General Surgery

A splenectomy is a procedure that involves the removal of the spleen by operative means.

The spleen, similar in structure to a large lymph node, acts as a blood filter. Current knowledge of its purpose includes the removal of old red blood cells and platelets, and the detection and fight against certain bacteria. It's also known to create new blood cells. The spleen is enlarged in a variety of conditions such as malaria, mononucleosis and most commonly in "cancers" of the lymphatics, such as lymphomas or leukemia.

It is removed under the following circumstances:
1. When it becomes very large such that it becomes destructive to platelets/red cells
2. For diagnosing certain lymphomas
3. When platelets are destroyed in the spleen as a result of an auto-immune process (see also idiopathic thrombocytopenic purpura)
4. When the spleen bleeds following physical trauma
5. Following spontaneous rupture
6. For long-term treatment of congenital erythropoietic porphyria (CEP) if severe hemolytic anemia develops.

- Spleen is also removed if gastric cancer has spread in any of its area.

In cases where the spleen is enlarged due to illness (mononucleosis), the smallest things such as leaning over a counter or straining at stool can cause it to rupture.

In general, spleens are removed by laparoscopy (minimal access surgery) when the spleen is not too large and when the procedure is elective. It is performed by open surgery for trauma or large spleens. Both methods are major surgeries, and are performed under general anesthesia. The spleen is located and disconnected from its arteries. The ligaments holding the spleen in place are dissected and the spleen is removed. When indicated a drain is left in place and the incision(s) is closed. If necessary, tissue samples are sent to a laboratory for analysis.