Laparoscopic spleen removal in adults - discharge

The type of surgery you had is called laparoscopic splenectomy. The surgeon made 3 to 4 small cuts (incisions) in your belly. The laparoscope and other medical instruments were inserted through these cuts. A harmless gas was pumped into your belly to expand the area to help your surgeon see better.

Recovering from surgery usually takes several weeks. You may have some of these symptoms as you recover:

• Pain around the incisions. When you first get home, you may also feel pain in one or both shoulders. This pain comes from any gas still left in your belly after the surgery. It should go away over several days to a week.
• A sore throat from the breathing tube that helped you breathe during surgery. Sucking on ice chips or gargling may be soothing.
• Nausea, and maybe throwing up. Your surgeon can prescribe nausea medicine if you need it.
• Bruising or redness around your wounds. This will go away on its own.
• Problems taking deep breaths.

Make sure your home is safe as you are recovering. For example, remove throw rugs to prevent tripping and falling. Be sure that you can use your shower or bathtub safely. Have someone stay with you for a few days until you can get around better on your own.

Start walking soon after surgery. Begin your everyday activities as soon as you feel up to it. Move around the house, shower, and use the stairs at home during the first week. If it hurts when you do something, stop doing that activity.

You may be able to drive after 7 to 10 days if you are not taking narcotic pain medicines. Do not do any heavy lifting or straining for the first 1 to 2 weeks after surgery. If you lift or strain and feel any pain or pulling on the incisions, avoid that activity.

You may be able to go back to a desk job within a few weeks. It can take up to 6 to 8 weeks to get your normal energy level back.

Your doctor will prescribe pain medicines for you to use at home. If you are taking pain pills 3 or 4 times a day, try taking them at the same times each day for 3 to 4 days. They may work better this way. Ask your surgeon about taking acetaminophen (Tylenol) or ibuprofen for pain instead of narcotic pain medicine.

Try getting up and moving around if you are having some pain in your belly. This may ease your pain.

Press a pillow over your incision when you cough or sneeze to ease discomfort and protect your incision.

If stitches, staples, or glue were used to close your skin, you may remove any dressings (bandages) and take a shower the day after surgery.

If strips of tape were used to close your skin, cover the incisions with plastic wrap before showering for the first week. Do not try to wash the tape off. They will fall off in about a week.

Do not soak in a bathtub or hot tub or go swimming until your surgeon tells you it is OK (usually 1 week).

Most people live a normal active life without a spleen. But there is always a risk of getting an infection. This is because the spleen is part of the body's immune system, helping fight infections.

After your spleen is removed, you will be more likely to get infections:

• For the first week after surgery, check your temperature every day.
• Tell the surgeon right away if you have a fever, sore throat, headache, belly pain, or diarrhea, or an injury that breaks your skin.

Keeping up to date on your immunizations will be very important. Ask your doctor if you should have these vaccines:

• Pneumococcal
• Meningococcal
• Haemophilus influenzae
• Flu shot (every year)

Things you can do to help prevent infections:

• Avoid crowds for the first 2 weeks after you go home.
• Wash your hands often with soap and water. Ask family members to do the same.
• Get treated for any bites, human or animal, right away.
• Protect your skin when you are camping or hiking or doing other outdoor activities. Wear long sleeves and pants.
• Tell your provider if you plan to travel out of the country.
• Tell all of your providers (dentist, doctors, nurses, or nurse practitioners) that you do not have a spleen.
• Buy and wear a bracelet that indicates you do not have a spleen.

Contact your provider if you have any of the following:

• Temperature of 101°F (38.3°C), or higher
• Incisions are bleeding, red or warm to the touch, or have a thick, yellow, green, or pus-like drainage
• Your pain medicines are not working
• It is hard to breathe
• Cough that does not go away
• Cannot drink or eat
• Develop a skin rash and feel ill

Splenectomy - microscopic - discharge; Laparoscopic splenectomy - discharge

Cameron J. Spleen. In: Cameron J, ed. Current Surgical Therapy. 14th ed. Philadelphia, PA: Elsevier; 2023:651-662.

Nassar AK, Hawn M. The spleen. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 57.

Updated by: Debra G. Wechter, MD, FACS, General Surgery Practice Specializing in Breast Cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.