely monitored. Any additional pain associated with the procedure will be treated
  • Individuals are usually discharged from the hospital after a stay of 3-5 days, if there are no complications

After the Splenectomy surgical procedure:

What are the possible Risks and Complications after the Splenectomy surgical procedure?

The possible risks and complications that may arise after Splenectomy procedure are:

  • Excessive bleeding
  • Infection within surgical wound
  • Incisional hernia
  • Partial or complete collapse of the lung (atelectasis)
  • Excessive swelling of the pancreas (pancreatitis)
  • Formation of blood clots
  • Pneumonia
  • Injury to bowel walls

What is the Prognosis after the Surgery?

A complete recovery from the Splenectomy procedure is usually achieved, without any serious complications being noted.

When do you need to call your Physician?

Do contact your physician if you notice any of the following symptoms:

  • Worsening pain and swelling of the surgical wound
  • Excessive bleeding or fluid drainage from the surgical wound
  • Signs of an infection
  • Headache
  • Fever (over 101°F)
  • Dizziness
  • Muscle aches
  • Feeling sick
  • Swelling of abdomen
  • Complications associated with prescription medications used in treatment

What Post-Operative Care is needed at Home after the Splenectomy surgical procedure?

At home, the following post-operative care is recommended, after a Splenectomy procedure:

  • Slowly resume regular/daily activities as early as possible, which aids in faster recovery
  • Use a heat pad or warm compress to relieve pain due to the incision
  • Resume showering and keep the wound clean and dry. Avoid taking baths until the surgical wound is completely healed. Gently wash the surgical wound with mild unscented soap.  Replace the dressing after showering
  • Complete the course of prescribed medication as advised by your physician
  • Take stool softeners to prevent constipation
  • Take prescription antibiotic medication to help combat or prevent infection
  • Avoid taking non-prescription medications, such as aspirin. However, individuals may take acetaminophen to relieve pain, under advice from the physician
  • Avoid all activities that are physically strenuous for 6 weeks after surgery
  • Resume driving only after 4 weeks of being discharged from the healthcare facility (or as advised by your physician)
  • Avoid sex till complete healing has taken place (under advice by the physician)

Individuals are advised to have to a clear liquid diet immediately after surgery and until the gastrointestinal tract begins to function properly. Following this, individuals may have a well-balanced diet, which can aid in a faster recovery. Also, one must increase the fluid and fiber intake, in order to prevent constipation and stress during bowel movements and urination.

How long does it normally take to fully recover, from the Procedure?

It usually takes approximately 4 to 6 weeks to fully recover from the Splenectomy surgical procedure.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

The tissue is taken for further examination and later disposed as per the standard medical procedure.

When should you expect results from the pathologist regarding tissue taken out, during the

  • The tissue removed is processed in the laboratory under a pathologist's supervision.
  • Slide(s) are prepared once the tissue is processed and is examined by a pathologist and a pathology report issued
  • Depending on the complexity of the case, issue of the report may take anywhere between 72 hours to a week's time

Who will you receive a Bill from, after the Splenectomy surgical procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers. 

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

  • A hospital
  • An anesthesiologist
  • A pathologist (if the tissue was sent for analysis)
  • A general surgeon

The patient is advised to inquire and confirm the type of billing, before the Splenectomy is performed.

Thanks and Gratitude:

We sincerely acknowledge and thank Dr. Douglas J. Jones for reviewing the article. His valuable input and feedback has helped enrich the contents of this article.

Douglas J. Jones, MD FACS
Board Certified General Surgeon and Faculty Member
University of Illinois, College of Medicine at Urbana-Champaign
506 S. Mathews Ave., Urbana, IL 61801, USA

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: July 10, 2017
Last updated: April 24, 2019