Right before your surgery, you will be given a general anesthetic. The anesthesiologist or anesthetist gives you an anesthetic medication as a gas — to breathe through a mask — or injects a liquid medication into a vein. The surgical team monitors your heart rate, blood pressure and blood oxygen throughout the procedure. You will have a blood pressure cuff on your arm and heart-monitor leads attached to your chest.
After you're unconscious, your surgeon begins the surgery using either a minimally invasive (laparoscopic) or open (traditional) procedure. The method used often depends on the size of the spleen. The larger the spleen, the more likely your surgeon will choose to do an open splenectomy.
Laparoscopic splenectomy. During laparoscopic splenectomy, the surgeon makes four small incisions in your abdomen. He or she then inserts a tube with a tiny video camera into your abdomen through one of the incisions. Your surgeon watches the video images on a monitor and removes the spleen with special surgical tools that are put in the other three incisions. Then he or she closes the incisions.
Laparoscopic splenectomy isn't appropriate for everyone. A ruptured spleen usually requires open splenectomy. In some cases your surgeon may begin with a laparoscopic approach and find it necessary to make a larger incision because of scar tissue from previous operations or other complications.
- Open splenectomy. During open splenectomy, your surgeon makes an incision in the middle of your abdomen and moves aside muscle and other tissue to reveal your spleen. He or she then removes the spleen and closes the incision.