Indications:
- Splenic cysts/abscesses/tumours
- Spleen damaged as a result of certain auto-immune diseases
- Enlarged spleen/”Wandering spleen”
- Traumatic injury to and/or spontaneous rupture of the spleen.
Procedure:
A laparoscope is inserted through a small (1 cm) incision above the belly button. Four other similar incisions are made to insert the necessary instruments for the operation and to remove the spleen. The spleen is attached to the stomach, colon, pancreas and diaphragm, and must be dissected free. In a small number of patients ( 10%) it may not be possible to operate via the laparoscope due to adhesions from previous operations, bleeding obscuring vision, awkward fatty tissue or other technical problems. It will then be necessary to revert to the open operation, where a cut is made below the ribs on the left side.
- The main surgical complication is significant bleeding. This occurs in less than 5% of patients. This can be life threatening and may require urgent repeat surgery.
- Other risks include bowel or splenic injury, bleeding, pancreatitis, delayed return of bowel function, wound infection, deep vein thrombosis, pulmonary emboli (blood clot that blocks an artery in the lungs), collapse of a lung, pneumonia.
- Late complications may occur such as a persistent wound pain or a hernia at the site of the wound.
After your consultation:
- Obtain authorization from your medical aid and book your bed for your hospital admission.
- Carefully read through pre-operative information provided.
Day before surgery:
- Do not eat/drink after 22h00, the night before your surgery, unless otherwise specified by your surgeon or anaesthetist (you should be fasting for at least 6 hours before the procedure for solids but you are allowed to take clear liquids up to two hours before your procedure).
Day of surgery:
- Arrive for admission at indicated time on ‘Code & Consent’ sheet.
- Change into theatre attire, remove all valuable belongings.
Approximately 2 hours
Duration of hospital stay:
- 3-5 days (dependent on pain management, general state of patient and first bowel movement).
Activities:
- Refrain from strenuous activities (incl. exercise) for at least 2-4 weeks post-operatively.
Back to work:
Sick leave required post-operatively is approximately 10-14 days.
Some pain and discomfort post operatively may be expected following any operation, but the following measures are used to lessen the pain experienced:
- Warming devises in theatre as well as warm intravenous fluids.
- Intra-operative pain medication through the drip.
- Post-operative medication through the drip, please inform the nurses if you are in pain so that medication will be administered to you.
- As close to one week after discharge as possible. Please contact the rooms to schedule an appointment.
More procedures performed by Dr Jeske
A SKIN INCISION IS MADE AND THE CONTENTS OF THE ABSCESS IS DRAINED.
THE FISTULA TRACT IS IDENTIFIED AND IS OPENED ALONG ITS LENGTH, AND THE EXPOSED INSIDE OF THE TRACT IS THEN CLEANED OUT.
AN OPERATION TO REMOVE AN APPENDIX THAT IS INFLAMED/SWOLLEN/HAS RUPTURED/HAS FORMED AN ABSCESS.
THE COMMON BILE DUCT (CBD – THE MAIN TUBE CARRYING BILE FROM THE LIVER TO THE INTESTINE) IS OPENED UP. ANY GALLSTONES WITHIN THE DUCT CAUSING A BLOCKAGE CAN BE REMOVED.
PTC is a procedure performed by a radiologist (specialist X-ray doctor) who takes X-ray pictures of the bile ducts which are tubes inside the liver.
