Splenectomy (splenectomy) for benign and malignant diseases of the spleen is a safe method with increasingly fewer complications. It can be performed either in the traditional way via an abdominal incision or by means of a minimally invasive procedure. With appropriate patient care, the quality of life of patients after a splenectomy is only minimally restricted.
Here you will find further information as well as selected splenectomy specialists and centers.
The spleen is an organ in the left upper abdomen. With an average size of 4x7x11 cm, it weighs around 200g. It is part of the hematologic-lymphatic system.
The spleen has two main functions:
In rare cases, so-called secondary spleens may exist. These are small conglomerates of spleen tissue that develop separately from the spleen during embryological development. Knowledge of such peculiarities is very important for further surgical planning to avoid complications and recurrences.
Malignant diseases (cancer) can develop directly in the spleen(primary tumor). However, a primary spleen tumor is rare. More frequently, the spleen is affected secondarily by cancer in other organ systems, such as blood cancer or metastases.
Metastases are cancer cells that spread from a tumor in another organ, for example via the bloodstream, and form new tumors. In ovarian cancer, for example, cancer cells often spread to the spleen and form a secondary tumor there.
The location of the spleen in the human body © bilderzwerg | AdobeStock
A splenectomy isusually performed to treat
are performed.
More rarely, a malignant disease is the reason for splenectomy. In the case of malignant diseases originating in the blood, splenectomy may be necessary to treat spleen-related symptoms. These symptoms include, for example, anemia or functional hypersplenism (hyperfunction of the spleen) with consecutive loss of
A splenectomy may also be necessary in the case of metastases. The aim is to surgically remove as much tumor tissue as possible from the body before chemotherapy kills any remaining cancer cells.
A complete splenectomy is not always necessary. In some cases, partial removal is sufficient to achieve the surgical goal.
A splenectomy can basically be performed in two ways:
In minimally invasive surgery, the abdominal cavity is first filled with harmless CO2 gas. This lifts the abdominal wall. The surgeon then makes four to five additional working accesses to the abdominal cavity. Through these 0.5 to 1.5 cm incisions, so-called trocars are inserted into the abdominal cavity. A trocar is a type of metal sleeve through which instruments and a camera connected to a light source are brought to the surgical site.
This camera makes it possible to view the entire abdominal cavity by transmitting the images to large monitors in the operating room.
Theadvantage of this minimally invasive method is that no large abdominal incision is required. For the patient, this generally means
This minimally invasive splenectomy is being used more and more frequently due to its many advantages.
Every operation carries a risk of complications. However, careful preoperative preparation of patients and further development of surgical methods and instruments are reducing this risk. For example, the rate of wound infection and incisional hernias has fallen sharply thanks to the use of minimally invasive methods.
As the spleen is an organ with a good blood supply, there is always an increased risk of bleeding during and after the operation. Injury to neighboring organs, such as the intestine, should also be mentioned as a possible complication.
A special possible consequence of splenectomy is the so-called post-splenectomy syndrome ("OPSI" = Overwhelming Post Splenectomy Infection). This severe clinical picture can occur in up to 5% of patients after a splenectomy. It is caused by an isolated disruption of specific macrophages. The result is a limited defense function of the body against encapsulated bacteria, e.g.
Pneumococci usually trigger OPSI. Children are particularly at risk. Vaccination against the most common encapsulated bacteria is therefore recommended before splenectomy.
If a patient has secondary spleen, the underlying disease may recur after splenectomy. This is considered a late complication.
The usual postoperative inpatient monitoring focuses in particular on possible
As part of the so-called fast-track surgery for the patient's rapid return to everyday life, the doctors must
ensure that patients are quickly mobilized.
The use of minimally invasive methods in particular has fundamentally changed spleen surgery. The previously often limiting size of the spleen is no longer an obstacle to safe, even partial splenectomy due to the further development of technology (e.g. ultrasound cutting devices).
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