This may be required in certain situations when the spleen is not functioning properly. These are conditions where too many blood cells or platelets are destroyed by the spleen.

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• ITP (immune thrombocytic purpura)

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• Hereditary spherocytosis

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• Hemolytic anemia

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• Hypersplenism – seen in sickle cell patients and pts with thalasemia

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Other indications for splenectomy are hypersplenism (overactive spleen) or symptomatic splenomegaly (enlarged spleen) seen in some cancers

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• Hairy Cell Leukemia

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• Chronic Lymphocytic Leukemia (CLL)

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• Chronic Meylogenous Leukemia (CML)

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• Non-Hodgkins Lymphoma

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Cancers whether metastatic (originating elsewhere) or primary may be another indication for splenectomy.

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Benign conditions that may lead to splenectomy include:

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• Splenic Cysts

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• Splenic Abscess (infection in the spleen)

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• Trauma to the spleen

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• Clotting of the Splenic vein – this can lead to gastric varices (dilated blood vessels) that can cause severe bleeding.

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In most cases, excluding trauma, the spleen can be removed laparoscopically through 3-4, 0.5-2cm incisions. It typically requires an overnight hospitalization with discharge within 24 hours. If the surgery has to be done through an open incision then the hospital stay is typically 3-4 days.

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Two weeks prior to surgery it is recommended to give the patient vaccinations for 3 different bacteria. This will help prevent post splenectomy sepsis which can occur in 1 patient out of 800-1,000 after surgery. It is also recommended that patients that develop fever after splenectomy be started on antibiotics immediately to prevent post splenectomy sepsis. Many times your hematologist will send you to the surgeon specifically to have your spleen removed for treatment of a blood borne disease, ITP etc. In this case it will be best to ask him/her what the reasons for splenectomy are as they are more familiar with the overall treatment of hematologic diseases.