What is splenectomy?

A splenectomy (say "splih-NEK-tuh-mee") is surgery to take out the spleen. You may have your spleen taken out because a disease made it get too big. Or maybe your spleen no longer works as it should. The doctor also may remove the spleen if it was damaged in an accident or injury.

Your surgery may be done through one large cut (incision). This is called open surgery. Or you may have laparoscopic surgery. To do this, the doctor puts a lighted tube, or scope, and other tools through several small cuts.

The spleen helps protect you from illness. After your spleen is gone, you may be more likely to get certain infections. So before or soon after your surgery, you will need a pneumococcal shot. You may also need other vaccinations.

Open surgery will leave a scar about 6 to 10 inches long on your belly. Laparoscopic surgery leaves small scars. They will fade over time.

Activity

• Have your child rest when he or she feels tired.
• Have your child try to walk a little each day. Make each walk a little longer than the day before.
• Your child should not ride a bike, play running games, or take part in gym class until your doctor says it is okay.
• Your child may shower 24 to 48 hours after surgery, if your doctor okays it. Pat the incision dry. Do not let your child take a bath for 1 week, or until your doctor tells you it is okay.

Diet

• Your child can eat a normal diet. If your child's stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
• Have your child drink plenty of fluids to avoid becoming dehydrated.
• You may notice a change in your child's bowel habits right after surgery. You can help him or her to avoid constipation and straining. Have your child drink plenty of water. The doctor may suggest fiber, a stool softener, or a mild laxative.

Medicines

• Be safe with medicines. Read and follow all instructions on the label.
  • If the doctor gave your child a prescription medicine for pain, give it as prescribed.
  • If your child is not taking a prescription pain medicine, ask the doctor if your child can take an over-the-counter medicine.
• If the doctor prescribed antibiotics for your child, give them as directed. Do not stop using them just because your child feels better. Your child needs to take the full course of antibiotics.
• Your doctor will tell you if and when your child can restart his or her medicines. The doctor will also give you instructions about your child taking any new medicines.

Incision care

• Your child will go home with a bandage and stitches or staples over the cut (incision) the doctor made. Your doctor may remove your child's stitches or staples 10 to 14 days after the surgery. If your child has stitches that dissolve in the body over time, the doctor will not need to take them out. Your doctor will tell you if your child needs to come back to have any stitches removed.
• If your child has strips of tape on the incision the doctor made, leave the tape on for a week or until it falls off.
• You may cover the area with a gauze bandage if it oozes fluid or rubs against clothing.
• Change the bandage every day.
• Wash the area daily with warm water, and pat it dry. Don't use hydrogen peroxide or alcohol. They can slow healing.
• Keep the area clean and dry.

Preventing infections

• You will need to take steps to avoid infections in your child. Without a spleen, your child has a higher chance of getting very sick with some infections.
  • If your child did not get all the vaccinations they need before surgery, be sure they get all the vaccines the doctor recommends in the weeks after surgery.
  • Your child may need to take antibiotics each time he or she has a fever. This could be a sign of a serious infection. Ask the doctor what to do if your child has a fever.
  • Do not have your child travel to areas where he or she could get serious infections such as malaria.
  • Have your child avoid contact with people who are sick.
  • Have your child wash his or her hands often.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• Talk with your doctor about any vaccines you may need before surgery. The spleen helps the body fight certain types of bacteria. After your spleen is removed, your body will be less able to fight certain serious infections.
• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what procedure is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

The spleen helps the body fight certain types of bacteria. If your spleen is removed (splenectomy), your body will be less able to fight serious infections. So your doctor will suggest that you have:

Vaccines.

The pneumococcal, meningococcal, and Haemophilus influenza type B (Hib) vaccines will help prevent serious infections, such as pneumonia. If you know in advance that you will have your spleen removed, plan to get these vaccines 2 weeks before your surgery. If you have your spleen removed after a trauma, you can have the vaccines as soon after surgery as your doctor recommends.

Antibiotics.

Many people who have their spleen removed take antibiotics for a while. They also may need to take antibiotics whenever they have a fever, which could be a sign of a serious bacterial infection. Talk to your doctor about what to do if you have a fever.

After a splenectomy, you are likely to have pain for several days. You may also feel like you have the flu. You may have a low fever and feel tired and nauseated. This is common. You should feel better after a few days and will probably feel much better in about a week.

The spleen helps protect against infections. Now that your spleen has been removed, you will need to be careful to prevent certain infections. If you did not get all the vaccinations you need before surgery, be sure to get all the vaccines your doctor recommends in the weeks after surgery.

You may need to take antibiotics for a while. You may also need to take them each time you have a fever. This could be a sign of a serious infection. Talk to your doctor about what to do if you have a fever.

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
• Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
• Do not shave the surgical site yourself.
• Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

• Bring a picture ID.
• The area for surgery is often marked to make sure there are no errors.
• You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.
• The surgery may take 2 to 4 hours.
• You may have a tube in your nose that goes down the back of your throat into your stomach. This is called a nasogastric tube. It removes stomach fluids for the first few days after the surgery.