Splenectomy (removal of the spleen) as a result
of a ruptured spleen is often an emergency surgery,
but, still, the decisions you make and the actions
you take before your surgery can be every bit as
important as the procedure itself in ensuring a
healthy recovery.
Any
physical problems or changes in your overall health,
such as a fever or infection, should be reported
to your surgeon, and you should notify your surgeon
of any new medications you are taking.
Learn
the potential risks and benefits of the surgery
by asking your surgeon any questions that will help
you better understand the procedure.
Prior
to surgery, the physician will ask when you last
ate or drank anything.
Surgery to remove your spleen, called a splenectomy,
takes about 30-90 minutes to perform. General anesthesia
will be used.
With
the patient lying on his back with arms usually
extended back, an incision is made in the upper
left portion of the abdomen.
The
blood vessels to the spleen are clamped or tied,
as are the splenic artery and vein. They are then
cut and the spleen is removed. Bleeding is controlled
by cauterization, in which a hot instrument or electric
current is used to burn the bleeding tissue.
The
wound is washed with sterile warm saline solution
and closed up. The muscles will be sutured and the
skin is sutured or stapled. The external stitches
or staples can usually be removed in a week or two.
You are then taken to the recovery room.
Preventive
antibiotics are usually given during surgery.
After your splenectomy, you will be transported
to the recovery room where you will be closely observed
for one to two hours while the immediate effects
of anesthesia wear off. The area of the surgery
will be bandaged. Some discharge is normal, but
you should tell your physician or nurse if discharge
seems excessive. After surgery, you usually experience
some pain. Adequate pain medications, which may
include narcotic pain killers, will be prescribed
for you. You will be given intravenous (IV), oral,
or intramuscular pain medications as needed. You
likely will be restricted to bed, and your physician
will determine when you will be moved to a regular
room.
Patients who undergo a splenectomy usually remain
in the hospital for four or five days after surgery.
You will have a drain in your abdomen for one or
more days. Most of the first day is spent in bed,
though later in the day or on the second day, you
will be able to move to a sitting position. As your
physician feels you are able, you will begin to
walk short distances, with the distances and time
of your walks increasing as you are able. Your physician
and the staff will encourage coughing and deep breathing
to help keep your lungs clear. You may need to hold
a pillow over the area of the surgery when you cough
so that there isn’t undue pressure on the
area. The staff will regularly take your temperature,
ask you about your pain, check the drainage of blood
from the incision, as well as the area around the
incision. The most important reason they will do
these things is to watch for any signs of infection,
which is a vital concern following a splenectomy.
Eventually, you will be able to move more freely,
but you will not able to do any vigorous activities
for some time. Pain medicines will be needed for
at least a few days or as long as a few weeks. You
will not be able to drive, so when you are released,
be sure to have arranged for someone to drive you
home.
Physicians generally recommend that you take it
easy for several weeks following a splenectomy (removal
of the spleen). You should be able to walk and exercise
lightly within a few days after returning home.
However, you should not do any heavy lifting or
strenuous exercise for several weeks. You may need
to use pain medication prescribed by your physician.
Pain usually decreases within a few days. It can
be helpful to have someone around the house who
can assist with any physical chores. You will need
to continue monitoring your healing, as infection
will remain a concern for about two weeks after
surgery. You should report any fever, increased
pain, or abnormal discharge from the wound to your
physician. You will return to your physician about
a week after surgery for a follow-up appointment
and to remove sutures or staples.
Abdominal strengthening exercises may be recommended
once you have regained strength following surgery
to remove your spleen. General aerobic conditioning
exercises will help you maintain physical fitness
during your recovery. Ask your physician for more
information on these exercises.
Any
physical problems or changes in your overall health,
such as a fever or infection, should be reported
to your surgeon, and you should notify your surgeon
of any new medications you are taking.
