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Spleen removal

Splenectomy; Laparoscopic splenectomy; Spleen removal - laparoscopic

Spleen removal is surgery to remove a diseased or damaged spleen. This surgery is called splenectomy.

The spleen is in the upper part of the belly, on the left side underneath the ribcage. The spleen helps the body fight germs and infections. It also helps filter the blood.

Description

The spleen is removed while you are under general anesthesia (asleep and pain-free). Your surgeon may do either an open splenectomy, a laparoscopic splenectomy, or a robotic splenectomy.

During open spleen removal:

  • Your surgeon makes a cut (incision) in the middle of the belly or on the left side of the belly just below the ribs.
  • The spleen is located and removed.
  • If you are also being treated for cancer, lymph nodes in the belly are examined. They may also be removed.
  • The incision is closed using stitches or staples.

During laparoscopic or robotic spleen removal:

  • Your surgeon makes 3 or 4 small cuts in the belly.
  • Your surgeon inserts an instrument called a laparoscope through one of the cuts. The scope has a tiny camera and light on the end, which allows the surgeon to see inside the belly. Other instruments are inserted through the other cuts.
  • A harmless gas is pumped into the belly to expand it. This makes it easier for your surgeon to work.
  • Your surgeon uses the scope and other instruments to remove the spleen.
  • The scope and other instruments are removed. The incisions are closed using stitches or staples.

With laparoscopic or robotic surgery, recovery is often faster and less painful than with open surgery. Talk to your surgeon about which type of surgery is right for you or your child.

Why the Procedure Is Performed

Conditions that may require spleen removal include:

Risks

Risks of having anesthesia and surgery in general are:

Risks associated with this surgery include:

  • Blood clot in the portal vein (an important vein that carries blood to the liver)
  • Collapsed lung
  • Hernia at the surgical cut site
  • Increased risk for infection after splenectomy (children are at higher risk than adults for infection)
  • Injury to nearby organs, such as the pancreas, stomach, and colon
  • Pus collection under the diaphragm

Risks are about the same for both open, robotic and laparoscopic spleen removal.

Before the Procedure

You or your child will have many visits with your health care providers and several tests before surgery. You may have:

  • A complete physical exam
  • Immunizations, such as the pneumococcal, meningococcal, Haemophilus influenzae, flu, and COVID-19 vaccines
  • Blood tests, special imaging tests, and other tests to make sure you are healthy enough to have surgery
  • Transfusions to receive extra red blood cells and platelets, if you need them

Tell the surgeon or nurse if:

  • You are, or could be pregnant.
  • You are taking any medicines, including medicines, drugs, supplements, or herbs you bought without a prescription.
  • You have been drinking a lot of alcohol, more than 1 or 2 drinks a day. 

Planning for your surgery:

  • If you have diabetes, heart disease, or other medical conditions, your surgeon may ask you to see the provider who treats you for these conditions.
  • If you smoke, it's important to cut back or quit. Smoking can slow healing and increase the risk for blood clots. Ask your provider for help quitting smoking.
  • If needed, prepare your home to make it easier to recover after surgery.
  • Ask your surgeon if you need to arrange to have someone drive you home after your surgery
  • During the week before your or your child’s surgery:
  • You or your child may be asked to temporarily stop taking medicines that keep your blood from clotting. These medicines are called blood thinners. This includes over-the-counter medicines and supplements such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and vitamin E. Many prescription medicines are also blood thinners.).
  • Ask your surgeon which medicines you or your child should still take on the day of surgery.
  • Let your surgeon know about any illness you may have before your surgery. This includes COVID-19, cold, flu, fever, herpes breakout, or other illness. If you do get sick, your surgery may need to be postponed

On the day of surgery:

  • Follow instructions about when you or your child should stop eating or drinking.
  • Take the medicines the surgeon told you or your child to take with a small sip of water.
  • Arrive at the hospital on time.

After the Procedure

You or your child will spend less than a week in the hospital. The hospital stay may be only 1 or 2 days after a laparoscopic splenectomy. Healing will likely take 4 to 6 weeks.

After going home, follow instructions on taking care of yourself or your child.

Outlook (Prognosis)

The outcome of this surgery depends on what disease or injuries you or your child has. People who do not have other severe injuries or medical problems often recover after this surgery.

After the spleen is removed, a person is more likely to develop infections. Talk with your provider about getting needed vaccinations, particularly the flu and COVID-19 vaccines. Children may need to take antibiotics to prevent infections. Most adults do not need antibiotics long-term.

Open References

References

Cameron J. Spleen. In: Cameron J, ed. Current Surgical Therapy. 14th ed. Philadelphia, PA: Elsevier; 2023:651-662.

Nassar AK, Hawn M. The spleen. In: Townsend CM, Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. Philadelphia, PA: Elsevier; 2022:chap 57.

Remiker AS, Brandow AM. Hyposplenism, splenic trauma, and splenectomy. In: Kliegman RM, St. Geme JW, Blum NJ, et al, eds. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 536.

  • Red blood cells, target cells

    Red blood cells, target cells - illustration

    These abnormal red blood cells (RBCs) resemble targets. These cells are seen in association with some forms of anemia, and following the removal of the spleen (splenectomy).

    Red blood cells, target cells

    illustration

  • Spleen removal - series

    Spleen removal - series

    Presentation

    •  
  • Red blood cells, target cells

    Red blood cells, target cells - illustration

    These abnormal red blood cells (RBCs) resemble targets. These cells are seen in association with some forms of anemia, and following the removal of the spleen (splenectomy).

    Red blood cells, target cells

    illustration

  •   Spleen removal - series

    Spleen removal - series

    Presentation

    •  
 

Review Date: 1/21/2025

Reviewed By: Jonas DeMuro, MD, Diplomate of the American Board of Surgery with added Qualifications in Surgical Critical Care, Assistant Professor of Surgery, Renaissance School of Medicine, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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