Splenectomy; partial (separate procedure)
CPT4 code
Name of the Procedure:
Splenectomy; partial (separate procedure)
Common Names: Partial Splenectomy
Medical Terms: Laparoscopic Partial Splenectomy
Summary
A partial splenectomy is a surgical procedure where only a portion of the spleen is removed. This is different from a total splenectomy, where the entire spleen is taken out.
Purpose
Partial splenectomy is performed to treat conditions such as spleen injuries, cysts, tumors, or certain blood disorders. The goal is to preserve spleen tissue to retain its immune function while addressing the underlying problem.
Indications
- Spleen trauma or injury
- Benign or malignant spleen tumors
- Spleen cysts or abscesses
- Certain hematological conditions like thalassemia or hereditary spherocytosis
- Persistent splenomegaly causing discomfort or other complications
Preparation
- Fasting for at least 8 hours prior to surgery.
- Discontinuation of certain medications as advised by the doctor.
- Pre-operative blood tests, imaging studies (CT scan, MRI), and possibly a spleen function test.
- Vaccinations against pneumococcus, meningococcus, and Haemophilus influenzae type B (Hib) to prevent post-splenectomy infections.
Procedure Description
- General anesthesia is administered.
- A small incision is made in the abdomen, and laparoscopic tools are inserted.
- The spleen is partially mobilized, and the affected portion is isolated.
- The targeted section of the spleen is resected using surgical instruments.
- Hemostasis (stopping of bleeding) is achieved, and the remaining spleen is inspected to ensure proper function.
The surgical site is closed with sutures or staples, and bandages are applied.
Duration
The procedure typically takes about 1-3 hours, though it can vary depending on the complexity.
Setting
This procedure is performed in a hospital operating room equipped with specialized laparoscopic surgical tools.
Personnel
- Surgeon specialized in general surgery or surgical oncology
- Anesthesiologist
- Surgical nurses
- Operating room technicians
Risks and Complications
- Infection
- Bleeding
- Damage to surrounding organs (stomach, pancreas, colon)
- Reactions to anesthesia
- Postoperative blood clot formation
- Potential need for a subsequent total splenectomy
Benefits
- Preservation of partial spleen function, maintaining some immune capabilities
- Resolution of the underlying condition causing spleen enlargement or damage
- Reduction of symptoms associated with spleen conditions
Recovery
- Hospital stay of 2-5 days post-procedure.
- Gradual resumption of regular activities over 4-6 weeks.
- Follow-up appointments to monitor recovery and spleen function.
- Instructions on wound care, physical activity limits, and signs of complications to watch for.
Alternatives
- Total splenectomy: Complete removal of the spleen. Pros: More definitive treatment for certain conditions. Cons: Loss of spleen function, higher risk of infections.
- Non-surgical options: Observation, medications, or less invasive procedures. Pros: Avoids surgical risks, may manage symptoms effectively. Cons: May not be sufficient for severe conditions, potential for recurrence.
Patient Experience
During the procedure, the patient is under general anesthesia and will not feel pain. Post-operatively, there may be pain at the incision site, manageable with prescribed pain medication. Patients might also experience fatigue, temporary restrictions on physical activity, and a need for specific follow-up care.