Splenectomy is a surgical procedure of removal of the spleen located under the rib cage on the upper left side of the abdomen. Removing a spleen in children is mainly for blood disorders such as thalassemia, anemia, sickle cell disease, etc. The spleen helps fight infection and filters unwanted materials from the blood, such as damaged blood cells. The most common reason to remove a spleen or splenectomy is to treat a ruptured spleen caused by an abdominal injury. In addition, splenectomy treats other conditions, including an enlarged spleen, some blood disorders, cancers, infections, and benign tumors.
The surgeons mostly use a laparoscopic surgical procedure to remove the spleen. Surgeons perform laparoscopic splenectomy using a tiny video camera and a unique surgical tool. After this surgical procedure, you may leave the hospital the same day and recover fully in two weeks.
What would be the reason to remove a spleen in children?
Removal of the spleen in children can be due to several reasons. In most cases, surgeons remove the spleen to treat blood disorders, such as spherocytosis, elliptocytosis, idiopathic thrombocytosis purpura (ITP), and sickle cell anemia. When surgeons remove the spleen to treat blood disorders, the spleen usually functions, but the blood abnormalities produce problems.
Some of the reasons for splenectomy are:
· Idiopathic thrombocytopenic purpura (ITP)
In this disorder, the antibodies often cover the platelets. This is because the body’s immune system mistakenly produces these antibodies. As a result of such alteration in platelets, the spleen identifies them as foreign particles and filters them from the blood leading to excessive destruction in the body. ITP is one of the reasons to remove a spleen.
· Sickle cell anemia
In the case of sickle cell disease, the spleen does not work as it should. Furthermore, with sickle cell disease, children are at risk of infections. In addition, splenic sequestration is a life-threatening condition in which the spleen traps the red blood cells and causes severe anemia. Doctors perform splenectomy in such cases.
· Gallstone
Premature destruction of RBCs results in anemia. In anemia, the spleen removes the red blood cells after 100 days. Moreover, the hemoglobin in the broken-down red blood cells is excreted as bilirubin in the bile from the liver. If the bilirubin level in the bile is abnormally high, it results in gallstones.
· Anemia
Typically, red blood cells are disk-shaped and mature with time. Then, the internal membrane of these cells breaks down, and the cell assumes a spherical shape. After that, the spleen removes the red blood cells about 100 days after they are created.
Premature red blood cells are destroyed in some conditions, such as spherocytosis and elliptocytosis. The premature destruction of the red blood cells results in anemia (low red cell count). In addition, low cell count increases the risk of developing gallstones. Anemia is one of the reasons for removing a spleen.
· Thalassemia
The genetic defect in thalassemia results in ineffective red blood cells. And the spleen removes these red blood cells and enlarges them. This is the main reason to remove a spleen in a thalassemic. In addition, a splenectomy can lengthen the lifespan of red blood cells. As a result, the thalassemic needs less transfusion.
Diagnosis of spleen disorders
Spleen disorders are diagnosed with:
- Blood tests
- Physical examination
- Ultrasound
- Computerized tomography (CT) scan
- Tissue biopsy of bone marrow
Surgery for removal of the spleen
Surgeons remove the spleen in children by “open” or laparoscopic method.
· Open Splenectomy
In open splenectomy, the surgeon cuts under the child’s left ribs in the upper abdomen or down the middle of the abdomen. Surgeons recommend this procedure to children with too large spleens for laparoscopic removal. In such cases, the surgeon removes the spleen using an open approach with a single large incision.
Along with the spleen size, scar tissue from previous surgeries may lead the surgeon to choose the open splenectomy. Usually, doctors make such decisions before or during the surgery. Indeed, it is always a chance that a surgeon can convert a laparoscopic surgical case to open in case of any bleeding problems.
· Laparoscopic Splenectomy
In the laparoscopic surgical procedure, the surgeon makes four small cuts in the abdomen. The surgeon then inserts a tube with a small video camera in the stomach through one of the cuts. Next, the surgeon watches the images on a monitor and removes the spleen with specialized surgical instruments that he inserts in the other three incisions. When the spleen is out, they close the incisions. For laparoscopic surgical procedure, you can consider the Best laparoscopic surgeon in Lahore.
The laparoscopic splenectomy surgical procedure is not suitable for every individual. In case of a ruptured spleen, surgeons recommend open splenectomy. Sometimes the surgeon may begin the surgery with a laparoscopic procedure but switch to open splenectomy because of scarring from the previous surgeries or complications.
Advantages of laparoscopic surgery
Apart from such severe cases, laparoscopic surgery has many advantages compared to open surgical methods.
- Small scars
- Fewer days in the hospital
- Fewer incisions
- Less pain while the scar heals
- Less medication
- Resume daily life activities sooner
- Quick healing of more minor scars
- Less risk of infection as exposure of internal organs gets reduced to external contamination
· Partial Splenectomy
A surgeon may advise a partial splenectomy in some cases of spherocytosis and elliptocytosis. Although, in these cases, the red blood cell destruction rate is not too high due to partial splenectomy, the red blood cell destruction rate decreases. And this procedure preserves some of the spleen’s capacity to filter blood.
Cost of spleen removal surgery cost
The best place for Splenectomy in Pakistan is ALSA. Dr. Tahir Yunus, a highly trained and qualified surgeon at ALSA Pakistan. He is very committed to providing patients with efficient and safe surgical treatment under the supervision of his managerial staff. Spleen removal at ALSA is affordable for patients and performed by the best laparoscopic surgeon in Lahore. Along with the affordable Splenectomy in Pakistan, we provide the emotional support the patients need. The Spleen Removal Surgery Cost in Lahore is between 250k – 300k.
