Spleen Removal Surgery

The spleen is a blood filled organ located in the upper left abdominal cavity. It is a storage organ for red blood cells and contains many specialized white blood cells called macrophages (disease fighting cells) which act to filter blood.

Spleen Removal Surgery

The spleen is part of the immune system and also removes old and damaged blood particles from your system. The spleen helps the body identify and kill bacteria. The spleen can affect the platelet count, the red blood cell count and even the white blood count.

 
 

WHAT is Laparoscopic Spleen Removal Surgery?

A cannula (hollow tube) is placed into the abdomen by your surgeon and your abdomen will be inflated with carbon dioxide gas to create a space to operate. A laparoscope (a tiny telescope connected to a video camera) is put through one of the cannulas which projects a video picture of the internal organs and spleen on a television monitor. Several cannulas are placed in different locations on your abdomen to allow your surgeon to place instruments inside your belly to work and remove your spleen.

A search for accessory (additional) spleens and then removal of these extra spleens will be done since 15% of people have small, extra spleens. After the spleen is cut from all that it is connected to, it is placed inside a special bag. The bag with the spleen inside is pulled up into one of the small, but largest incisions on your abdomen. The spleen is broken up into small pieces (morcelated) within the special bag and completely removed.

SYMPTOMS

There are several reasons why a spleen might need to be removed, and the following list, though not all inclusive, includes the most common reasons:

  • The most common reason is a condition called idiopathic (unknown cause) thrombocytopenia (low platelets) purpura (ITP). Platelets are blood cells which aid is blood clotting.
  • Hemolytic anemia (a condition that breaks down red blood cells) requires a spleen removal to prevent or decrease the need for transfusion.
  • Also, hereditary (genetic) conditions that affect the shape of red blood cells, conditions known as spherocystosis, sickle cell disease or thalassemia, may require splenectomy.
  • Often patients with cancers of the cells which fight infection, known as lymphoma or certain types of leukemia, require spleen removal.
  • When the spleen gets enlarged, it sometimes removes too many platelets from your blood and has to be removed.
  • Sometimes the blood supply to the spleen becomes blocked (infarct) or the artery abnormally expands (aneurysm) and the spleen needs to be removed.

Diagnosis

An evaluation typically includes a complete blood count (CBC), a visual look at the blood cells placed on a glass slide called a smear, and often a bone marrow examination. Sometimes an ultrasound examination of spleen or a computerized tomography (CT scan) is needed to know the underlying cause.

Complications

Long-standing inflammation of esophagus can lead to following complications

  • Esophageal Ulcer: Stomach acid can severely erode tissues in the esophagus, causing an open sore to form. The esophageal ulcer may bleed, cause pain and make swallowing difficult.
  • Esophageal Stricture/ Stenosis (Narrowing of the esophagus): Damage to cells in the lower esophagus from acid exposure leads to formation of scar tissue. The scar tissue narrows the food pathway, causing difficulty swallowing.
  • Precancerous changes to the esophagus (Barrett's esophagus): In Barrett's esophagus, the color and composition of the tissue lining the lower esophagus change. These changes are associated with an increased risk of esophageal cancer. The risk of cancer is low, but need regular endoscopy exams to look for early warning signs of esophageal cancer.
 

Prevention

Whether you're at risk of obesity, currently overweight or at a healthy weight, you can take steps to prevent unhealthy weight gain and related health problems. Not surprisingly, the steps to prevent weight gain are the same as the steps to lose weight: daily exercise, a healthy diet, and a long-term commitment to watch what you eat and drink.

  • Exercise regularly.
  • Follow a healthy-eating plan
  • Know and avoid the food traps that cause you to eat.
  • Monitor your weight regularly
  • Be consistent
 

Preparation for surgery

Our health care team members shall help you to prepare for surgery.

Pre-operative testing

in most cases, you will need some tests before your surgery. The tests routinely used include:

  • Blood tests to measure your blood counts, your risk of bleeding or infection.
  • Chest x-ray and ECG (electrocardiogram) to check your lungs and your hearts electrical system.

