Type of Surgery
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Last updated: 11/24/2009
The most important part of a medical assessment in disorders of the spleen is the measurement of splenomegaly. The normal spleen cannot be felt when the doctor palpates the patient's abdomen. A spleen that is large enough to be felt indicates splenomegaly....
In some cases, the doctor will hear a dull sound when he or she thumps (percusses) the patient's abdomen near the ribs on the left side. Imaging studies that can be used to confirm splenomegaly include ultrasound tests, technetium-99m sulfur colloid imaging, and CT scans. The rate of platelet or red blood cell destruction by the spleen can also be measured by tagging blood cells with radioactive chromium or platelets with radioactive indium.
Preoperative preparation for a splenectomy procedure usually includes:
- Correction of abnormalities of blood clotting and the number of red blood cells.
- Treatment of any infections.
- Control of immune reactions. Patients are usually given protective vaccinations about a month before surgery. The most common vaccines used are Pneumovax or Pnu-Imune 23 (against pneumococcal infections) and Menomune-A/C/Y/W-135 (against meningococcal infections).
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The spleen is one of the most misunderstood organs in the body. This narrated animation describes both the anatomy and function (physiology) of the spleen.
There are two options for accessing the spleen for a splenectomy (A, 1 and 2). After the abdomen is entered, the spleen is located, and the artery leading to it is tied off (B). The ligament connecting the stomach and spleen is cut (C), as is the ligament connecting the spleen and colon (D). This frees the spleen for removal (E). (Illustration by GGS Inc.)
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A splenectomy is a procedure that involves the removal of the spleen by operative means.
Vaccination for pneumococcus, H. influenza and meningococcus should be given pre-operatively if possible. 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.
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