Our Summary

This research paper looks at the use of laparoscopic surgery (a minimally invasive type of surgery) for removing the spleen in trauma patients. The researchers used data from the National Trauma Database between 2007 and 2015. They compared the outcomes of patients who had laparoscopic spleen removal (LS) and those who had open spleen removal (OS), which is the traditional, more invasive method.

The study found that 25,408 patients had OS and only 113 patients had LS, showing that LS is not as common. It also showed that patients who had LS were less severely injured than those who had OS. They found that there was no major difference in the length of hospital stay, complication rates, or death rates between the two groups. They also noted that LS was often performed later after the injury than OS.

Overall, the study concludes that LS is becoming more commonly used in certain trauma centers across the United States and that it is a safe procedure with similar outcomes to OS, at least for selected patients.

FAQs

  1. What is the difference between laparoscopic spleen removal (LS) and open spleen removal (OS)?
  2. Did the study find any major differences in outcomes for patients who had LS compared to those who had OS?
  3. Is laparoscopic spleen removal (LS) becoming more common, according to the study?

Doctor’s Tip

A doctor might tell a patient considering splenectomy that laparoscopic spleen removal (LS) is a safe and effective alternative to traditional open surgery (OS). While LS may not be as common, it has similar outcomes in terms of hospital stay, complications, and mortality rates. Patients should discuss with their doctor if they are a candidate for LS and weigh the benefits of a minimally invasive procedure.

Suitable For

Patients who are typically recommended for splenectomy include those with:

  1. Traumatic injuries to the spleen, such as a ruptured spleen from a car accident or other trauma
  2. Non-traumatic conditions such as splenic tumors, cysts, or abscesses
  3. Hematologic conditions such as idiopathic thrombocytopenic purpura (ITP), hereditary spherocytosis, or autoimmune hemolytic anemia
  4. Sickle cell disease, where the spleen becomes enlarged and painful
  5. Severe cases of splenomegaly (enlarged spleen) due to various underlying conditions
  6. Patients with recurrent episodes of splenic sequestration crisis in sickle cell disease

It is important for patients to consult with their healthcare provider to determine if splenectomy is the best treatment option for their specific condition.

Timeline

  • Before splenectomy:
  1. Patient experiences trauma or injury leading to spleen injury or rupture.
  2. Patient undergoes diagnostic tests such as CT scans, ultrasounds, and blood tests to determine the extent of spleen damage.
  3. Patient may be monitored closely in the hospital for signs of internal bleeding or other complications.
  4. If surgery is deemed necessary, patient may be scheduled for either laparoscopic spleen removal (LS) or open spleen removal (OS) depending on the severity of the injury.
  • After splenectomy:
  1. Patient undergoes either LS or OS surgery to remove the spleen.
  2. Patient may experience pain, discomfort, and fatigue post-surgery.
  3. Patient may be monitored for signs of infection, bleeding, or other complications.
  4. Patient may receive vaccinations to prevent infections, as the spleen plays a role in the immune system.
  5. Patient may need to take antibiotics or other medications to prevent infections.
  6. Over time, patient’s body adapts to life without a spleen, but they may be at increased risk for certain infections and illnesses.
  7. Patient may need to follow up with their healthcare provider regularly to monitor their health and receive necessary vaccinations and screenings.

What to Ask Your Doctor

Some questions a patient should ask their doctor about splenectomy include:

  1. What are the reasons for recommending a splenectomy in my case?
  2. What are the potential risks and complications associated with a splenectomy?
  3. How will a splenectomy affect my immune system and overall health?
  4. What is the recovery process like after a splenectomy?
  5. Are there any alternative treatments or options to consider instead of a splenectomy?
  6. How often will I need follow-up appointments or monitoring after a splenectomy?
  7. Will I need any vaccinations or medications to prevent infections after a splenectomy?
  8. How will a splenectomy affect my lifestyle and activities?
  9. Are there any long-term effects or considerations I should be aware of after a splenectomy?
  10. Can you provide more information about the specific surgical technique that will be used for my splenectomy and how it compares to other methods?

Reference

Authors: Shamim AA, Zafar SN, Nizam W, Zeineddin A, Ortega G, Fullum TM, Tran DD. Journal: JSLS. 2018 Oct-Dec;22(4):e2018.00050. doi: 10.4293/JSLS.2018.00050. PMID: 30607102