Immunisation:

Immunization with a vaccine to help prevent bacterial infections after the spleen is removed should be given two weeks before surgery, if possible.

Blood product Arrangement

Blood transfusion and/or blood products such as platelets are arranged depending on your condition.

Anaesthetic Assessment before Surgery:

Our expert team of Anaesthetist will ask you questions pertaining to your health and to assess your fitness for surgery. You are requested to tell them in detail about your current and past medical ailments, allergic reactions you’ve had in the past and current medicines that you are taking like blood thinning medicine. This medicine should be stopped prior to surgery to minimize the risk of bleeding during /after surgery.

Informed Consent

Informed consent is one of the most important parts of “getting ready for surgery. It is a process during which you are told about all aspects of the treatment before you give written permission to perform the surgery.

Getting ready for Surgery

Depending on the type of operation you have, there may be things you need to do to be ready for surgery:

  • Emptying your stomach and bowels (digestive tract) is important. Vomiting while under anaesthesia can be very dangerous because the vomitus could get into your lungs and cause an infection. Because of this, you will be asked to not eat or drink anything starting the night before the surgery or atleast 6 hours before surgery.
  • Laxative: You may also be asked to use a laxative or an enema to make sure your bowels are empty.
  • Shaving of Operative part: You need to have an area of your body shaved to keep hair from getting into the surgical cut (incision). The area will be cleaned before the operation to reduce the risk of infection.

Anaesthesia

Anaesthesia is the use of drugs to make the body unable to feel pain for a period of time. General anaesthesia puts you into a deep sleep for the surgery. It is often started by having you breathe into a face mask or by putting a drug into a vein in your arm. Once you are asleep, an endotracheal or ET tube is put in your throat to make it easy for you to breathe. Your heart rate, breathing rate, and blood pressure (vital signs) will be closely watched during the surgery. A doctor watches you throughout the procedure and until you wake up. They also take out the ET tube when the operation is over. You will be taken to the recovery room to be watched closely while the effects of the drugs wear off. This may take hours. People waking up from general anaesthesia often feel "out of it" for some time. Things may seem hazy or dream-like for a while. Your throat may be sore for a while from the endotracheal (ET) tube.

recovery from surgery

Pain

You may feel pain at the site of surgery. We aim to keep you pain free after surgery with the help of latest and most effective technique or analgesic (pain relieving medicine).

Eating and Drinking

You will be allowed orally liquids once you recover from effect of anaesthesia medicine and you don't have nausea or vomiting. Gradually you can add soft to normal diet.

Activity

Our health care team will try to have you move around as soon as possible after surgery. You are encouraged to get out of bed and walk the same day. While this may be hard at first, it helps speed your recovery. It also helps your circulation and helps prevent blood clots from forming in your legs.

Going home

Once you are eating and walking, and then you are ready to go home, in most case in next day following surgery. Before leaving for home our health care team shall give you detailed guidance regarding diet, activities, medications & further plan of treatment

Risks and Side effects of SUrgery

There are risks that go with any type of medical procedure and surgery is no longer an exception. Success of surgery depends upon 3 factors: type of disease/surgery, experience of surgeon and overall health of patients. What's important is whether the expected benefits outweigh the possible risks.

Complications in major surgical procedures include:

Complications related to Anaesthesia: Reactions to drugs used (anesthesia) or other medicines. Although rare, these can be serious because they can cause dangerously low blood pressures.

Complications related to underlying medical illness like heart disease, diabetes, kidney disease, obesity, malnutrition.

Complications related to Specific Operations:

    • Possible complications may include cannula site infections, pneumonia, internal bleeding or infection inside the abdomen at the site where the spleen used to be, although these complications are infrequent.
    • Laxative: You may also be asked to use a laxative or an enema
    • Injury to the stomach, pancrease or internal organs.
    • You are encouraged with discuss in detail with our health care team before you give your consent for surgery. 
    • Complications related to Specific Operations:

Conversion to open surgery: In a small number of patients the laparoscopic method is not feasible because of the inability to visualize or handle the organs (appendix) effectively. Factors that may increase the possibility of converting to the open procedure may include perforated & densely adherent appendix to nearby organ, obesity, a history of prior abdominal surgery causing dense scar tissue, or bleeding problems during the operation. The decision to convert to an open procedure is strictly based on patient safety.

