Spleen Disorders

Dr. Konstantinidis MD, PhD, FACS - General Surgeon & Director of Bariatric, Laparoscopic & Robotic Surgery of Athens Medical Center.

Overview

The spleen is an organ located in the left upper abdomen and is the most fragile of the intra-abdominal organs.

A ruptured spleen is a serious complication in surgeries related to the lower digestive tract, liver, bile ducts and pancreas, which is almost eliminated when the operation is performed with robotic surgery.

Ruptured spleen and several other disorders of the spleen, such as enlarged spleen, splenic abscess, cancer, and various hematological diseases, are treated with the surgical removal of the organ (splenectomy).

Dr. Konstantinidis and his Surgical Team have many years of experience and specialization in performing robotic splenectomies, in order to ensure not only the optimal medical outcome for the patient, but also to minimize the risk of complications as a consequence of the surgery.

 

Which spleen disorders are treated with Splenectomy?

Splenectomy is indicated for the treatment of various spleen disorders, which cannot be treated conservatively, such as:

Enlarged Spleen

A viral infection, such as mononucleosis, or a bacterial infection, such as syphilis, can cause the spleen to swell (enlarged spleen).

The swollen spleen traps an excessive amount of blood cells and platelets. Eventually it also traps and destroys healthy red blood cells. This is called hypersplenism (overactive spleen), it is associated with enlarged spleen and leads to a significant reduction of healthy cells and platelets in the blood.

A swollen spleen can cause anemia, infection, and excessive bleeding. It may eventually rupture, a life-threatening condition that requires immediate surgery.

 

Spleen Abscess

A serious infection of the spleen may not respond to antibiotics or other treatments. This type of infection can lead to a more serious abscess or inflammation and accumulation of pus. The spleen may then need to be removed to treat the infection.

 

Cancer

Some cancers, such as lymphocytic leukemia, non-Hodgkin’s lymphoma, and Hodgkin’s lymphoma, affect the spleen.

In this case the spleen is swollen, which can lead to rupture.

The spleen may also need to be removed due to the presence of a cyst or even a tumor.

 

Hematological diseases

The spleen may need to be removed in the event of a severe blood disorder that does not respond to other treatments. Disorders of this type include:

  • Sickle cell anemia
  • Autoimmune hemolytic anemia
  • Mediterranean anemia
  • Idiopathic thrombocytopenic purpura (ITP)
  • Absolute (True) polycythemia (p. Vera)
  • Myeloid metaplasia
  • Hereditary spherocytosis

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Ruptured spleen

A ruptured spleen is usually the result of an abdominal injury. In rare cases, it can also be caused by an infection or hematological condition, as well as a complication of surgery in the abdomen.

Rupture of the spleen can lead to massive intra-abdominal bleeding and should therefore be treated as a medical emergency.

A splenic rupture is distinguished into acute or delayed.

An acute rupture, which is immediately accompanied by severe pain and shock, is different from a delayed rupture, which occurs with a sudden onset of pain and shock after an asymptomatic period lasting from days to weeks.

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Splenectomy

How are spleen disorders treated?

Surgical removal of the spleen, through an operation called splenectomy, is the treatment of choice for several disorders of the spleen, such as enlarged spleen, various hematological diseases (malignant or not) and ruptured spleen.

Splenectomy can be performed with:

Open surgery: This involves removing the spleen through a large incision under the left side of the chest.

Minimally invasive method: This includes laparoscopic splenectomy, which involves the removal of the spleen through small holes that open in the abdomen, and robotic splenectomy, which is performed with the assistance of a surgical robotic system, Da Vinci Xi, at Athens Medical Center.

 

LAPAROSCOPIC SPLENECTOMY

What is Laparoscopic Splenectomy?

During laparoscopic splenectomy, the spleen is removed through small holes in the patient’s abdomen. At the same time, the peritoneal cavity and the intra-abdominal organs are examined in detail.

The main advantages of the laparoscopic method, compared to the conventional, open surgery, are the following:

  • the operation is bloodless
  • postoperative pain is minimal
  • the risk of complications is dramatically reduced
  • the duration of hospitalization is shorter
  • recovery is faster
  • the cosmetic outcome is better, due to the absence of a large incision

The following are described in the literature as relevant contraindications to laparoscopic splenectomy:

  • severe cardiopulmonary disease
  • coagulation disorders that cannot be restored

ROBOTIC SPLENECTOMY

What is Robotic Splenectomy?

Robotic splenectomy is the evolution of the corresponding laparoscopic technique, which incorporates the advantages of the latter, but without its weaknesses.

The precision, flexibility and stability of robotic arms are incomparably superior to the hand of any surgeon.

This allows the surgeon, who navigates the arms from a screen that gives a three-dimensional view of the surgical field and at high magnification, to make movements and access anatomical points that are impossible during conventional laparoscopic splenectomy.

Therefore, the operation is performed without unnecessary tissue injury and minimizing the risk of complications that sometimes occur in open and conventional laparoscopic splenectomy.

What preoperative tests are required before Robotic Splenectomy?

To perform a safe laparoscopic splenectomy, a proper preoperative examination is required.

Two weeks before the surgery a multivalent vaccine against pneumococcus and against the hemophilia of the influenza is administered to the patient.

Imaging methods (ultrasound, computed tomography, or magnetic resonance imaging) determine the anatomy of the area.

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Why us

Why Dr. Konstantinidis?

Dr. Konstantinidis and his Surgical Team constitute a reference point in Greece for the treatment of spleen disorders with Robotic Surgery.

Robotic Surgery offers unique benefits for the treatment of spleen disorders by dramatically reducing the risk of postoperative complications.

Dr. Konstantinidis and his Surgical Team collaborate with leading specialists in all relevant medical specialties, such as Radiologists, Gastroenterologists, etc., to determine a treatment plan based on the specifics, needs and goals of each patient individually.