Our Summary

This research paper talks about a new, less invasive surgical technique for treating spleen disease known as near-total splenectomy (NTS). Instead of completely removing the spleen, this method leaves a small portion of it behind, which can help reduce the risk of serious infections and blood clots after surgery.

The authors discuss their experience with performing this surgery using a laparoscopic approach, which involves making small incisions and using a camera to guide the procedure. This is a less invasive alternative to traditional open surgery.

Between November 2006 and September 2016, the authors performed this procedure on 15 patients suffering from spleen and blood diseases. The patients were between 18 and 59 years old. The surgery took an average of 70 minutes and patients typically stayed in the hospital for around 3-7 days.

The authors found this technique to be safe and effective, with a low rate of complications during and after the operation. However, they highlight that one patient did need to have their entire spleen removed due to a complication during surgery.

The authors conclude that this technique is promising but suggest that more research is needed to fully understand its potential benefits and risks. They also mention that the technique may help to minimize side-effects associated with total removal of the spleen, but this needs further investigation.

FAQs

  1. What is a near-total splenectomy (NTS)?
  2. What are the benefits of a laparoscopic near-total splenectomy (LNTS)?
  3. What were the results and complication rates of the LNTS technique observed in the study?

Doctor’s Tip

A helpful tip a doctor might tell a patient about splenectomy is to be diligent about maintaining regular follow-up appointments with their healthcare provider to monitor for any potential complications or changes in their health. It is important for patients who have had a splenectomy to stay up to date on vaccinations, particularly for infections such as pneumonia and meningitis, as they are at increased risk without a functioning spleen. Additionally, patients should be aware of the signs and symptoms of infection, such as fever, and seek medical attention promptly if they experience any concerning symptoms.

Suitable For

Patients with splenic and hematologic diseases, such as splenic tumors, immune thrombocytopenic purpura (ITP), hereditary spherocytosis, and thrombocytopenia, are typically recommended for splenectomy. In particular, those who may benefit from a near-total splenectomy (NTS) technique, such as individuals at risk for severe infections or thromboembolic events after total splenectomy, may be candidates for this procedure. Additionally, patients who require splenectomy but would benefit from preserving a minimal residual spleen for immune function may also be recommended for a laparoscopic near-total splenectomy (LNTS) procedure.

Timeline

Before splenectomy:

  1. Patient presents with symptoms of splenic and hematologic disease.
  2. Patient undergoes evaluation and diagnostic tests to determine the need for splenectomy.
  3. Patient discusses the risks and benefits of splenectomy with their healthcare provider.
  4. Surgical team plans for the laparoscopic near-total splenectomy procedure.

After splenectomy:

  1. Patient undergoes laparoscopic near-total splenectomy surgery.
  2. Post-operative care includes monitoring for any complications and managing pain.
  3. Patient is discharged from the hospital after a few days of recovery.
  4. Patient is educated on the importance of post-splenectomy care, such as vaccinations and antibiotic prophylaxis.
  5. Patient follows up with their healthcare provider for monitoring of their spleen function and overall health.

What to Ask Your Doctor

  1. What is the reason for recommending a splenectomy?
  2. What are the potential risks and complications associated with a splenectomy?
  3. How will my immune system be affected after a splenectomy?
  4. Will I need any vaccinations or medications after the procedure?
  5. What is the difference between a total splenectomy and a near-total splenectomy?
  6. How long is the recovery period after a splenectomy?
  7. Are there any long-term effects or complications to be aware of?
  8. Will a near-total splenectomy still provide the same benefits as a total splenectomy in terms of reducing the risk of infections and thromboembolic events?
  9. Are there any lifestyle changes or restrictions I need to follow after the procedure?
  10. How often will I need follow-up appointments after the splenectomy?

Reference

Authors: Tartaglia E, Reggio S, Cuccurullo D, Fabozzi M, Sagnelli C, Miranda L, Corcione F. Journal: Minim Invasive Ther Allied Technol. 2019 Oct;28(5):298-303. doi: 10.1080/13645706.2018.1521433. Epub 2018 Oct 11. PMID: 30307349