Side effect of Surgery: Most people who have their spleens removed have no clinical side effects. Only few may have following condition. They are advised to inform about spleen surgery to their family doctor when they consult for any medical aliments.

Overwhelming Post-Splenectomy Infection (OPSI): There are certain bacterial infections that people are more susceptible to after a splenectomy. This is particularly important in younger patients, and it is important to seek medical attention early if any infection develops. The incidence of these bacterial infections overall is uncommon.

  • Preoperative vaccinations against the bacteria are normally administered to help decrease this incidence. It may be given after surgery if emergency surgery was done.
  • Antibiotics, like penicillin, is given after surgery for some time to prevent infection.
  • Don't neglect if have fever after surgery. Report to your to family doctor and tell him that your spleen has been removed. So he give you proper treatment.

Thrombocytosis: The platelet count can also rise after splenectomy and should be monitored. Patients occasionally have to take aspirin products to help reduce the function of platelets.

Life after Surgery

Nutrition

Our health care team shall advise you in detail regarding dietary habits, Briefly, your diet begins with liquids followed by gradual advance to solid foods.

Exercise

Patients are encouraged to engage in light activity while at home. You will be able to get back to your normal activities within a short amount of time (week).

Follow up

You may be advised to see our health care team after 1 week to assess your progress and to address your problems.

Obesity is a complex disease involving an excessive amount of body fat. Obesity isn't just a cosmetic concern. It is a medical problem that increases your risk of other diseases and health problems, such as heart disease, diabetes, high blood pressure and certain cancers.

There are many reasons why some people have difficulty avoiding obesity. Usually, obesity results from a combination of inherited factors, combined with the environment and personal diet and exercise choices.

The good news is that even modest weight loss can improve or prevent the health problems associated with obesity. Dietary changes, increased physical activity and behavior changes can help you lose weight. Prescription medications and weight-loss procedures are additional options for treating obesity.

Causes

Although there are genetic, behavioral, metabolic and hormonal influences on body weight, obesity occurs when you take in more calories than you burn through exercise and normal daily activities. Your body stores these excess calories as fat.

When most of the diets are too high in calories & often from fast food and high-calorie beverages. People with obesity might eat more calories before feeling full, feel hungry sooner, or eat more due to stress or anxiety.

Symptoms

Obesity is diagnosed when your body mass index (BMI) is 30 or higher. To determine your body mass index, divide your weight in pounds by your height in inches squared and multiply by 703. Or divide your weight in kilograms by your height in meters squared.

BMI Weight status
Below 18.5 Underweight
18.5-24.9 Normal
25.0-29.9 Overweight
30.0 and higher Obesity

For most people, BMI provides a reasonable estimate of body fat. However, BMI doesn't directly measure body fat, so some people, such as muscular athletes, may have a BMI in the obesity category even though they don't have excess body fat.

Risks

Obesity usually results from a combination of causes and contributing factors:

  • Family inheritance and influences
  • Lifestyle choices
  • Certain diseases and medications
  • Social and economic issues
  • Age
  • Other factors (Pregnancy, Quitting smoking, Lack of sleep, Stress, Microbiome, Previous attempts to lose weight etc)

Even if you have one or more of these risk factors, it doesn't mean that you're destined to develop obesity. You can counteract most risk factors through diet, physical activity and exercise, and behavior changes.

Prevention

Whether you're at risk of obesity, currently overweight or at a healthy weight, you can take steps to prevent unhealthy weight gain and related health problems. Not surprisingly, the steps to prevent weight gain are the same as the steps to lose weight: daily exercise, a healthy diet, and a long-term commitment to watch what you eat and drink.

