Splenectomy (removal of the spleen)

The spleen is an organ located in the upper left abdomen, under the ribs. It filters the blood, removes worn-out blood cells and helps defend against certain infections. Splenectomy is its removal. It is possible to live normally without a spleen, provided a few precautions are taken against infection. In most planned cases the operation is performed laparoscopically, through three or four small incisions; the spleen is removed in a bag. As an emergency, after trauma with bleeding, or for a very large spleen, an incision is sometimes necessary. Where possible, especially for a cyst, partial removal may be discussed to keep part of the organ. Indications include certain blood disorders (immune thrombocytopenic purpura not responding to treatment, hereditary spherocytosis, some anaemias), hydatid cyst of the spleen, some tumours, a very large and troublesome spleen, or a ruptured spleen after an injury. At Clinique Pasteur Tunis, planned splenectomy is prepared with the haematologist and includes the necessary vaccinations (pneumococcus, meningococcus, Haemophilus) at least two weeks before surgery. A card and instructions are given to the patient at discharge.