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Minimally Invasive Surgery - Surgery of the spleen

Removal of the spleen (splenectomy) is indicated in certain blood disorders which have failed medical therapy. Examples of such diseases are Immune Thrombocytopenic Purpura (ITP), hereditary spherocytosis (HS) and certain lymphomas and leukemias. Most patients will have already been cared for by a hematologist (a doctor specializing in blood disorders) before being referred to a surgeon.

ITP is an auto-immune disease where the body attacks a part of the blood called platelets. These are necessary to form clots, by which the body stops bleeding when injured or cut. When the number of platelets are very low, spontaneous bleeding can occur that can be life threatening. Typically, this condition is managed with medications but they may fail and this is when surgical removal of the spleen can help treat the disease.

Hereditary spherocytosis is a disorder of the shape of the red blood cells that people are born with. The spherical shape causes the blood cells to become trapped in the spleen and this makes it very large, while also causing the red blood cells to be digested by the body. This is what causes the anemia. Removal of the spleen can treat the anemia when it is severe and alters the quality life for a person.

The spleen can be safely removed laparoscopically via 4 or 5 small incisions made on the abdomen. Then, the spleen is removed through a small incision large enough to remove it, depending on the size. Typically, this incision is 3 inches or less. This is much smaller compared to the 10 inch or more incision used in conventional surgery. The smaller incisions allow patients to recover faster by experiencing less pain. Their smaller size also reduces the risk of infection and hernia. Patients typically can go home 2 days after the operation.

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