DEXTER G. TURNQUEST, MD PA

Spleen Surgery

Discover the healthier, happier you inside

What is the spleen?
This dark purple, bean shaped organ is located in the upper left-hand side of the abdomen, just under the lower ribs. One of the primary functions of the spleen is filtering the blood. Each day our entire blood volume filters through the spleen as bacteria, foreign materials and even tumor cells are sifted out and removed if needed by the guarding action of this secondary lymph gland. In addition, the spleen also functions to hold blood platelets in healthy adults.   


What conditions require a splenectomy?
The spleen is not essential to normal life however it role in removing bacteria and old blood cells is significant and if possible the undamaged spleen is spared as much as possible.
       
Idiopathic thrombocytopenic purpura (ITP). ITP is an autoimmune disease involving platelet destruction. Steroids are used to medically treat this condition, but this weakens the patient and sometimes doesn't effect the autoimmune response enough. Splenectomy is effective in about 70 percent of chronic ITP cases. 
        Trauma. The spleen can be ruptured by blunt as well as penetrating injuries to the chest or abdomen. In this situation, every attempt is made to preserve a portion of the spleen. 
      Abscesses in the spleen. These are relatively uncommon but have a high mortality rate. An abscess can sometimes be drained using percutaneous CT (using a needle through the skin to drain the fluid assisted by advanced imaging). This less invasive technique is considered before a surgical alternative is employed.
      Aneurysm (an out pouching) of the splenic artery. Again, every attempt is made to preserve some splenic functioning, if possible, by tying off the splenic artery.
     Some forms of leukemia, such as HCC (Hairy Cell Carcinoma) Hypersplenism- that is a group of symptoms that includes an enlarged spleen, defective blood cells and a high blood cell turnover rate. Mononucleosis can cause enlargement of the spleen. Malignancy Thalassemia, sickle cell 
    
Diagnosis Typically, spleenic disorders with the exception of trauma are diagnosed by blood test. Once diagnosed and medical treatment has failed you may be referred to a surgeon for removal of the spleen.

What if I need Surgery?
We attempt elective removal of the spleen preferentially in all cases. This is accomplished via 4 small incisions through which long instruments and a special camera (laparoscope) are used to free the spleen. It is then placed in pouch and removed through a 3 inch incision in the left upper abdomen. The procedure generally last 90 minutes and mist people are able to go home in 23 hrs and return to work in 1 week.