A laparoscopic splenectomy is an operation where the spleen is removed using keyhole, or laparoscopic, surgery techniques. The spleen is an organ which forms part of the immune system and is located on the left side of the body in the upper abdomen. During the laparoscopic splenectomy procedure, a number of small openings are cut in the abdomen and tubes are passed through them. Surgical instruments and a special viewing device called a laparoscope are inserted into the abdomen through the tubes. Guided by images of the operation displayed on a screen, the surgeon operates the surgical tools to cut the spleen away from surrounding tissue, before placing it in a bag and extracting it through one of the openings.
Preparing for a laparoscopic splenectomy typically involves undergoing a series of medical checks, such as a range of blood tests and a chest X-ray, to assess the health of the heart and lungs. Sometimes vaccinations are given in the weeks before the operation. This helps reduce the risk of infections occurring following removal of the spleen.
It is generally recommended to give up smoking, and certain drugs, including aspirin, will have to be stopped in the days leading up to the operation. No food or drink is allowed from midnight the night before surgery. The laparoscopic splenectomy procedure can take several hours to perform, and is carried out using a general anesthetic, where the patient is asleep.
Immediately after a laparoscopic splenectomy, pain relieving medication is given to reduce any discomfort. Fluids are normally given through a tube inserted into a vein in the arm. Sometimes a tube will have been passed through the nose into the stomach, and this may remain in place because the stomach is temporarily unable to empty itself after the operation. It is usually possible to return home soon after recovering enough to drink, pass urine and move about. Further recovery typically takes place gradually over the next few days, with individual advice from the surgeon about when more strenuous activities should be attempted.
The possible complications of a laparoscopic splenectomy are rare but can include infections. These could occur where openings were cut in the skin, inside the body in the place where the spleen was removed, or a more widespread infection could involve the whole body. It is also possible to develop the lung infection pneumonia or the condition known as pancreatitis, where the pancreas is inflamed. Antibiotic medication is generally used to treat any bacterial infections that arise. Other potential complications, which could require further surgery, are bleeding inside the abdomen, and failure to remove an extra, or accessory spleen, which is sometimes present.
