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Spleen removal surgery or splenectomy is a procedure performed by a surgeon to remove the spleen, either partially or completely. There are various conditions that make this surgery necessary, including damage to the spleen or enlargement of the spleen
The spleen is a solid organ the size of a fist which is located under the left rib cage. The role of this organ in the immune system is very important because it contains white blood cells that can fight infection. In addition, the spleen is also responsible for filtering and removing old red blood cells from the body's circulation.
When there is a problem with the spleen that can no longer be treated with medication, surgical removal of the spleen may be recommended by a doctor. To find out more about when spleen surgery is necessary, refer to the following description.
When is Spleen Removal Surgery Needed?
The following are some reasons or indications for the need for surgical removal of the spleen:
1. Spleen damaged (ruptured) due to injury
In patients who have damaged the spleen, for example as a result of a collision in a traffic accident, surgical removal of the spleen should be performed as soon as possible. The reason is, bleeding that occurs in the patient's stomach can threaten his safety.
2. Enlarged spleen
Viral infections, such as mononucleosis, or bacterial infections, such as syphilis, can cause an enlarged spleen (splenomegaly). An enlarged spleen traps and destroys many blood cells and platelets, including he althy red blood cells, causing their levels to decrease.
In addition, an enlarged spleen can cause the spleen to become blocked and its function impaired. This is at risk of causing anemia, infection, bleeding, and even rupture of the spleen which can be life threatening. In this condition, surgical removal of the spleen is necessary.
3. Certain blood disorders
Your spleen may need to be removed if you have severe blood disorders that cannot be treated with other treatments, such as sickle cell anemia, hemolytic anemia, idiopathic thrombocytopenic purpura (ITP), and polycythemia vera.
4. Cancer or large spleen cyst
Spleen removal surgery is also sometimes recommended in cancers, such as lymphocytic leukemia, non-Hodgkin's lymphoma, and Hodgkin's disease. This cancer can cause the spleen to enlarge and be at risk of rupture.
In addition to cancer, the spleen may also need to be removed due to a cyst or tumor.
A severe infection of the spleen may not improve with antibiotic therapy or other treatments. An infection like this can also cause a collection of pus (abscess) to form in the spleen. To overcome this, the doctor may suggest surgical removal of the spleen.
Types of Spleen Removal Surgery
There are 2 types of surgical removal of the spleen, namely open surgery and laparoscopic surgery. In open surgery, part or all of the spleen is removed through a large incision. Whereas in laparoscopy, the removal is done through small incisions with the help of a camera and small tools.
Due to the smaller incision size, laparoscopic surgery minimizes pain during recovery and reduces the risk of infection. However, this operation is sometimes not possible due to variations in the shape and location of the spleen.
An example is in the case of swelling of the spleen. The large size of the spleen does not allow it to be removed through small laparoscopic incisions, so open surgery is preferred.
Similarly in the case of a ruptured spleen due to injury. Through a wide incision, the surgeon can check for injuries to other organs and perform operations more quickly.
After undergoing surgery to remove the spleen, the patient will be more susceptible to infection and his body will not fight off the infection easily, especially in the first few months after the operation. Therefore, doctors will usually advise patients to receive vaccines to prevent pneumonia and meningitis.
The patient's immunity to infection will gradually increase within 2 years after the surgery to remove the spleen, but it is less likely to return to the condition as before the operation.
So, if you've had surgery to remove your spleen, it's important to always check with your doctor according to a predetermined schedule. If you happen to be sick and go to another doctor, do not forget to tell the doctor that you have had surgery to remove the spleen.
dr. Sonny Seputra, M.Ked.Klin, Sp.B, FINACS(Surgeon Specialist)