What's an "open" splenectomy like?

Have any of you received an "open" splenectomy? I'm a liver transplant patient with a platelet condition and my surgeons at the Cleve Clinic have opted to take my spleen out. It's seriously enlarged, so they can't do it laparascopy. I have enormous fears of surgeries and am scared what this may be like. Dr is hard to get answers from. How long will I be in the hospital? Recovery time? Side effects? Life-long things to deal with?
Thanks
Amanda

Hi Amanda,

My daughter is the one who has ITP--but I am the one with the splenectomy. I got mine after a car accident, so when the docs went looking for the source of the bleeding, they may have needed a longer slice (9 inches) so they could make sure I wasn't bleeding anywhere else. My scar is also not necessarily where yours would be, as mine is midline. At any rate, I was 'strongly encouraged' to get up the day after surgery, and once up, I was on the mend pretty quickly. I had to return to the surgeon for staple removal two weeks later (seriously!) and I was directing a weekend Girl Scout neighborhood encampment the week after that. If you're in fairly good shape going in, you should do fine. Don't baby yourself--don't mess with your dressings--and don't worry, you'll be up and running again soon. When I woke up, I was on a morphine pump, but it didn't seem to be working; when I was discharged, they gave me several pain prescriptions, but I don't remember being on them very long. The docs may want the open splenectomy to be sure there are no splenules--itty bitty spleens that don't grow until the main one is removed/damaged. I do have splenules--which is good for my immune system, and I thnk they've grown as I rarely get sick, but again, I don't have ITP. If they grow in a person who DOES have ITP, and had a splenectomy to deal with it, they can wind up with the same ITP symptoms all over again, as the spleen is effectively, back.

Life-long things to deal with: Well, there are several shots to get, one of which is the pneumovax vaccine to help ward off pneumonia and, I think, encephalitis? I have to get one of those every 5 years for life. Bring all your other immunizations up to date, too, and if you haven't had it, think about one against chicken pox, as then you may avoid the possibility of shingles later in life. Some people do report getting sick more often than before they lost their spleen. Frequent hand-washing and avoiding sick people/crowds/ shopping carts are your best defense! Infections are possible from other sources, too--for example, I should garden with gloves! The danger for spleenless people is sepsis, a whole-body infection that is tough to beat.

And that's what I know about splenectomy! Do a site search on this topic, and you should turn up recent info posted by Sandi about possible problems after heart attacks for people with splenectomies. Something about the spleen mitigating clotting??? Ann, Caitlin's (24) Mom

Ann has first-hand information, so her response will be more useful than mine. I had a laproscopic splenectomy about 7 years ago, and I suspect the long-term side-effects are the same as with an "open" splenectomy. I am careful, but I haven't contracted more colds or infections than I did before my splenectomy.

In about 2000, my brother had an open splenectomy because he had an enlarged spleen, and his oncologists wanted it removed before he began treatment for chronic lymphocetic leukemia. He was a good deal less comfortable than I was, but long-term, he is once again a practicing pediatrician and seems to be very well.

One interesting point: when I told my surgeon about my brother having to have the open splenectomy, she told me that SHE could have taken out his spleen laproscopically I think she thought that a really skillful surgeon could have done that--but we'll never know, of course, if that is true or not.

My "open" was 10y ago and was open just in case and to allow them to search for secondary spleen. Recovery is obviously longer but as I remember I was "up", although very slow about it, within a couple of days and was out of work on STD for 30+ days for the recovery. Doesn't seem it was that bad, but you definitely move slowly and hate to cough/laugh. Keep a pillow handy to squeeze into your stomach when you cough/laugh. Mine is 10-12 inches on a diagonal on my left side - lost a nerve connection or two there. MD said it would grow back but it didn't. Just feels funny if i push in a certain spot - doesn't hurt - just not normal. Not a big deal but I bet Laparoscopic is better when you can get it.