What Is a Splenectomy?

Taking out a whole organ sounds drastic, so it helps to know this operation is never a first resort. A splenectomy is the surgical removal of the spleen — in most cases the whole organ, occasionally just part of it. The spleen sits tucked under the ribs on the upper left side of your abdomen, about the size of a fist, and it spends its working life filtering your blood: pulling out worn-out blood cells and helping your immune system deal with certain bacteria. You can live without it — other organs pick up much of that work — but the decision to remove it is always a weighed one, and the steps below show how that decision usually unfolds.

The video at the top of this page, "Open Splenectomy HD Surgery Video", runs for just over three minutes and records the open form of the operation, in which the surgeon works through a single incision in the upper abdomen. Its own summary puts the definition plainly: splenectomy is a surgical procedure that partially or completely removes the spleen. Watching it first makes the steps that follow much easier to picture.

Step one: work out why the spleen has become the problem

Sometimes the reason is sudden. A spleen injured in a fall or a road accident can tear and bleed inside the abdomen, and if that bleeding can't be controlled another way, removing the organ is the safest option. Another video on this site, "When Is Spleen Removal Necessary?", walks through exactly that side of the question — a spleen damaged by injury, an enlarged spleen, or a spleen that has ruptured after trauma.

More often, the decision is planned rather than urgent. A spleen can become overactive and start destroying healthy blood cells too quickly, contributing to problems such as anaemia. It can swell as part of other illnesses, and it plays a central role in sickle cell disease, where it can trap blood cells during a crisis. In a smaller number of cases, tumours involving the spleen or nearby organs are the reason. The common thread is that the spleen itself — not just the illness behind it — has become a source of risk, and the team judges that risk to be greater than the risk of managing without the organ.

Step two: choose the route in — open or keyhole

There are two established ways to reach the spleen, and the choice shapes your recovery more than almost anything else. In an open splenectomy — the approach in the video above — the surgeon makes one larger incision in the upper abdomen and removes the spleen directly. This route is often chosen when the spleen is very enlarged, when the operation follows an injury, or when the surgeon needs the clearest possible access.

In a laparoscopic, or keyhole, splenectomy, the surgeon works through several small incisions with a camera and long instruments, and the spleen is taken out through one of those small openings. Smaller wounds generally mean an easier early recovery, but keyhole surgery isn't suitable for every spleen or every situation, and a planned keyhole operation can be converted to an open one if the surgeon finds that safer once inside. Which route fits you is a judgement your team makes from your scans, your size of spleen, and the reason for operating — it's worth asking them to explain the choice in your own case.

Step three: the operation itself, in plain terms

Whichever route is used, the core of the operation is the same, and it happens under a general anaesthetic, so you'll be fully asleep. The surgeon frees the spleen from the tissues that hold it in place in the upper left abdomen, carefully seals the blood vessels that supply it — the spleen holds a lot of blood, so this step is done with particular care — and lifts the organ out. In a partial splenectomy, only the diseased or damaged portion is removed and the rest is left in place, which is sometimes possible when the problem affects just one area.

The removed tissue is typically sent to a laboratory for examination, which can confirm the underlying diagnosis. Afterwards you'll wake up in a recovery area, usually with a drip and pain relief arranged, and the team will watch your blood counts and your wound or wounds over the following days. How long you stay in hospital depends on the route used and on how the operation went, and your team will tell you what to expect for lifting, driving and work as you heal.

Step four: adjust to life without a spleen

Most people are surprised by how ordinary life feels afterwards. Your liver and the rest of your immune system take over much of the spleen's filtering work, and day to day, most people notice nothing missing. The one lasting change is subtler: without a spleen, your defence against certain bacterial infections is weaker, and that increased risk doesn't fade with time.

That is why the aftercare conversation matters as much as the operation. Teams typically discuss vaccination with splenectomy patients — our overview of how vaccines work explains the principle behind that protection — and some people are advised to keep antibiotics at home or to carry information explaining that they have no spleen, so any clinician treating them knows. The consistent message you will hear is to take fevers seriously and seek medical care promptly rather than waiting one out. None of this is meant to alarm; it's a short list of habits that lets most people get on with life as normal, just with a lower threshold for getting a fever checked.

References & further reading

• MedlinePlus — Spleen removal (Medical Encyclopedia): https://medlineplus.gov/ency/article/002944.htm
• MedlinePlus — Spleen Diseases: https://medlineplus.gov/spleendiseases.html
• NHS — Spleen problems and spleen removal: https://www.nhs.uk/tests-and-treatments/spleen-problems-and-spleen-removal/
• Johns Hopkins Medicine — Splenectomy: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/splenectomy

Frequently Asked Questions

Can you live a normal life without a spleen?

Yes — most people do. The liver and other parts of the immune system take over much of the spleen's filtering work. The main lifelong difference is a higher risk from certain bacterial infections, which is why vaccination, prompt attention to fevers, and letting clinicians know you have no spleen become standing habits.

What is the difference between a total and a partial splenectomy?

A total splenectomy removes the whole spleen, which is the usual operation. A partial splenectomy removes only the affected portion and leaves the rest in place, preserving some of its function; it is only suitable when the problem is limited to one area, and your team will say whether it is an option in your case.

Is keyhole splenectomy always better than open surgery?

Not always. Keyhole surgery uses smaller incisions and often makes the early recovery easier, but a very enlarged spleen, an emergency after injury, or difficult access can make the open operation the safer choice. The right route depends on your spleen and your situation, not on a general rule.

Will I need vaccinations after a splenectomy?

Vaccination is a standard part of care after spleen removal, because the spleen helps fight certain bacteria and vaccines support the protection that remains. Which vaccines and when they are given is something your own team will schedule for you, sometimes starting before a planned operation.

MedicalVideos.com has published trusted medical videos since 2007. The site was founded by Dr. Mohamed Ibrahim, MD, PhD — physician-scientist.

Educational only — this article is general information about splenectomy, not medical advice and not a diagnosis. Whether this operation, or any treatment, is right for you is a matter for your own care team, who know your results and your history.