Splenectomy
The partial or total surgical removal of the spleen, often due to trauma, rupture, or hematologic disorders. The splenic artery and vein are ligated and divided to allow for the safe excision of the organ from the left upper quadrant.
Surgical instruments
18 on this table — tap a photo to zoom, the name for its full card.
The case
Spark notes
The 30-second rundown — scan this outside the room.
- The Surgery Sparknotes
- Make initial incision with a 15 or 10 blade on a #3 knife handle.
- Dissect through tissue using Adsons, Metz, Bovie, and retractors.
- Ligate all attachments and blood vessels using Bovie, Metz, or ties.
- Remove spleen carefully and pass it off as a specimen.
- Stop bleeding, close incision with staples, and no drains are needed.
Walkthrough
What the surgeon does — and what to have in your hand before they ask.
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.
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.
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.
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.
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.
Add your table
Every surgeon runs it a little differently. Submissions stay private, are reviewed by our team, and accepted contributions earn a credit in the contributor list.