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Splenectomy and Shunt Surgeries in Bhubaneswar

Splenectomy and Shunt Surgeries

Splenectomy and Shunt Surgeries in Bhubaneswar

The spleen is a fist-sized organ located on the upper left side of the belly, just behind the bottom of the rib cage. As a part of the immune system, the spleen is responsible for fighting infections, filtering worn-out blood cells, regulating blood flow to the liver, and storing excess blood cells. Splenectomy procedures that involve the partial or complete removal of the spleen are performed when the spleen is enlarged, damaged, or affected by cancer. Despite the spleen removal, the patients can lead a normal life.

In some cases, patients may need to undergo Distal Splenorenal Shunt Procedures to relocate the splenic vein connecting to the portal vein to the renal vein. This procedure helps treat complications arising from portal hypertension by creating an alternate pathway, thereby relieving pressure on the portal vein. By diverting the blood away from the portal vein, bleeding resulting from the varices can also be controlled.

The General Surgery Department at Manipal Hospitals, Bhubaneswar, Odisha, is staffed by highly skilled surgeons who can perform Splenectomy in Bhubaneswar and Shunt Placement Procedures with the utmost precision and safety. We ensure optimal outcomes and high satisfaction for patients who undergo these surgical procedures under our care. 

 

FAQ's

Splenectomy is performed in those individuals when the spleen has an irreversible lesion that ruptures its protective barrier. Internal bleeding can result from a ruptured spleen

Common reasons to remove the spleen are:

  • Injury to the spleen, which may lead to its rupture and internal bleeding

  • If you have blood disorders (sickle cell anaemia or idiopathic thrombocytic purpura)

  • Cancers (Hodgkin’s and non-Hodgkin’s lymphoma)

  • If the spleen becomes too active and destroys blood cells

  • Abscess or cyst in the spleen

  • Benign growth within the spleen

  • Enlarged spleen

  • Blood clots within the blood vessels of the spleen

  • Individuals with blood vessel defects (aneurysms in the spleen artery)

Road accidents and trauma to the abdomen sustained while playing physically demanding sports like football and boxing are among the common causes of Splenectomy.

During consultation, you will be thoroughly examined and your health status will be assessed. Additionally, diagnostic tests may be ordered to check whether surgery is feasible in your case. When the decision for surgery is made, the doctor gives you the surgery date.

Just before the surgery, you will need to stop taking some medications or supplements before the procedure. Doctors advise you to stop eating several hours before the procedure. A blood transfusion may be given before the procedure to ensure you have enough blood after the spleen is removed.

A shrivelled-up, non-functioning spleen is the result of Auto-Splenectomy. It occurs rarely and is linked to specific illnesses, including sickle-cell disease, systemic lupus erythematosus, and malignancies.

In autoimmune diseases such as idiopathic thrombocytopenic purpura, antibodies are directed against platelets, thereby impeding the process of clotting. Because the spleen is in charge of producing antibodies, its removal helps combat the illness.

Risks or complications include:

  • Allergic reactions to the anaesthesia

  • Infections and bleeding

  • Accumulation of excess fluid within the abdomen (ascites)

  • Encephalopathy

Portal veins are one of the main vessels supplying the liver. Elevated pressure within the portal venous system is known as portal hypertension.   

Portal hypertension results in a liver injury that is brought on by:

  • Drinking

  • Cirrhosis of the liver

  • Hepatitis viruses that cause blood clots 

In open procedures, an incision is made in the abdomen, and the muscles and tissues are reflected to reveal the spleen. After the spleen is removed, the incision is closed. During the laparoscopic approach, three or four small incisions are made on the abdomen. With the help of the video camera and surgical tools, the spleen is removed and the incision is closed.

The following can be experienced after a Splenectomy:

  • There is an increased risk of blood clots and infections.

  • In the absence of a spleen, there is a high chance of small infections spreading quickly, resulting in serious health issues. For example, if you do not seek medical attention, an overwhelming post-splenectomy infection (OPSI), a kind of severe sepsis, can occur and be fatal. 

It is important to follow your doctor's recommendations to prevent infections and to get help right away if you start to feel sick.
 

Portal hypertension is the high blood pressure resulting from the blockage or narrowing of the portal vein. The high blood pressure causes the blood to be forced out of the portal vein into new blood vessels formed in the oesophagus or stomach. As the pressure builds, the blood vessels may swell and leak blood into the abdomen. If the blood vessels rupture, it becomes a medical emergency requiring swift action.

You may need open surgery if your spleen is too large to be removed using a laparoscopy. Also, if the bleeding is severe, your surgeon may choose to perform an open operation. A laparoscopy might always be switched to open Surgery if something goes wrong. An open Surgery and a Laparoscopy both follow comparable protocols. The main difference is that instead of making multiple little incisions across the abdomen, your surgeon makes one larger one.

After a Splenectomy, you can resume your normal life, provided you take preventative measures against infection. Nonetheless, if you lack a spleen, your chances of contracting an infection or experiencing an associated complication—including death rates —-are increased. For this reason, you must protect yourself by being vaccinated and adhering to your healthcare provider's advice.
 

If diagnostic tests reveal you have enlarged or bleeding veins in your oesophagus or stomach, you will have to undergo the procedure. Individuals who develop complications of portal hypertension, such as fluid buildup in the stomach or swelling in the limbs, may also have to undergo the procedure.

You will undergo a thorough physical examination, and the consulting doctor will review your medical history. The doctors will order blood tests, liver function tests, angiograms, and endoscopies to further analyse your condition.

The two major goals of Splenorenal Shunt Therapy are to lower portal vein pressure and control bleeding. With DSRS, a surgically created blood flow path, or shunt, is established via an already-existing vein. Another procedure known as Transjugular Intrahepatic Portosystemic Shunt (TIPS) uses a minimally invasive (catheter-based) approach to join your portal vein directly to the hepatic vein, which is the vein that transports blood from your liver to your heart. TIPS is generally used more frequently than DSRS. 

Two other splenorenal shunts exist:

  • Proximal Splenorenal Shunt: To implant this shunt, doctors may need to remove your spleen.

  • Distal Splenorenal Shunt: Helps in controlling the bleeding by diverting the flow away from a major vein, typically a portal vein.

Along with a physical examination, your provider usually inquires about your medical history. Tests are also performed to assess the severity of portal hypertension, your general health, and the function of your liver.

The following are the tests that could be suggested:

  • Blood examinations

  • An ECG

  • Tests for liver function and chest X-ray

You will be administered general anaesthesia before the procedure. An incision is placed in the middle of the abdomen, and the muscles and tissues are carefully deflected to expose the spleen, splenic vein, and renal vein.

The surgery creates a vascular connection between the splenic vein and the left renal vein with the help of a graft. After the stunt creation, the surgeon ensures there is no more excess bleeding and the incision is closed. 

After surgery, a temporary catheter will be placed in your bladder to allow the passage of urine. Within a week following surgery, an angiogram will be performed to check the functioning of the shunt. 

 

 

Complications associated with the procedure are:

 

  • Bleeding during and after the procedure

  • Ascites

  • Kidney dysfunction

  • Post-surgical infection



 

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