Our Summary

This research paper looks at the benefits of using a laparoscopic splenectomy (a less invasive surgery using a camera to remove the spleen) compared to a traditional open splenectomy (where a larger incision is made) for patients with enlarged spleens. The study looked at patients who had their spleens removed at one hospital from 1997 to 2017.

The study found that using a laparoscopic splenectomy took longer to perform than a traditional open splenectomy, but other factors like the amount of blood lost, the length of the hospital stay, and the rate of complications were similar between the two methods.

For the largest spleens, the study found a higher rate of patients needing to be readmitted to the hospital after a laparoscopic splenectomy compared to a traditional open surgery.

Overall, the study suggests that while a laparoscopic splenectomy can be used for patients with enlarged spleens, it doesn’t show clear benefits over a traditional open splenectomy. More research is needed to clarify these findings.

FAQs

  1. What is the difference between a laparoscopic splenectomy and a traditional open splenectomy?
  2. According to the study, what are the similarities and differences in the outcomes of a laparoscopic splenectomy and a traditional open splenectomy?
  3. Does the study suggest that a laparoscopic splenectomy is preferable to a traditional open splenectomy?

Doctor’s Tip

One helpful tip a doctor might tell a patient about splenectomy is to follow post-operative care instructions carefully to reduce the risk of complications. This may include avoiding heavy lifting or strenuous activities, taking prescribed medications as directed, and attending follow-up appointments with your healthcare provider. It’s also important to be aware of signs of infection or other complications, such as fever, persistent pain, or difficulty breathing, and to seek medical attention if any concerns arise.

Suitable For

Patients who are typically recommended for splenectomy include those with conditions such as:

  1. Enlarged spleens (splenomegaly) due to various causes such as infections, blood disorders, or cancer
  2. Hemolytic anemias such as hereditary spherocytosis, thalassemia, or sickle cell disease
  3. Immune thrombocytopenia (ITP) where the immune system attacks platelets, leading to low platelet counts
  4. Autoimmune conditions such as systemic lupus erythematosus (SLE) or rheumatoid arthritis where the spleen is involved in the immune response
  5. Spleen trauma or injury causing severe bleeding or rupture
  6. Certain types of cancers like lymphoma or leukemia that involve the spleen

It is important for a healthcare provider to evaluate each patient individually to determine if splenectomy is the best treatment option for their specific condition.

Timeline

Before splenectomy:

  1. Patient may experience symptoms such as fatigue, abdominal pain, anemia, and susceptibility to infections due to an enlarged spleen.
  2. Patient undergoes diagnostic tests such as blood tests, ultrasound, and CT scan to confirm the need for splenectomy.
  3. Patient receives preoperative counseling and preparation for the surgery.

After splenectomy:

  1. Patient undergoes the splenectomy surgery, either laparoscopic or traditional open surgery.
  2. Patient is monitored in the recovery room and then admitted to the hospital for postoperative care.
  3. Patient may experience pain, fatigue, and discomfort in the days following surgery.
  4. Patient is discharged from the hospital once stable and given instructions for postoperative care.
  5. Patient is at an increased risk for infections, particularly from encapsulated bacteria, and may need vaccinations and antibiotics.
  6. Patient may need to undergo follow-up appointments to monitor for any complications or long-term effects of splenectomy.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a splenectomy, both laparoscopic and traditional open surgery?
  2. How long is the recovery period expected to be following a splenectomy?
  3. Will I need any special vaccinations or medications after having my spleen removed to prevent infections?
  4. How will my immune system be affected by not having a spleen, and what precautions should I take to protect my health?
  5. What is the likelihood of needing additional surgeries or treatments in the future as a result of having my spleen removed?
  6. Are there any alternative treatments or therapies that could be considered instead of a splenectomy?
  7. How will the absence of a spleen impact my overall health and well-being in the long term?
  8. Will I need to make any changes to my lifestyle or diet after having a splenectomy?
  9. How often should I follow up with my doctor after the surgery, and what signs or symptoms should I watch for that may indicate a complication?
  10. Are there any specific factors about my health or medical history that may influence the decision between a laparoscopic or traditional open splenectomy for me personally?

Reference

Authors: Shin RD, Lis R, Levergood NR, Brooks DC, Shoji BT, Tavakkoli A. Journal: Surg Endosc. 2019 Apr;33(4):1298-1303. doi: 10.1007/s00464-018-6394-7. Epub 2018 Aug 27. PMID: 30167946