splenectomy

Splenectomy is the surgical removal of the spleen, a fist-sized organ situated in the left upper quadrant of the abdomen. The spleen filters damaged red blood cells, recycles iron, and contributes to the immune response by producing B lymphocytes and storing monocytes. Splenectomy is indicated for traumatic splenic rupture, splenic laceration with hemorrhage, hypersplenism due to portal hypertension or hematologic disorders, immune thrombocytopenic purpura, autoimmune hemolytic anemia, hereditary spherocytosis, and certain splenic neoplasms or cysts. In some cases, partial splenectomy or spleen-preserving procedures are pursued to maintain immune function.

Splenectomy can be performed by an open approach through a left upper abdominal incision or by a minimally invasive laparoscopic technique, with or without conversion to open. Laparoscopic splenectomy is common for intact spleens and suitable conditions, offering shorter recovery in many patients. The procedure generally involves ligation of the splenic vessels and removal of the organ; in partial splenectomy a portion of splenic tissue is left in place to preserve immune function.

Postoperative care includes monitoring for bleeding and infection. A key consideration is the lifelong increased risk of severe infection after splenectomy (overwhelming post-splenectomy infection, OPSI). Patients should receive appropriate vaccinations against pneumococcus, meningococcus, and Haemophilus influenzae type b, ideally before splenectomy when possible, and may require long-term antibiotic prophylaxis in some cases. Removal of the spleen is effective but reduces immune and hematologic reserve, and decision-making balances disease control with preservation of splenic function.