  • Exercise regularly.
  • Follow a healthy-eating plan
  • Know and avoid the food traps that cause you to eat.
  • Monitor your weight regularly
  • Be consistent

When to see a doctor

If you're concerned about weight-related health problems, you have come at the right place Request a Callback to discuss about obesity management. We can evaluate your health risks and discuss your weight-loss options.

How we can HELP

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Types of Weight Loss Surgery

Bariatric Surgery / Weight Loss Surgeries / Obesity Surgeries.

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  • Roux-en Y Gastric Bypass Surgery

  • Gastric Balloon Surgery

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  • Single Incision Sleeve Gastrectomy

  • Adjustable Gastric Banding Surgery

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  • Duodenal Switch (DS) & Duodeno-Jejunostomy (DJB)

  • Revisional Bariatric Surgery

Why Surgery ?

Benefits of Bariatric Surgery and Why you sould choose it.

Bariatric/weight loss surgery is the only valid treatment option that leads to sustained weight loss in patients suffering from clinically severe obesity. Most people who suffer from obesity have usually tried all methods to lose weight without success before they consider surgery.

Bariatric surgery is recommended for people who are suffering from morbid obesity (if they are more than 30 to 35 kg above their ideal body weight). Bariatric surgery is also a very good treatment option for obese people who suffer from type 2 diabetes mellitus. Surgery leads to significant improvement in diseases associated with obesity such as- diabetes, high blood pressure, dyslipidemia, knee joint pains, PCOD, obstructive sleep apnoea, fatty liver disease, infertility and so on.

Bariatric surgery is the only way people can lose massive amount of weight. It is also easier to maintain the weight loss after surgery than after any other method of losing weight. Surgery also leads to a significant improvement in the quality of life of these patients.

On a daily basis, we see patients who put in their heart and soul into their efforts to lose weight. They have been to every weight loss clinic, celebrity dieticians, gyms, yoga gurus and weight loss retreats. Unfortunately, more often than not, they meet with disappointment and tend to yo-yo between weight loss and weight gain. This entire process is extremely disheartening and demotivating for the patients.

So, if you have tried hard to lose weight without success and the weight is bearing you down, you have come to the right place because bariatric surgery is the only way at the moment that can lead to sustained weight loss in patients suffering from morbid obesity.

Frequently Asked Questions

  1. How much weight can I lose after bariatric surgery and how much time does it take?

    Bariatric surgery leads to about 65 to 75% excess weight loss. Excess weight is calculated as actual weight minus ideal body weight. It takes about 12 to 18 months to lose this weight. Weight loss is very quick in the first 6 months and then it tends to slow down.

  2. Obesity is a chronic progressive disease. Diet and lifestyle modification are an integral part of management of obesity. Patients who embrace the diet and lifestyle modification after surgery tend to get better results. Some degree of weight regain is expected in the long term but it can be controlled if the patient is following a healthy lifestyle.

  3. After bariatric surgery, patients need to be on a liquid diet for about 15 days. This is followed by a phase of semi-solid or soft diet for another 15 days. After a month, most patients are able to have normal food, albeit in limited quantity. Initially the intake is very low but over a period of time, patients are able to eat better. It is also advised to have nutritional supplements in the form of protein supplement, iron, calcium and multivitamins. These will be advised by your doctor based upon your reports as well as the type of surgery.

  4. The cost of bariatric surgery depends on the type of surgery and the room category that you choose. At the moment insurance companies do not cover it routinely but evaluate on case to case basis. There is also an option of medical loan through which patients can get the facility of paying for the surgery in monthly EMIs.

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  • Roux-en Y Gastric Bypass Surgery

  • Gastric Balloon Surgery

  • Gastric Sleeve Surgery OR Sleeve Gastrectomy

  • Single Incision Sleeve Gastrectomy

  • Adjustable Gastric Banding Surgery

  • c

  • Duodenal Switch (DS) & Duodeno-Jejunostomy (DJB)

  • Revisional Bariatric Surgery

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Obesity is one of the biggest health problems in the world.

