Thank you for choosing Georgia Health Sciences Medical Center and the Minimally Invasive and Digestive Diseases Surgery Section for your healthcare needs. This information is to help answer come common questions you may have about your operation and provide instructions to follow during your recovery period.
Removal of the spleen (splenectomy) may need to be done for many different reasons, sometimes for benign diseases and sometimes for cancer. Regardless of the reason for removal, the procedure is the same. Removal of the spleen is done as an elective procedure and you will stay in the hospital for 2-4 days after the operation. Sometimes emergency removal is needed, usually if there is rupture of the spleen causing life threatening bleeding. For these types of surgery, recovery time is usually longer and other problems like injury to other body systems can be more common.
Prior to removal of the spleen, you will be asked not to eat anything after midnight prior to your surgery. You will be given specific instructions from your surgeon or anesthesiologist about which medications you should or should not take prior to your surgery. You should not take any blood thinning medications, such as asprin, ibuprofen, Coumadin or plavix at least 5 days prior to your operation. This should be discussed with your surgeon at your preop visit.
You may be prescribed a bowel prep in order to clean the stool from your colon before removal of the spleen. There are several different types of bowel prep available to prescribe to you, based on the preference of your surgeon. If you are given a bowel prep, it is very important you take the full prep as directed.
Prior to removal of your spleen, you will be given vaccinations against several infectious diseases that are more common after splenectomy.
Removal of the spleen is performed laparoscopically in most cases. In the event that a larger incision is required, recovery time may be longer than the typical described below.
You can resume most usual activities gradually beginning shortly after surgery. You should begin walking the night of surgery or the following morning and continue to increase as you are able. Increased activity reduces the risk of blood clots, and improves breathing to prevent pneumonia
While in the hospital, you will be asked to walk several times a day, beginning no later than the morning after surgery in most cases. You will usually need assistance to get out of bed, especially the first time, since you will likely have IV tubing and sometimes drains or catheters that need to be disconnected in order for you to get around. A Physical Therapist often helps you get out of bed and regain your strength after major surgery. Walkers, canes or crutches will be made available as needed. In some cases a short stay in a rehabilitation center or short-term nursing home may be needed. This is uncommon and usually only needed for people who had to have emergency operations or had some other complications and a long hospital stay.
Avoid lifting more than 10 pounds for 4 weeks and excessive bending or twisting for 1-2 weeks following surgery. This is to allow healing of the incisions, specifically the fascia (the strongest layer of the abdomen wall) and decrease the risk of developing a hernia.
Avoid driving until you no longer need narcotic pain medication and you feel you can make rapid movements unimpaired by pain. Driving while taking narcotics can impair your ability to drive safely.
You should be able to return to work 1-3 weeks after surgery.
A small gauze and clear tape dressing is typically placed over each incision. These dressings can be removed 48 hours (2 days) after the operation. Below this dressing are small brown or white pieces of tape (called Steri-Strips); these will fall off on their own within 1-2 weeks or be removed at your follow-up visit with your surgeon. If your surgeon gives you specific instructions other than this, please follow those instructions.
You may shower after 48hours (after the gauze and clear tape dressing is removed). It is okay to get soap and water on the incisions. Pat the area dry. It is not recommend that you submerge underwater (in a bathtub, pool, or hot-tub) for at least two weeks post-op.
If you notice drainage from your incisions, particularly if it is thick and foul-smelling or associated with a fever, contact your surgeon.
If you notice redness around your incisions, especially if it is getting worse or associated with drainage or a fever, contact your surgeon.
Medications - Pain Management
Pain is typically just around the site of incisions, but after laparoscopic surgery, you may have more general abdominal pain or even shoulder pain due to the air used to inflate your abdomen during the surgery. Pain from air inflation will go away in 24 to 48 hours.
You will be discharged with pain medication, typically a mild to moderate strength narcotic. Take as needed and as prescribed. You may also take over-the-counter medications such as ibuprofen for pain. Most narcotic medications prescribed are combined with Tylenol (acetaminophen) and you should not take additional Tylenol if you are taking a narcotic medication that already contains Tylenol.
You may be prescribed a stool softener when you go home. Pain medications can cause constipation and a stool softener may help. You may also be given nausea medication if you experience nausea or vomiting from taking your pain medication.
Unless otherwise instructed, you should be able to resume your usual home medications the night of or the morning following your surgery.
Click here for more detailed information on commonly prescribed medications.
You may resume your usual diet as you feel able unless otherwise instructed. You may have some abdominal bloating or mild nausea after your operation, so eat slowly and only what you can tolerate. Your appetite may be less than usual but typically returns to normal within a week or two. Be sure to drink plenty of liquids (6-8 glasses of water or juice each day) if your appetite is not very good.
You will be given a date and time to see your surgeon following surgery. If you are discharged late in the day or over the weekend, you will be given a number to call the following business day for an appointment. If you are having trouble making an appointment, call your doctors' office directly for assistance.
Call Your Doctor If:
Although not frequent, some people may develop abdominal pain with low-grade fevers and increases in white blood cell count and platelets as a result of clots that can form in the remaining portion of the vein draining the spleen as well as the portal vein after splenectomy. If this happens, a CT scan or ultrasound of the abdomen will confirm the diagnosis of portal vein thrombosis. This condition can occur months after removal of the spleen and treated with blood thinners such as Coumadin.
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After hours and weekends: Call 706-721-8400