Our Summary

This research paper presents a new surgical technique for removing enlarged spleens, a condition known as splenomegaly, using a laparoscopic (minimally invasive) procedure. The study was carried out over a ten-year period from 2010 to 2020.

Out of the 14 patients who underwent the procedure, 13 were successful, while one patient had to be converted due to bleeding. There were no injuries to the tail of the pancreas, which can sometimes occur during this type of surgery.

The average operation time was approximately three hours, and the average amount of blood lost was 50 milliliters, which is relatively low. Two patients needed blood transfusions. There were no other complications or deaths and patients typically stayed in the hospital for two days after the procedure.

The authors conclude that this new technique for removing the spleen, which avoids touching the organ as much as possible and uses imaging to guide the procedure, is safe and effective for patients with significantly enlarged spleens.

FAQs

  1. What is the new surgical technique for removing enlarged spleens?
  2. How successful was the new procedure for splenectomy based on the study?
  3. What is the average operation time and blood loss for this new surgical technique?

Doctor’s Tip

One helpful tip a doctor might tell a patient about splenectomy is to be aware of the potential risks and complications associated with the procedure. These can include bleeding, infection, blood clots, and injury to surrounding organs such as the pancreas. It’s important for patients to follow their doctor’s post-operative care instructions carefully and to report any unusual symptoms or complications immediately. Additionally, patients who have had their spleen removed should be aware of the increased risk of infections, particularly from encapsulated bacteria such as Streptococcus pneumoniae, and may need to receive vaccinations or take antibiotics as recommended by their healthcare provider.

Suitable For

Patients who are typically recommended for splenectomy include those with:

  1. Enlarged spleens (splenomegaly) that are causing symptoms such as pain, fullness, or discomfort in the abdomen.
  2. Conditions such as idiopathic thrombocytopenic purpura (ITP), autoimmune hemolytic anemia, hereditary spherocytosis, and thalassemia, where the spleen is involved in the disease process.
  3. Certain types of cancers, such as lymphomas or leukemia, where the spleen may be affected or involved in the spread of the cancer.
  4. Trauma or injury to the spleen that cannot be managed conservatively and requires surgical removal.
  5. Other conditions such as hypersplenism, where the spleen is overactive and causing low blood cell counts, or portal hypertension, where the spleen is enlarged due to liver disease.
  6. Recurrent infections or complications related to the spleen, such as splenic abscesses or infarctions.

It is important for patients to discuss the risks and benefits of splenectomy with their healthcare provider before undergoing the procedure. In some cases, alternative treatments or management strategies may be considered depending on the underlying condition and individual circumstances.

Timeline

Before the splenectomy:

  • Patient experiences symptoms of an enlarged spleen, such as abdominal pain, feeling full quickly, and frequent infections
  • Patient undergoes diagnostic tests, such as blood tests and imaging scans, to confirm the diagnosis of splenomegaly
  • Patient discusses treatment options with their healthcare provider, including the possibility of splenectomy

After the splenectomy:

  • Patient undergoes the laparoscopic splenectomy procedure, which takes approximately three hours to complete
  • Patient loses an average of 50 milliliters of blood during the procedure, with two patients requiring blood transfusions
  • Patient stays in the hospital for two days post-procedure for monitoring and recovery
  • Patient experiences successful removal of the spleen with no complications or injuries to surrounding organs
  • Patient is able to return to normal activities after a period of recovery following the surgery

Overall, the patient’s quality of life may improve after the splenectomy, as symptoms of an enlarged spleen are alleviated.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a splenectomy?
  2. How long is the recovery period after a splenectomy?
  3. Will I need any special vaccinations or medications after having my spleen removed?
  4. How will my immune system be affected by not having a spleen?
  5. Will I need to make any lifestyle changes or avoid certain activities after the surgery?
  6. How often will I need follow-up appointments or monitoring after the procedure?
  7. Are there any alternative treatments or procedures that could be considered instead of a splenectomy?
  8. How experienced are you in performing laparoscopic splenectomies?
  9. What is the success rate of this new technique compared to traditional open surgery for splenectomy?
  10. Are there any long-term effects or complications to be aware of after having my spleen removed?

Reference

Authors: Gadiyaram S, Nachiappan M. Journal: Langenbecks Arch Surg. 2023 Jan 16;408(1):30. doi: 10.1007/s00423-023-02800-z. PMID: 36642735