spleen disease can be divided into several groups:
- The first group is a disease in which the spleeninstead of destroying the old and damaged blood cells start destroying healthy, which leads to disruption of the mechanisms of the body, depending on the presence of blood cells. the normal functioning of the spleen Change due to the fact that, because of some pathological processes of healthy blood cells are marked as affected. Such diseases include autoimmune thrombocytopenia, in which the spleen destroys healthy platelets, and hemolytic anemia, red blood cells are destroyed when healthy.
- the second group of diseases is cancer of the spleen, leading to organ malfunction, among them there are both benign and malignant, such as lymphoma.
Increasing the size of the spleen is observed,for example, malaria and other parasitic diseases, blood poisoning (sepsis), diseases of the hematopoietic system - thrombocytopenic anemia, leukemia, Hodgkin's disease.
Diseases such as autoimmunethrombocytopenia, decided to treat steroid hormones that alter a pathological reaction of the immune system. In some chronic diseases and the development of tumors part of the treatment process is the removal of the spleen. Until recently, this operation was carried out across a wide section of the anterior abdominal wall, but in recent times it is performed laparoscopically. This technique has been used since 1992 and are now a growing number of splenectomy performed in micro-technology.
The patient is under general anesthesia. The surgeon performs a small incision in the abdomen or left in the umbilicus small incision through which introduces a laparoscope (tube), it is equipped with a video camera and the optical fiber illuminating the abdomen. The camera sends the image on a special screen that allows the surgeon to see the whole picture. With a few additional small holes it introduces special equipment, through which the spleen is separated from the surrounding tissue and its blood vessels sutured. Spleen now completely separated from the other tissues, it is placed and sealed in a special bag that is also introduced into the abdominal cavity. The neck of the bag is closed, whereupon the vacuum suction is removed the contents out of the bag.
The main advantages of laparoscopicoperation include the fact that this process does not cause such severe pain as traditional surgery, and also leads to a much more rapid recovery. In addition, very small size of the holes allows operating much more effectively prevent the development of postoperative infections. Usually, the patient is discharged home after one or two days after surgery and during the week back to a normal lifestyle.
Sometimes there are patients who conductlaparoscopy is impossible or undesirable. This happens when using the tools for micro-operation can not be separated from the spleen of the surrounding tissues, or when the anatomy of the abdominal cavity such that the lens unit does not provide a clear picture on the screen. Certain restrictions on the use of laparoscopy technique, and imposes a significant increase in spleen size, although in cases where it does not exceed the diameter of 20 cm, a special laparoscopic instruments.
In each case, the decision on the method of operation according toremoval of the spleen takes surgeon after a thorough examination of the patient. It happens so that the operation, originally scheduled as a laparoscopy, in the process requires a shift in the "open" surgery.
Possible complications after surgery
Any operation, regardless of the manner of its implementation can sometimes cause complications, especially this infection and bleeding. It should be noted that complications are less common at micro-ops.
The most disturbing complication, fortunately,occurring in exceptional cases, this microbial infection, which is very difficult to treat due to the fact that the removal of the spleen extremely weakened immune system activity. To prevent this complication, all patients who had surgery to remove the spleen gets vaccinated against the most common germs that may cause infection. In addition, antibiotic treatment is recommended for any microbial inflammation, and to begin this treatment should be as soon as possible. In some cases, the doctor prescribed to patients prophylactically long course of antibiotics. Furthermore, there is extremely small risk of other internal organs such as the stomach, pancreas and others.
In rare cases, a subphrenicinflammation that needs cleaning the source of inflammation. Such cleaning is usually carried out through a hole in the skin, but sometimes even a full-fledged operation is required for this.
After laparoscopic splenectomythe patient can return to normal life after about a week, including walking, driving, climbing stairs, lifting objects and sexual activity. If a temperature of the order of 37.5 deg., Chills, vomiting, difficulty in urination or discomfort in the joints operating, the patient should seek emergency surgeon to operate.