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About surgery to remove your spleen (splenectomy)

Find out what the spleen is and why doctors might need to remove it for hairy cell leukaemia.

The spleen

The spleen is an organ on the upper left side of your tummy (abdomen).

It is part of the lymphatic system. It:

  • stores red blood cells (erythrocytes) and white blood cells (lymphocytes) 
  • filters the blood, removing worn out red blood cells 

Your white blood cells are part of your immune system, helping to fight infection. 

Diagram showing the position of the spleen

Why you might have surgery

Hairy cell leukaemia can cause the spleen to be bigger than normal (enlarged).

The spleen can get clogged up with abnormal blood cells, stopping it from working properly. 

An enlarged spleen might destroy too many red blood cells and platelets (cells that help the blood to clot). This can make you tired and breathless. Or you might bruise or bleed easily.

You might have surgery if your spleen:

  • is so large it is making you uncomfortable or causing you pain
  • is destroying too many red blood cells or platelets
  • has not shrunk after chemotherapy

You might have several months to recover after your operation, before having other treatments. During this time your doctor monitors your blood results. If the number of leukaemia cells (hairy cells) in your blood goes up, you might have more treatment.

What happens

Your surgeon might remove your spleen through either:

  • a large cut just under your ribs in the middle or left side of your abdomen (open surgery)
  • keyhole (laparoscopic) surgery

Keyhole surgery is where the surgeon makes a few small cuts in your abdomen. They put a thin tube called a laparoscope through one of the cuts. The tube has a camera attached. The surgeon can see the pictures of the inside of your abdomen on a TV screen. 

Through the other cuts they put in surgical instruments to remove the spleen.

You usually recover more quickly from keyhole surgery than open surgery, and you can go home sooner. But it may not be possible for you to have keyhole surgery if your spleen is too large.

Helping protect your immune system

The spleen is part of your immune system and helps to fight infection. Without a spleen you are more at risk of infection.

To help prevent infection in the future, you have some vaccinations before, or just after, the operation.

You need to take antibiotics for the rest of your life because of these changes to your immune system.

In case of a medical emergency, you should carry a card saying that you don't have a spleen. Talk to your doctor before going abroad. They might advise extra vaccinations because you have a lower immunity.

Information and help