Splenectomy and Shunt Surgeries in Broadway

Splenectomy is the removal of the spleen using laparoscopic or open surgery to treat different illnesses. While Laparoscopic Splenectomy offers a faster recovery with the use of specialised equipment and small incisions, it may not be appropriate for difficult patients. Open Splenectomy, which is usually selected for larger spleens or complex disorders, necessitates a larger incision for direct access. Customised to each patient's medical circumstances, both techniques seek to remove the spleen safely while promoting the best possible recovery.
 

Your surgeon will start the operation with either an open (conventional) or minimally invasive (laparoscopy) approach after you're unconscious. The size of the spleen frequently determines the technique employed. Your surgeon is more likely to choose an open Splenectomy if the spleen is larger.

Laparoscopic Splenectomy involves a surgeon making four small incisions in the abdomen, inserting a tube with a video camera through one of the incisions, and then using special surgical tools to remove the spleen. However, this procedure is not suitable for everyone, as ruptured spleens usually require open Splenectomy. In some cases, a larger incision may be necessary due to scar tissue or other complications.

Open Splenectomy: Your spleen is visible during an open Splenectomy, which involves the surgeon making an incision in the center of your abdomen and reflecting muscle and other tissue. The spleen is subsequently removed, and the wound is sealed.

Your surgeon will start the operation with either an open (conventional) or minimally invasive (laparoscopy) approach after you're unconscious. The size of the spleen frequently determines the technique employed. Your surgeon is more likely to choose an open Splenectomy if the spleen is larger.

Laparoscopic Splenectomy involves a surgeon making four small incisions in the abdomen, inserting a tube with a video camera through one of the incisions, and then using special surgical tools to remove the spleen. However, this procedure is not suitable for everyone, as ruptured spleens usually require open Splenectomy. In some cases, a larger incision may be necessary due to scar tissue or other complications.

Open Splenectomy: Your spleen is visible during an open Splenectomy, which involves the surgeon making an incision in the center of your abdomen and reflecting muscle and other tissue. The spleen is subsequently removed, and the wound is sealed.

By redirecting blood flow away from the portal vein, Distal Splenorenal Shunt (DSRS) surgery aids in the prevention or management of bleeding related to portal hypertension. DSRS opens up a new blood vessel for circulation by severing the spleen vein from the portal vein and joining it with the left kidney vein. This keeps the liver's blood supply constant while releasing pressure and decreasing oedema. 
 

You are taken to a recovery room following surgery. You should be able to return home the same day or the day following if you have laparoscopic surgery. You might be able to return home after two to six days if you underwent open surgery.
Consult your physician about the best time to resume your regular activities. It could take two weeks if you undergo laparoscopic surgery. Following open surgery, recovery may take six weeks.

DSRS is a crucial procedure to manage complications arising from portal hypertension. Your doctor may recommend the procedure if they notice enlarged or bleeding veins in the oesophagus or stomach. Ascites, oedema, bleeding in the stomach and rectal area, hypoxemia, renal failure, and minor cognitive impairment are some more symptoms that may require DSRS. The variety of these symptoms highlights how severe and intricate portal hypertension is.
 

In general, a Splenectomy is a safe procedure. However, Splenectomy carries the usual risk of problems associated with any surgery, such as:

• Bleeding

• Blood clots

• Infection

• Damage to adjacent organs, such as the colon, pancreas, and stomach. 

Procedures called DSRS and Transjugular intrahepatic portosystemic shunt (TIPS) are used to manage bleeding in portal hypertension. While TIPS connects the portal vein to the hepatic vein through minimally invasive surgery, DSRS forms a shunt surgically. Because TIPS is less intrusive than DSRS, it is more widely used. 
There are two alternative shunt options: Spontaneous Splenorenal Shunt (SSRS), which is a spontaneous procedure performed in late liver illness, and proximal splenorenal shunt, which may necessitate spleen resection. By changing the direction of blood flow and lowering pressure in the portal vein system, these procedures try to relieve symptoms.
 

A procedure called a Distal Splenorenal Shunt (DSRS) is performed to reduce portal vein pressure. Your liver receives blood from your digestive system through the portal vein. DSRS is used by surgeons to manage bleeding and other portal hypertension side effects.
When your portal vein narrows or becomes clogged, usually as a result of a liver injury, you develop portal hypertension, which is elevated blood pressure. Blood is forced from your portal vein into the huge new blood vessels (varices) that grow inside your esophagus or stomach due to high pressure.

Although Splenectomy is generally safe, there are some hazards to be aware of, such as bleeding, blood clots, infection, and possible organ damage. One's vulnerability to severe infections is heightened in the absence of a spleen, making immunisations against meningococcal germs, influenza, pneumonia, and Hib necessary. 
Additionally, preventive antibiotics might be recommended, particularly for people with weakened immune systems. Patients must adhere to medical advice about immunisations, medications, and continuous monitoring to properly manage infection risks and facilitate postoperative recovery.
 

The Distal Splenorenal Shunt diverts blood flow away from the portal vein, which helps to stop or lessen bleeding. This ensures that blood flows to your liver while releasing pressure and reducing swelling.
Your splenic vein, which is connected to your portal vein, is cut off by your surgeon during DSRS. The splenic vein is then joined to the renal vein, which is the vein in your left kidney, by the surgeon, opening up a new channel for blood to flow through.

Because of the spleen's function in immunological defence, Splenectomy raises the risk of blood clots and serious infections. Without it, infections—particularly those caused by certain bacteria—may quickly worsen and develop into serious illnesses like overwhelming post-splenectomy infection (OPSI), which, if left untreated, can result in sepsis and even death. It is imperative to seek medical assistance as soon as an infection is noticed to minimise risks and guarantee the best possible outcome for your health after surgery.
 

Usually, DSRS takes four hours or so. You are first put under general anesthesia. Throughout the process, you are unconscious and experience no pain. Next, the surgical care group:

• Take off the vein from your portal vein that is connected to your spleen.
• Connect the vein to your kidney on the left.
   

The management of portal hypertension symptoms is thought to be safe and successful with the Distal Splenorenal Shunt (DSRS) operation. The greatest risk of bleeding recurrence, however, occurs during the first month following surgery. Together with you, your medical team will put procedures into place to lessen this danger and ensure your safety. Vigilant observation is essential throughout this time to quickly handle any potential issues. 
To lower the chance of a bleeding recurrence, your healthcare experts will also offer advice on medication management and lifestyle changes. The benefits of DSRS can be maximised for a better quality of life, and the risk of problems can be reduced with proactive management and careful care.
 

DSRS is a safe and effective procedure to prevent recurrent variceal bleeding. With proper care and monitoring, individuals can lead a regular life after the shunt procedure. Even though DSRS can significantly improve the quality of life for portal hypertension patients, ongoing medical care and lifestyle adjustments are necessary to prevent complications.
 

In general, Distal Splenorenal Shunt surgery is a secure and successful process. You are most at risk of bleeding again within the first month following surgery. To help you control your risk and stay safe, your care team will work closely with you.