Splenectomy is the surgical removal of the spleen, an important organ of the immune system located in the upper left side of the abdomen.
Although the spleen performs essential functions, including the storage and breakdown of red blood cells and defence against microorganisms, its removal is necessary in certain cases to protect the patient’s health.
Laparoscopic splenectomy is now considered the method of choice, as it is minimally invasive and offers faster recovery and fewer complications compared with open surgery.
When is splenectomy required?
Splenectomy is indicated in a variety of pathological conditions:
• Haematological disorders such as idiopathic thrombocytopenic purpura (ITP), spherocytosis, thalassaemia, or autoimmune haemolytic anaemia.
• Tumours of the spleen, whether benign or malignant.
• Splenic injuries associated with haemorrhage that do not respond to conservative management.
• Infections or abscesses that are not treated effectively with medication.
• Symptomatic splenomegaly or complications that make splenic function problematic.
Laparoscopic Splenectomy
This is a minimally invasive surgical technique in which the spleen is removed through small abdominal incisions, using a specialised camera and instruments.
The camera transmits high-definition images to a monitor, allowing the surgeon to perform the operation with precision and safety.
Compared with open splenectomy, the laparoscopic approach:
• Causes less tissue trauma
• Significantly reduces postoperative pain
• Enables faster recovery and return to daily activities
• Provides a better cosmetic outcome
Preoperative Preparation
The success of laparoscopic splenectomy also depends on proper preparation:
• Imaging studies using ultrasound or CT scan to assess the size and position of the spleen
• Laboratory evaluation including full blood count and coagulation profile
• Vaccination against pneumococcus, meningococcus, and Haemophilus influenzae approximately two weeks before surgery, as the risk of severe infections increases after splenectomy
• Anaesthetic and cardiological assessment, particularly in patients with underlying medical conditions
Surgical Procedure
The operation is performed under general anesthesia and lasts approximately 1.5 to 3 hours.
The patient is placed in a lateral position, and the surgeon makes 3–4 small abdominal incisions.
Through these incisions, the laparoscopic instruments and the camera are introduced.
The spleen is carefully mobilized from the ligaments and vessels that hold it in place, with great attention to avoid bleeding.
It is then removed inside a special retrieval bag (endobag) and extracted through one of the incisions, which may be slightly enlarged.
Postoperative Course and Instructions
Most patients:
• Remain in the hospital for 1–3 days, depending on their recovery
• Begin oral intake and mobilization within the first 24 hours
• Gradually return to daily activities within 1–2 weeks
However, because the spleen plays a key role in the body’s immune defence:
• Patients must always inform healthcare professionals of their splenectomy history
• Antibiotic prophylaxis may be recommended in certain situations, such as before dental or invasive procedures
• Long-term or lifelong vaccination may be advised
Laparoscopic splenectomy is a modern and effective surgical solution for splenic conditions.
It combines safety with the advantages of a minimally invasive technique and offers the patient faster recovery and fewer complications.
Close collaboration with the treating surgeon and proper preoperative and postoperative care ensure the best possible therapeutic outcome.