It’s associated with several related conditions, collectively known as metabolic syndrome. These include high blood pressure, elevated blood sugar and a poor blood lipid profile.

People with metabolic syndrome are at a much higher risk of heart disease and type 2 diabetes, compared to those whose weight is in a normal range.

Over the past decades, much research has focused on the causes of obesity and how it could be prevented or treated.

Many people seem to think that weight gain and obesity are caused by a lack of willpower.

That’s not entirely true. Although weight gain is largely a result of eating behavior and lifestyle, some people are at a disadvantage when it comes to controlling their eating habits.

The thing is, overeating is driven by various biological factors like genetics and hormones. Certain people are simply predisposed to gaining weight ( 1 Trusted Source ).

Of course, people can overcome their genetic disadvantages by changing their lifestyle and behavior. Lifestyle changes require willpower, dedication and perseverance.

Nevertheless, claims that behavior is purely a function of willpower is far too simplistic.

They don’t take into account all the other factors that ultimately determine what people do and when they do it.

Here are 10 factors that are leading causes of weight gain, obesity and metabolic disease, many of which have nothing to do with willpower.

Obesity has a strong genetic component. Children of obese parents are much more likely to become obese than children of lean parents.

That doesn’t mean that obesity is completely predetermined. What you eat can have a major effect on which genes are expressed and which are not.

Non-industrialized societies rapidly become obese when they start eating a typical Western diet. Their genes didn’t change, but the environment and the signals they sent to their genes did.

Put simply, genetic components do affect your susceptibility to gaining weight. Studies on identical twins demonstrate this very well ( 2 Trusted Source ).

Summary Some people appear to be genetically susceptible to weight gain and obesity.

Heavily processed foods are often little more than refined ingredients mixed with additives.

These products are designed to be cheap, last long on the shelf and taste so incredibly good that they are hard to resist.

By making foods as tasty as possible, food manufacturers are trying to increase sales. But they also promote overeating.

Most processed foods today don’t resemble whole foods at all. These are highly engineered products, designed to get people hooked.

Summary Stores are filled with processed foods that are hard to resist. These products also promote overeating.

Many sugar-sweetened, high-fat junk foods stimulate the reward centers in your brain ( 3, 4 Trusted Source ).

In fact, these foods are often compared to commonly abused drugs like alcohol, cocaine, nicotine and cannabis.

Junk foods can cause addiction in susceptible individuals. These people lose control over their eating behavior, similar to people struggling with alcohol addiction losing control over their drinking behavior.

Addiction is a complex issue that can be very difficult to overcome. When you become addicted to something, you lose your freedom of choice and the biochemistry in your brain starts calling the shots for you.

Summary Some people experience strong food cravings or addiction. This especially applies to sugar-sweetened, high-fat junk foods which stimulate the reward centers in the brain.

Junk food producers are very aggressive marketers.

Their tactics can get unethical at times and they sometimes try to market very unhealthy products as healthy foods.

These companies also make misleading claims. What’s worse, they target their marketing specifically towards children.

In today’s world, children are becoming obese, diabetic and addicted to junk foods long before they’re old enough to make informed decisions about these things.

Summary Food producers spend a lot of money marketing junk food, sometimes specifically targeting children, who don’t have the knowledge and experience to realize they are being misled.

Insulin is a very important hormone that regulates energy storage, among other things.

One of its functions is to tell fat cells to store fat and to hold on to the fat they already carry.

The Western diet promotes insulin resistance in many overweight and obese individuals. This elevates insulin levels all over the body, causing energy to get stored in fat cells instead of being available for use ( 5 Trusted Source ).

While insulin’s role in obesity is controversial, several studies suggest that high insulin levels have a causal role in the development of obesity ( 6 Trusted Source ).

One of the best ways to lower your insulin is to cut back on simple or refined carbohydrates while increasing fiber intake ( 7 Trusted Source ).

