What is Splenectomy? Purpose, Procedure & Recovery

A splenectomy is the surgical removal of your spleen, an organ located in your upper left abdomen that helps fight infections and filter your blood. While losing your spleen might sound scary, many people live full, healthy lives after this procedure when it's medically necessary.

Your spleen works like a specialized filter and immune helper, but sometimes it needs to be removed due to injury, disease, or other medical conditions. The good news is that other parts of your immune system can take over many of its functions, though you'll need to take some extra precautions to stay healthy.

What is a splenectomy?

A splenectomy is a surgical procedure where doctors remove your spleen completely. Your spleen is a fist-sized organ that sits behind your ribs on the left side of your body, just below your diaphragm.

This organ normally filters old red blood cells from your bloodstream and helps your immune system fight certain types of bacteria. When the spleen becomes damaged, diseased, or enlarged beyond what's safe, removal becomes the best treatment option.

The surgery can be done through traditional open surgery or minimally invasive laparoscopic techniques. Most people recover well from this procedure, though you'll need to take extra steps to protect yourself from infections afterward.

Why is splenectomy done?

Doctors recommend splenectomy when your spleen is causing more harm than good to your health. This typically happens when the organ becomes severely damaged, diseased, or starts destroying healthy blood cells.

Let's look at the most common reasons why you might need this surgery, keeping in mind that your doctor will always try other treatments first when possible.

Traumatic injury: Severe abdominal trauma from car accidents, sports injuries, or falls can rupture your spleen, causing life-threatening internal bleeding. When the damage is too extensive to repair, emergency removal saves your life.

Blood disorders: Conditions like idiopathic thrombocytopenic purpura (ITP) cause your spleen to destroy healthy platelets, leading to dangerous bleeding problems. Hereditary spherocytosis makes your spleen break down red blood cells too quickly, causing severe anemia.

Enlarged spleen (splenomegaly): When your spleen grows too large due to conditions like portal hypertension or certain cancers, it can press against other organs and cause pain or complications.

Splenic cysts or tumors: Large cysts or both benign and malignant tumors in the spleen may require removal, especially if they're causing symptoms or pose cancer risks.

Certain cancers: Blood cancers like lymphoma or leukemia sometimes require spleen removal as part of treatment. This helps doctors stage the cancer or remove a source of abnormal cell production.

Less common reasons include splenic abscesses that don't respond to antibiotics, certain autoimmune conditions, or complications from other medical procedures.

What is the procedure for splenectomy?

The splenectomy procedure can be performed using two main approaches, and your surgeon will choose the best method based on your specific situation. Both techniques are safe and effective when performed by experienced surgeons.

Your surgery will typically take 1-3 hours, depending on the complexity of your case and which surgical approach your doctor uses.

Laparoscopic splenectomy: This minimally invasive approach uses several small incisions (about half an inch each) in your abdomen. Your surgeon inserts a tiny camera and specialized instruments through these small openings to carefully remove your spleen.

The laparoscopic method usually means less pain, smaller scars, and faster recovery times. Most people can go home within 1-2 days and return to normal activities sooner than with open surgery.

Open splenectomy: This traditional approach requires a larger incision across your upper left abdomen. Your surgeon opens the abdominal cavity to directly access and remove your spleen.

Open surgery might be necessary if your spleen is very large, if you have scar tissue from previous surgeries, or in emergency situations. Recovery typically takes a bit longer, with hospital stays of 3-5 days.

During either procedure, your surgeon will carefully disconnect your spleen from surrounding blood vessels and organs before removing it completely. They'll also check for any accessory spleens (small extra pieces of spleen tissue) that might need removal.

How to prepare for your splenectomy?

Preparing for splenectomy involves several important steps to ensure the best possible outcome and reduce your risk of complications. Your medical team will guide you through each preparation step carefully.

The most crucial preparation involves protecting yourself from infections, since your spleen normally helps fight certain bacteria.

Vaccination schedule: You'll need specific vaccines at least 2-3 weeks before surgery when possible. These include pneumococcal, meningococcal, and Haemophilus influenzae type b vaccines to protect against bacteria your spleen normally fights.

Medical evaluation: Your doctor will perform blood tests, imaging studies, and a complete physical exam. They'll also review all your medications and may adjust or stop certain ones before surgery.

Pre-surgery instructions: You'll need to stop eating and drinking for 8-12 hours before surgery. Your medical team will give you specific timing based on your surgery schedule.

Medication management: Tell your doctor about all medications, supplements, and herbal remedies you take. Some blood thinners or other medications may need to be stopped several days before surgery.

Planning for recovery: Arrange for someone to drive you home and help you for the first few days after surgery. You'll need assistance with daily activities while you heal.

If you're having emergency surgery due to trauma, some of these preparation steps may need to be shortened or skipped, but your medical team will still prioritize your safety.

How to read your splenectomy results?

After splenectomy, you won't have traditional "test results" like you might with blood work, but your recovery progress and ongoing health monitoring are what matter most. Your medical team will track several important markers to ensure you're healing well.

Understanding what to expect during recovery helps you recognize normal healing versus potential complications that need medical attention.

Immediate post-surgery monitoring: Your medical team will watch your vital signs, pain levels, and incision sites. They'll also monitor your blood counts since removing your spleen can initially affect your white blood cell and platelet numbers.

Blood count changes: It's normal for your white blood cell count to increase after splenectomy, sometimes staying elevated permanently. Your platelet count may also rise, which your doctor will monitor to prevent clotting problems.

