The spleen lies in the left upper abdomen next to the stomach. It is part of the immune system and filters bacteria from the blood. As the blood is filtered, the spleen removes damaged and old blood cells. The three main types of blood cells are red blood cells, which carry oxygen and nutrients, white blood cells that help kill bacteria, and platelets that help with the clotting of blood. There are many disorders of the spleen that affect the number of blood cells and platelets circulating in the body. Certain disorders can be improved by removing the spleen including Idiopathic (unknown cause) Thrombocytopenia (low platelet count) or ITP and Hemolytic Anemia (low red blood cell count). Other disorders such as Hereditary Spherocytosis, Sickle Cell Disease, and Thallasemia, and certain types of lymphoma and leukemia are treated with splenectomy also.
Removal of the spleen or splenectomy is accomplished laparoscopically to avoid a large (12-15 inch) incision and prolonged hospital stay. Laparoscopic Splenectomy is performed through 4 small incisions (all < 1 inch). A laparoscope and long thin instruments are used to perform the operation. The laparoscope functions as a camera to visualize and magnify the abdominal contents to monitors outside of the body. The spleen is dissected away from its attachments to the stomach and large intestine. The blood vessels to the spleen are stapled and divided. The spleen is then placed in a bag and removed through one of the small incisions.
The advantages of a laparoscopic splenectomy include a smaller incision, less pain, a shorter hospital stay, a lower chance of future hernia formation and wound complications, and a faster recovery.
A liquid diet is started after surgery and advanced to a regular diet as tolerated. Pain medication is given by mouth and the majority of patients return home one or two days after surgery. Most patients return to work in approximately one week depending on the physical requirements of their occupation. Patients return two weeks after surgery for routine follow-up with their surgeon.
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