This usually leads to an automatic reduction in calorie intake and effortless weight loss — no calorie counting or portion control needed ( 8 Trusted Source , 9 Trusted Source ).

Summary High insulin levels and insulin resistance are linked to the development of obesity. To lower insulin levels, reduce your intake of refined carbs and eat more fiber.

Many pharmaceutical drugs can cause weight gain as a side effect ( 10 Trusted Source ).

For example, antidepressants have been linked to modest weight gain over time ( 11 Trusted Source ).

Other examples include diabetes medication and antipsychotics ( 12 Trusted Source , 13 Trusted Source ).

These drugs don’t decrease your willpower. They alter the function of your body and brain, reducing metabolic rate or increasing appetite ( 14 Trusted Source , 15 Trusted Source ).

Summary Some medications may promote weight gain by reducing the number of calories burned or increasing appetite.

Leptin is another hormone that plays an important role in obesity.

It is produced by fat cells and its blood levels increase with higher fat mass. For this reason, leptin levels are especially high in people with obesity.

In healthy people, high leptin levels are linked to reduced appetite. When working properly, it should tell your brain how high your fat stores are.

The problem is that leptin isn’t working as it should in many obese people, because for some reason it cannot cross the blood-brain barrier ( 16 Trusted Source ).

This condition is called leptin resistance and is believed to be a leading factor in the pathogenesis of obesity.

Summary Leptin, an appetite-reducing hormone, doesn’t work in many obese individuals.

Another factor that dramatically influences people’s waistline is food availability, which has increased massively in the past few centuries.

Food, especially junk food, is everywhere now. Shops display tempting foods where they are most likely to gain your attention.

Another problem is that junk food is often cheaper than healthy, whole foods, especially in America.

Some people, especially in poorer neighborhoods, don’t even have the option of purchasing real foods, like fresh fruit and vegetables.

Convenience stores in these areas only sell sodas, candy and processed, packaged junk foods.

How can it be a matter of choice if there is none?

Summary In some areas, finding fresh, whole foods may be difficult or expensive, leaving people no choice but to buy unhealthy junk foods.

Added sugar may be the single worst aspect of the modern diet.

That’s because sugar changes the hormones and biochemistry of your body when consumed in excess. This, in turn, contributes to weight gain.

Added sugar is half glucose, half fructose. People get glucose from a variety of foods, including starches, but the majority of fructose comes from added sugar.

Excess fructose intake may cause insulin resistance and elevated insulin levels. It also doesn’t promote satiety in the same way glucose does ( 17 Trusted Source , 18 Trusted Source , 19 Trusted Source ).

For all these reasons, sugar contributes to increased energy storage and, ultimately, obesity.

Summary Scientists believe that excessive sugar intake may be one of the main causes of obesity.

People all over the world are being misinformed about health and nutrition.

There are many reasons for this, but the problem largely depends on where people get their information from.

Many websites, for example, spread inaccurate or even incorrect information about health and nutrition.

Some news outlets also oversimplify or misinterpret the results of scientific studies and the results are frequently taken out of context.

Other information may simply be outdated or based on theories that have never been fully proven.

Food companies also play a role. Some promote products, such as weight loss supplements, that do not work.

Weight loss strategies based on false information can hold back your progress. It’s important to choose your sources well.

Summary Misinformation may contribute to weight gain in some people. It can also make weight loss more difficult.

If you have concerns about your waistline, you should not use this article as an excuse to give up.

While you can’t fully control the way your body works, you can learn how to control your eating habits and change your lifestyle.

Unless there is some medical condition getting in your way, it is within your power to control your weight.

It often takes hard work and a drastic lifestyle change, but many people do succeed in the long run despite having the odds stacked against them.

The point of this article is to open people’s minds to the fact that something other than individual responsibility plays a role in the obesity epidemic.

The fact is that modern eating habits and food culture must be changed to be able to reverse this problem on a global scale.

The idea that it is all caused by a lack of willpower is exactly what food producers want you to believe, so they can continue their marketing in peace.

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