Laparoscopic Splenectomy is a technique whereby the spleen can be removed using several small incisions. Traditionally, removal of the spleen has been accomplished using one larger incision. The use of smaller incisions leads to less pain after surgery, less time in the hospital, and a quicker return to work and full activity. This specialized procedure cannot be performed on all patients who need spleen removal surgery.
What Is Laparoscopic Splenectomy ?
Laparoscopic splenectomy is the surgical removal of the spleen. It differs from the traditional 'open' technique in that the procedure is performed through small incisions. This usually allows a much faster recovery and is significantly less painful.
What Are The Indications For Splenectomy ?
- Blood disorders
- Enlarged spleen
- Benign tumors of the spleen
- Auto immune diseases of the spleen
- Splenic cysts
- Selected leukemias or lymphomas that affect the spleen
The surgery is done as an overnight stay in most patients. The remaining patients typically go home the following day. Patients can resume light daily activity immediately. Most patients after laparoscopic surgery will experience a sharp shoulder pain that resolves after 2-4 hours. It is important that patients get out of bed and go for a walk as soon as possible (the night of surgery), to improve lung function and decrease the risk of abnormal blood clots. The average patient will require 1-2 weeks recovery before resuming more vigorous activity. There is no forced limitation of activity, instead patients are asked to advance their activity as tolerated. This applies to the resumption of work, sports, and sexual activity.
Patients are given a clear liquid diet the night after surgery. The morning after surgery they are given regular food as tolerated.
Patients are seen in the office 5 to 9 days after surgery for a postoperative check, but patients are encouraged to contact the office sooner if they have any questions or problems. Nausea or vomiting that persists for greater then 24 hours after surgery - nausea shortly after surgery is commonly due to general anesthesia and usually resolves within this time period.
- Temperature greater than 101.5 degrees - Temperature elevations less than this are very common after surgery and usually have little significance.
- Pain that is not relieved by the oral pain medication prescribed.
- Inability to pass urine.
- Any questions or concerns.
- Patients experiencing any difficulty breathing, chest pain, change in level of consciousness, or loss of vision or strength should promptly call 911 for transport to the nearest emergency department.
Risks Of Both Open And Laparoscopic Splenectomy Include : -
- Injury to nearby structures: including intestines, pancreas, and stomach
- Need for transfusion
- Infection in the wound
- Deep infection within the abdomen (Subphrenic abscess)
- Pancreatitis (inflammation of the pancreas)
- OverwhelmingPost Splenectomy Sepsis (OPSS) - infection that can occur even years after splenectomy. Occurs in less than 1% of cases. After splenectomy patients need to be closely monitored for this infections and should call there physician if they have any febrile illness.
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