Spleen surgery, also known as splenectomy, is a procedure to remove all or part of the spleen. The spleen is an organ located in the upper left part of the abdomen that helps filter blood and fight infection. Some reasons a spleen surgery may be necessary include spleen injury, certain cancers and blood disorders, and spleen enlargement. This article will provide an overview of how long spleen surgery typically takes and what factors affect the length of the procedure.
Average Surgery Duration
On average, a full spleen removal surgery takes between 1 to 3 hours. However, the duration can vary significantly depending on the specifics of the case. Some of the factors that influence how long the surgery takes include:
- Reason for splenectomy – The underlying cause necessitating spleen removal impacts surgery time. Procedures for trauma or rupture often take less time than surgery for diseases like cancer.
- Open vs laparoscopic – Laparoscopic splenectomy, which uses small incisions and cameras, generally takes 1 to 2 hours. Open surgery with a larger abdominal incision usually lasts 2 to 3 hours.
- Spleen size – Removing an abnormally enlarged spleen takes longer than removing a spleen of normal size.
- Additional procedures – If the surgeon is performing other procedures in addition to splenectomy, like removing lymph nodes or other organs, it lengthens the operation.
- Surgeon’s experience – More experienced surgeons typically can remove the spleen faster than less experienced ones.
While the average duration is 1 to 3 hours, some spleen surgeries can take 4 hours or longer if complications arise or additional procedures are necessary. Typically though, splenectomy is considered a major yet relatively quick surgery.
Preparing for Surgery
Patients will meet with the surgeon beforehand to discuss the upcoming spleen removal procedure. The surgeon will explain the details of the operation, its risks and benefits, and answer any questions. They will take the patient’s medical history and perform tests to assess overall health prior to surgery.
For a scheduled, non-emergency splenectomy, patients will need to:
- Get certain vaccines 1-2 weeks before surgery to help prevent infection
- Stop taking blood thinners, aspirin, and anti-inflammatory medications
- Stop eating or drinking at a specified time the night before surgery
- Arrange for a ride home from the hospital
The night before and morning of surgery, patients will need to shower with antibacterial soap to reduce the risk of infection at the incision site.
Day of Surgery
On the day of the spleen removal procedure, the patient will check into the hospital or surgical center. They will change into a gown and get an IV line placed to deliver fluids and anesthesia during surgery. The anesthesia provider will discuss options like general anesthesia or an epidural to keep the patient comfortable.
Right before surgery, patients will need to remove any dentures, glasses, contact lenses, wigs, and jewelry. Any last minute preparation will get completed before the patient is taken to the operating room.
During the Procedure
At the start of spleen surgery, anesthesia will be administered to make the patient unconscious if general anesthesia is used. The abdomen will be cleaned and surgical drapes applied. The surgeon will make an incision, either under the left ribs or vertically down the middle of the abdomen depending on if it is laparoscopic or open surgery.
Once the abdomen is open, the surgeon will locate the spleen and isolate its blood vessels. These vessels will be sealed off and divided to detach the spleen. Depending on the reason for surgery, the surgeon may remove part or all of the spleen. Any bleeding will be controlled as the spleen gets excised.
After removing the necessary portion of spleen, the surgeon will check for bleeding and ensure the stomach, pancreas, colon, and other organs are unharmed. In some cases, a piece of the spleen may get preserved and reimplanted if spleen function needs protection.
Finally, the incisions will be closed with stitches or staples and bandaged. The surgeon will verify no bleeding before concluding the operation.
Recovery in the Hospital
Initially after surgery, patients wake up in a recovery area where nurses monitor their vital signs. Once awake and stable, patients get transferred to a hospital room to continue recovering.
Hospital stays typically last 3 to 7 days after spleen removal. This allows medical staff to manage pain, monitor for complications like infection, and remove any surgical drains. Patients also begin walking soon after surgery to prevent blood clots. Diet is slowly advanced from clear liquids to solid foods as bowel function returns.
Before hospital discharge, patients learn how to care for their incision site and receive instructions on limiting activity, diet, medications, and follow-up appointments.
Recovery Time at Home
Most people need around 4 to 6 weeks for full recovery after a splenectomy. Restrictions after leaving the hospital usually include:
- No heavy lifting over 10 pounds for 2-4 weeks
- No strenuous exercise for 2-3 weeks
- Driving restricted for 2 weeks
- No submerging incisions under water for 3-4 weeks
People will likely feel fatigued as they continue healing over the first several weeks. Managing postoperative pain and discomfort during daily activities remains important.
Patients should attend scheduled follow-up appointments so the surgeon can assess how they are recovering. Additional lab tests and vaccinations may be necessary after splenectomy as well.
Risks and Complications
Spleen removal surgery carries some risks including:
- Bleeding
- Infection
- Blood clots
- Injury to surrounding organs
- Reactions to anesthesia
Rare but serious complications after surgery can involve issues like pancreatic fistula formation, pneumonia, or sepsis. That’s why monitoring and follow-up care are so important.
Results and Outcomes
For most patients, the spleen is removed without any major adverse outcomes. After recovering from surgery, people can return to their normal routines and live without a spleen. However, there are some long-term effects to be aware of:
- Increased infection risk – The spleen helps fight certain kinds of infections. Antibiotics may be recommended with any signs of infection.
- Thrombocytosis – Increased platelets raise clotting risk. Blood thinners can help prevent problematic clot formation.
Patients may need to receive vaccines after spleen removal and take daily antibiotics to reduce their infection vulnerability. Wearing a medical alert bracelet is also recommended in case of injury or illness.
With proper preventive care, most people adapt well over time after having their spleen removed. The benefits of splenectomy typically outweigh the long-term impacts for conditions necessitating surgery.
Conclusion
Splenectomy is a common surgery to remove all or part of the spleen, often lasting around 1 to 3 hours. Exact duration depends on factors like laparoscopic versus open method, spleen size, patient health, and additional procedures performed. While serious complications can occur, spleen removal is generally safe when done for necessary medical reasons. Following all postoperative instructions can help patients smoothly recover and adjust to life without a spleen.