Overview
A small organ that can cause big problems.
Splenectomy is the removal of the spleen, an immune and blood-filtering organ tucked under the ribs on the left side. The most common reasons we remove it are immune thrombocytopenia (ITP) — a condition where the spleen destroys platelets — and hemolytic anemias such as hereditary spherocytosis, where the spleen attacks red blood cells. We also remove spleens for tumors, cysts, abscesses, very large symptomatic spleens, and selected traumatic injuries.
For most patients, splenectomy is performed minimally invasively — laparoscopically or robotically — through three or four small incisions in the left upper abdomen. The blood vessels feeding the spleen are sealed and divided, the spleen is freed from its surrounding ligaments, and the organ is placed in a retrieval bag and removed through one of the incisions. Most patients are home the day after surgery and back to normal activity within two to three weeks.
Who is a candidate?
Most adults with a clear indication for spleen removal are candidates for minimally invasive splenectomy — laparoscopic or robotic — regardless of body size. Spleens that have grown to massive size sometimes require a hand-assisted or open approach simply because of the bulk. Open surgery is also reserved for trauma cases when the patient is unstable. We carefully review imaging before surgery and coordinate with hematology for blood-disorder patients to time platelet transfusions, IVIG, or steroid taper appropriately.
How we perform it
Under general anesthesia, you are positioned slightly on your right side. Three or four small ports are placed in the left upper abdomen. The splenic ligaments are taken down, the short gastric vessels along the stomach are sealed, and the splenic artery and vein are individually divided with a stapler. The spleen is placed in a strong retrieval bag, broken into pieces inside the bag, and removed through one of the small incisions. We look carefully for accessory spleens — small extra pieces of spleen that, if left behind, can cause ITP to recur. The operation usually takes 90–120 minutes.
Recovery
Most patients stay one night and go home the next day. You will walk the evening of surgery, eat a light meal, and have routine post-op imaging only if needed. Pain at the small incision sites is controlled with non-opioid medication for most patients. Desk work is possible at 7–10 days, full activity — including exercise — at 2–3 weeks. After splenectomy you should call us promptly with any fever, as the immune system is slightly more vulnerable to certain infections. You'll see Dr. Shaw or Dr. Decio in our Coral Springs office 1–2 weeks after surgery.
Why Florida Surgical
Splenectomy is a careful operation — the spleen has a generous blood supply and sits close to the pancreas tail, and small mistakes can become large complications. Dr. Shaw and Dr. Decio have extensive experience with minimally invasive splenectomy across a range of patient sizes and conditions. We coordinate with experienced hematology and transfusion-medicine teams at our five South Florida hospitals, perform the operation with the appropriate technique for each patient, and make sure your vaccinations and follow-up plan are in place before you leave the office for surgery.
Frequently asked questions
Can I live without my spleen?
Yes. The liver and other immune tissues take over most of the spleen's filtering and immune functions. The main long-term concern is a slightly higher risk of severe infection from a small group of encapsulated bacteria — which is why we give vaccinations before surgery and ask patients to seek care promptly for any high fever.
Will I need vaccines before surgery?
Yes. Standard practice is to give pneumococcal, meningococcal, and Haemophilus influenzae type b vaccines at least two weeks before elective splenectomy. Boosters are recommended at intervals afterwards. We coordinate these with your primary care doctor.
Is laparoscopic splenectomy outpatient?
For most patients, splenectomy is a one-night stay. Patients with very large spleens, significant medical issues, or those who need close monitoring of blood counts may stay longer. Truly outpatient splenectomy is uncommon.
How long is recovery?
Most people return to desk work in 7–10 days and full activity at 2–3 weeks after minimally invasive splenectomy. Open splenectomy — usually only needed for very large spleens or trauma — takes longer, typically 4–6 weeks.
Will splenectomy cure my ITP?
Approximately 60–80% of adults with steroid-dependent or refractory ITP have a lasting response to splenectomy, and many can come off platelet-raising medications entirely. The decision is made jointly with your hematologist, who follows your platelet counts before and after surgery.