The spleen is a small, fist-sized organ located on the left side of your abdomen, just above your ribs. You may not have heard of it, but it is a very important part of our immune system. Simply put, the spleen's main function is to produce white blood cells that fight disease, and to filter out old, damaged blood cells. So, if the spleen is unable to do these jobs properly, whether due to an accident or illness, it can be a threat to your health. That's when doctors decide to surgically remove the spleen (splenectomy).
Is it possible to live without a spleen?
This question may have come to you too. Yes, it definitely can. After the spleen is removed, most of the work it did is taken over by our liver and bone marrow. Therefore, there is no obstacle for you to live a normal, healthy, and full life.
But there's one thing. The spleen is a powerful soldier that fights infections. So when it's gone, our body's ability to fight infections becomes a little weaker. So we have to be a little more careful than usual.
That means we need to be especially careful about things like getting vaccines on time and being vigilant about symptoms of infection.
Why do you need to remove this spleen?
There are several reasons why the spleen may be removed. From an accident to a long-term illness, there are many reasons for this. Let's take a look at the main reasons.
| Reason | Description |
|---|---|
| Ruptured Spleen | This is the most common emergency. Imagine you have a hard blow to the left side of your abdomen, whether from a car accident, a fall from a height, or while playing sports. This can damage your spleen and cause bleeding inside. This can be life-threatening and requires immediate surgery. |
| Blood Disorders | The spleen is removed when other treatments are unsuccessful for certain blood-related diseases. Examples include: Idiopathic Thrombocytopenic Purpura (ITP), Polycythemia Vera, Thalassemia, Sickle Cell Anemia, and Autoimmune Hemolytic Anemia. |
| Types of Cancers | If the spleen becomes enlarged and painful due to cancers such as Hodgkin Lymphoma and Non-Hodgkin Lymphoma, it may need to be removed. The spleen is also sometimes removed during pancreatic cancer surgery. |
| Splenomegaly | If the spleen is enlarged for no apparent reason and is causing symptoms such as abdominal pain, the spleen may be removed to find the cause and control the symptoms. |
| Infections | Very rarely, if something like an abscess forms inside the spleen, surgery is needed to remove it. |
What should you do before surgery?
If this surgery is not an emergency, but a planned one, you will have some time to prepare. Your doctor will explain these things to you.
- Getting vaccinated: This is very important. Since the risk of developing infections is higher after the spleen is removed, it is important to get the necessary vaccines to protect against those infections a few weeks before the surgery. This way, your body's immunity will be at its peak when the surgery is performed.
- Avoid smoking: If you are a smoker, quitting before surgery can greatly help your wounds heal faster.
- Medical tests: Your doctor will examine you, perform blood tests, scans, and other tests to make sure your body is in a good condition for surgery.
- Other instructions: Your doctor will advise you on when to stop eating and drinking the day before surgery, and whether you need to temporarily stop taking certain medications, such as blood thinners.
How is the surgery done?
There are two main surgical procedures to remove the spleen. In both procedures, you are put under general anesthesia, so you don't feel anything and are asleep.
Laparoscopic Surgery
This is the most commonly used method now. It is also called "keyhole surgery." Instead of making a large incision in the abdomen, the surgery is performed through 3 or 4 very small incisions, through which a camera (laparoscope) and delicate surgical instruments are inserted. The surgeon performs the surgery while watching the images from the camera on a monitor. In this method, the incisions are small, so there is less pain, faster recovery , and less time in the hospital.
Open Surgery
If the spleen is very large or is bleeding uncontrollably, it may be difficult to remove it laparoscopically. That's when doctors resort to open surgery. This involves making a slightly larger incision in the abdomen.
What happens after the surgery?
You will be able to go home in two to three days if you had laparoscopic surgery, and in about five to seven days if you had open surgery. Before you go home, the medical team will explain to you in detail the things you need to take care of while living without a spleen.
- Getting the right vaccines: You will be given a specific vaccination schedule. These include vaccines against Pneumococcus, Meningococcus, Haemophilus influenzae type b (Hib), and the annual flu vaccine and COVID vaccine. It is important to get these vaccines on time.
- Antibiotics: Some people, especially children under 5 years of age and those with weakened immune systems, may be prescribed a daily course of antibiotics. In addition, your doctor may prescribe emergency antibiotics to take when you have symptoms of an infection, such as a fever or cough.
- Medical ID: It is very important to always carry a card or medical ID bracelet stating that your spleen has been removed. This will be a great help to those treating you in the event of an emergency.
- When traveling: If you are going on a long trip, especially to an area where diseases like malaria are common, see your doctor a few weeks before you leave to get the necessary advice and vaccinations.
Things to watch out for and when to seek medical advice
For someone without a spleen, even a minor infection can quickly become serious. So be very aware of these symptoms. These are also known as "red flag signs."
| If you have these symptoms, go to the nearest Emergency Department (ETU) immediately! | |
|---|---|
| Fever (over 101°F / 38.5°C) | Shivering due to cold |
| Pus-like discharge from a surgical wound | Redness and swelling around the wound |
| Coughing and difficulty breathing | Severe stomach pain, nausea, and vomiting |
| If you are bitten by an animal (especially a dog, cat) | Pain that does not subside despite taking painkillers |
OPSI (Overwhelming Post-Splenectomy Infection) is a severe infection that occurs after surgery. This can be life-threatening if not treated promptly. Therefore , if you experience any of the above symptoms, do not waste time and go to a hospital's Emergency Department (ETU) immediately.
Take-Home Message
- Splenectomy is a surgery to remove the spleen. Although this is a major operation, you can live a full, healthy life without a spleen.
- Without a spleen, your body's ability to fight infections is somewhat reduced. So protecting yourself from infections is the most important thing.
- Get all the vaccines prescribed by your doctor on time, without skipping any of them.
- If you develop any signs of infection, such as fever, chills, or swelling of the wound, do not ignore it. Seek medical advice immediately or go to the nearest Emergency Department (ETU).
- By following your doctor's instructions exactly, you can stay safe and healthy.
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