38120 Laparoscopy, surgical, splenectomy

Name of the Procedure:

Laparoscopy, Surgical, Splenectomy

• Common Names: Laparoscopic Splenectomy
• Medical Terms: Laparoscopic Removal of the Spleen

Summary

Laparoscopic splenectomy is a minimally invasive surgical procedure to remove the spleen using small incisions and a camera known as a laparoscope. This approach is less invasive than traditional open surgery, typically resulting in shorter recovery times and less post-operative pain.

Purpose

This procedure is performed to treat various conditions that affect the spleen, such as traumatic injury, blood disorders, certain cancers, and infections. The primary goal is to resolve or manage these medical conditions while minimizing patient recovery time and discomfort.

Indications

• Hemolytic Anemia
• Idiopathic Thrombocytopenic Purpura (ITP)
• Hodgkin's and non-Hodgkin's Lymphomas
• Spleen Rupture from Trauma
• Splenic Abscess or Cysts
• Hypersplenism causing blood cells destruction

Preparation

• Patients may be instructed to fast for 8-12 hours before the procedure.
• Discontinuation of certain medications (e.g., blood thinners) as advised by the healthcare provider.
• Pre-surgical blood tests, imaging tests, and a complete medical evaluation.
• Likely administration of vaccinations to prevent post-splenectomy infections.

Procedure Description

1. General anesthesia is administered to the patient.
2. Small incisions are made in the abdomen.
3. Carbon dioxide gas is introduced to inflate the abdominal cavity, improving visibility.
4. A laparoscope (a tiny camera) and specialized surgical instruments are inserted through the incisions.
5. The spleen is carefully dissected and detached from its surrounding tissues and blood vessels.
6. The spleen is then removed through one of the small incisions.
7. The incisions are closed with sutures or surgical glue.

Duration

The procedure typically takes 2 to 3 hours.

Setting

Laparoscopic splenectomy is performed in a hospital operating room or a surgical center.

Personnel

• General Surgeon or Laparoscopic Surgeon
• Anesthesiologist
• Surgical Nurses
• Surgical Technicians

Risks and Complications

• Infection at the incision sites
• Bleeding or hematoma formation
• Injury to surrounding organs
• Blood clot formation
• Reaction to anesthesia
• Post-splenectomy sepsis (serious infection risk due to spleen removal)

Benefits

• Resolution or management of the underlying spleen-related condition.
• Reduced recovery time and postoperative pain compared to traditional open surgery.
• Shorter hospital stay and quicker return to normal activities.

Recovery

• Patients may stay in the hospital for 1-2 days post-procedure.
• Pain management will include medications and advice on activity restrictions.
• Avoid heavy lifting and strenuous activities for several weeks.
• Follow-up appointments for wound check and to monitor recovery.
• Lifelong vigilance for infections is advised since the spleen plays a role in immune function.

Alternatives

• Open Splenectomy: Larger incision, longer recovery, may be necessary depending on the spleen's size or disease impact.
• Non-Surgical Management: Observation, medication, and other treatments tailored to the specific spleen condition.
• Pros and Cons: Laparoscopic surgery offers quicker recovery but has risks like any surgical procedure. The open method might be needed for larger spleens or complex cases but comes with a longer recuperation period.

Patient Experience

• During the Procedure: Patients will be under general anesthesia, thus unconscious and feeling no pain.
• Post-Procedure: Expect some pain and discomfort at the incision sites managed with pain relief methods.
• Recovery: Gradual improvement in symptoms, initial fatigue, and limited mobility. Pain management involves medications and gradual increase in activity levels as recommended by the healthcare team.