Mayo stand and back table instruments for Splenectomy surgery setup

Clamping & Occluding

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  Allis Forceps

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  Babcock

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  Curved Hemostat

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  Kelly Forceps

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  Kocher Forceps

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  Tonsil Clamp

Cutting & Dissecting

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  #3 Knife Handle

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  Metzenbaum Scissor

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  Straight Mayo Scissor

Grasping & Holding

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  Adson Forceps

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  Bonney Forceps

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  Debakey Forcep

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  Toothed Forcep

Retracting & Exposing

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  Army-Navy Retractor

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  Richardson Retractor

Suctioning

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  Poole Suction Probe

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  Yankauer Suction

Suturing & Stapling

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  Mayo-Hegar Needle Holder

What to expect during Splenectomy

Splenectomy is a surgical procedure that involves the removal of the spleen, which is an organ located in the upper left side of the abdomen. This procedure may be necessary if the spleen is enlarged, damaged, or affected by a medical condition such as cancer, infection, or blood disorders. The surgery is performed under general anesthesia, and the spleen is removed through a small incision in the abdomen. After the surgery, patients may need to take medications and follow certain precautions to prevent infections. Splenectomy can improve or resolve symptoms associated with spleen-related conditions, but it can also increase the risk of certain infections and other health issues.

Positioning
Supine

Drapes
Folded towels or utility drapes and a laparotomy drape

Step 1: Initial Incision
During a Splenectomy, the surgical team will first need to make an incision to gain access to the abdomen. For this, a 15 or 10 blade loaded on a #3 knife handle is typically used. This initial incision will be made with precision to ensure minimal tissue damage and create enough space for the surgical team to work effectively.

Step 2: Dissecting Through Tissue
Once the incision has been made, the doctor will start to dissect through the tissue to enter the abdomen. To do this, they will use a combination of Adsons, Metz, Bovie, and smaller retractors. These instruments will allow the surgical team to carefully maneuver through the tissue and minimize damage to the surrounding structures.

Step 3: Ligation of Attachments and Blood Vessels
Once the spleen has been reached, the surgical team will need to ligate all of its attachments and blood vessels to remove it successfully. For this, they will typically use a combination of Bovie, Metz, or ties loaded on tonsils or used freehand. The surgical team should have a lot of 0 and 2-0 ties available, along with vessel loops, to ensure they have enough supplies to complete the procedure effectively.

Step 4: Removal of the Spleen
After all of the attachments have been ligated and removed, the spleen will be passed off as a specimen. This requires careful handling to avoid damaging the organ or spilling its contents. The surgical team must ensure that the spleen is removed entirely and that there are no remaining attachments or vessels that could cause bleeding or other complications.

Step 5: Stop Bleeding and Close Incision
Once the spleen has been removed, the surgical team will need to stop any bleeding and close the incision. Drains are usually not used for splenectomies, and staples are typically used to close the skin. The surgical team will need to ensure that the incision is closed correctly to prevent any postoperative complications.

The Surgery Sparknotes
1. Make initial incision with a 15 or 10 blade on a #3 knife handle.
2. Dissect through tissue using Adsons, Metz, Bovie, and retractors.
3. Ligate all attachments and blood vessels using Bovie, Metz, or ties.
4. Remove spleen carefully and pass it off as a specimen.
5. Stop bleeding, close incision with staples, and no drains are needed.