Name of the Procedure:

Splenectomy; total, en bloc for extensive disease, in conjunction with other procedure

Summary

A splenectomy is a surgical procedure to remove the spleen. When performed for extensive disease, it is often done en bloc (in one piece) alongside other surgical procedures.

Purpose

The procedure addresses diseases or conditions that severely affect the spleen, including certain cancers, blood disorders, or trauma. The goal is to remove the diseased spleen to improve the patient's health or to assist in the treatment of another underlying condition.

Indications

• Enlarged spleen (splenomegaly) causing discomfort or pressure on other organs.
• Ruptured spleen due to injury.
• Blood disorders like idiopathic thrombocytopenic purpura (ITP) or hemolytic anemia.
• Certain cancers such as lymphoma or leukemia.

Preparation

• Patients may need to fast for 8-12 hours before the procedure.
• Medication adjustments may be necessary, especially blood thinners.
• Pre-surgical diagnostic tests may include blood tests, imaging studies (such as CT scans or ultrasounds), and complete medical history reviews.

Procedure Description

1. The patient is given general anesthesia.
2. An incision is made in the abdomen.
3. Depending on the extent of the disease, adjacent structures or organs may also be examined or removed en bloc with the spleen.
4. The spleen is carefully dissected and removed.
5. The incision is closed with sutures or staples.
6. The patient is monitored in the recovery area.

Duration

This procedure typically takes about 2-4 hours, depending on the complexity and if additional procedures are performed.

Setting

A splenectomy is performed in a hospital surgical suite.

Personnel

• Primary Surgeon
• Surgical Assistants
• Anesthesiologist
• Surgical Nurses
• Operating Room Technicians

Risks and Complications

• Infection
• Bleeding
• Injury to nearby organs
• Blood clots
• Complications related to anesthesia
• Immunity changes, as the spleen plays a role in fighting certain infections

Benefits

The benefits include the removal of the diseased spleen, which can relieve symptoms, treat underlying conditions, and potentially improve overall health. Benefits are usually realized shortly after recovery from surgery.

Recovery

• Initial recovery often takes 1-2 weeks, with full recovery in about 4-6 weeks.
• Patients are often instructed to avoid heavy lifting and strenuous activities during the initial recovery period.
• Follow-up appointments are crucial to monitor healing and address any complications.

Alternatives

• Medication management for certain conditions, such as blood disorders.
• Partial splenectomy in specific cases.
• Radiation therapy for some cancers. Each alternative has its own set of pros and cons compared to a total en bloc splenectomy.

Patient Experience

During the procedure, the patient will be under general anesthesia and won't feel anything. Post-surgery, patients might experience pain at the incision site, which can be managed with pain medications. Fatigue and limited activity will likely be advised during the initial recovery period.