Infection monitoring: Since your spleen helped fight infections, your medical team will watch closely for any signs of illness. You'll learn to recognize symptoms that require immediate medical attention.

Long-term follow-up: You'll need regular check-ups to monitor your overall health and ensure your other organs are compensating well for your spleen's absence.

Your surgeon will also examine your incision sites during follow-up visits to ensure they're healing properly without signs of infection or other complications.

How to manage life after splenectomy?

Living without a spleen requires some adjustments, but most people adapt well and maintain excellent quality of life. The key is understanding how to protect yourself from infections while staying active and healthy.

Your immune system will adapt over time, with your liver and lymph nodes taking over many of your spleen's functions, though you'll always need to be more cautious about certain infections.

Infection prevention: Take all prescribed preventive antibiotics as directed. Some people need daily antibiotics for life, while others may only need them during illness or before dental procedures.

Vaccination schedule: Stay up-to-date with annual flu vaccines and any other recommended immunizations. Your doctor may recommend additional vaccines or boosters compared to people with spleens.

Recognizing warning signs: Learn to identify early signs of serious infection, including fever, chills, severe fatigue, or flu-like symptoms that come on quickly. These require immediate medical attention.

Travel precautions: When traveling, especially to areas with higher infection risks, discuss additional precautions with your doctor. You may need extra vaccines or preventive medications.

Medical alert identification: Wear a medical alert bracelet or carry a card indicating you've had a splenectomy. This helps emergency responders provide appropriate care if you become ill.

Most people return to their normal activities within 4-6 weeks after surgery, though you should avoid heavy lifting and contact sports during initial recovery.

What are the risk factors for splenectomy complications?

While splenectomy is generally safe, certain factors can increase your risk of complications during or after surgery. Understanding these risk factors helps your medical team plan the safest approach for your specific situation.

Your overall health, age, and the reason for your splenectomy all play important roles in determining your risk level.

Age-related factors: Very young children and older adults may face higher risks. Children under 5 have less developed immune systems, while older adults may have other health conditions that complicate recovery.

Underlying health conditions: Conditions like diabetes, heart disease, or compromised immune systems can increase surgical risks and slow healing. Blood disorders that led to your splenectomy may also affect recovery.

Emergency surgery: When splenectomy is needed urgently due to trauma, the risks are higher than with planned surgery. Emergency situations don't allow for optimal preparation time.

Spleen size and condition: Very large or severely diseased spleens can make surgery more challenging and increase complication risks. Extensive scar tissue from previous surgeries also adds complexity.

Surgical approach: While both laparoscopic and open surgery are safe, open surgery generally carries slightly higher risks of infection, bleeding, and longer recovery times.

Your surgeon will discuss your specific risk factors and how they plan to minimize potential complications based on your individual situation.

What are the possible complications of splenectomy?

Like any surgery, splenectomy carries some risks, though serious complications are relatively uncommon when performed by experienced surgeons. Understanding potential complications helps you make informed decisions and recognize problems early.

Most people recover from splenectomy without major complications, but being aware of what to watch for ensures you get prompt treatment if issues arise.

Immediate surgical complications: Bleeding, infection at incision sites, and reactions to anesthesia can occur with any surgery. Your medical team monitors closely for these issues during your hospital stay.

Organ injury: In rare cases, surgery may cause injury to nearby organs like the stomach, colon, or pancreas. This is more likely when the spleen is very large or when extensive scar tissue is present.

Blood clot formation: Your risk of developing blood clots in your legs or lungs may increase after surgery, especially if you have limited mobility during recovery.

Overwhelming post-splenectomy infection (OPSI): This rare but serious complication can occur months or years after surgery. Certain bacteria can cause severe, rapidly progressing infections that require immediate treatment.

Blood count abnormalities: Some people develop persistently high platelet counts after splenectomy, which can increase clotting risks. Others may experience changes in white blood cell counts.

Long-term infection risks: Without your spleen, you're more susceptible to infections from encapsulated bacteria like pneumococcus and meningococcus throughout your life.

The good news is that most complications are preventable or treatable when caught early, which is why following your doctor's post-surgery instructions is so important.

When should I see a doctor after splenectomy?

Knowing when to seek medical attention after splenectomy can be lifesaving, since people without spleenser more vulnerable to certain types of infections. Your medical team will teach you to recognize warning signs that require immediate care.

While most post-surgery symptoms are normal parts of healing, some signs indicate serious complications that need prompt treatment.

Emergency symptoms requiring immediate care: Fever over 101°F (38.3°C), severe chills, rapid heartbeat, difficulty breathing, or feeling extremely unwell very quickly. These could indicate serious infection.

Incision site problems: Increasing redness, warmth, swelling, or pus around your surgical incisions suggests infection. Incisions that reopen or bleed significantly also need medical attention.

Abdominal concerns: Severe or worsening abdominal pain, persistent nausea and vomiting, or inability to eat or drink normally may indicate complications.

Signs of blood clots: Leg swelling, pain, or warmth, especially if accompanied by shortness of breath or chest pain, could indicate dangerous blood clots.

Unusual bleeding: Easy bruising, nosebleeds, or bleeding gums might indicate blood count problems that need evaluation.

Any illness symptoms: Even seemingly minor cold or flu symptoms deserve medical attention, since infections can progress rapidly without a spleen.

Don't hesitate to contact your doctor with questions or concerns. It's always better to check with your medical team than to wait and potentially face serious complications.