SPLENECTOMY (LAPAROSCOPIC/OPEN)
AN OPERATION TO REMOVE THE SPLEEN.

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.
If you experience any worrisome problems, please contact the rooms during working hours or the emergency number (012) 333 6000 after hours.

Other procedures performed by Dr Jeske

ABSCESS DRAINAGE
ABSCESS DRAINAGE

A SKIN INCISION IS MADE AND THE CONTENTS OF THE ABSCESS IS DRAINED.

ADRENALECTOMY (OPEN/LAPAROSCOPIC)
ADRENALECTOMY (OPEN/LAPAROSCOPIC)

AN OPERATION TO REMOVE ONE (OR BOTH) ADRENAL GLANDS.

ANAL FISTULECTOMY
ANAL FISTULECTOMY

THE FISTULA TRACT IS IDENTIFIED AND IS OPENED ALONG ITS LENGTH, AND THE EXPOSED INSIDE OF THE TRACT IS THEN CLEANED OUT.

APPENDISECTOMY (LAPAROSCOPIC/OPEN)
APPENDISECTOMY (LAPAROSCOPIC/OPEN)

AN OPERATION TO REMOVE AN APPENDIX THAT IS INFLAMED/SWOLLEN/HAS RUPTURED/HAS FORMED AN ABSCESS.

BILE DUCT EXPLORATION
BILE DUCT EXPLORATION

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.

COLECTOMY
COLECTOMY

AN OPERATION TO REMOVE PART OF/THE ENTIRE COLON.

COLONOSCOPY
COLONOSCOPY

AN ENDOSCOPIC EXAMINATION OF THE LARGE INTESTINE (COLON & RECTUM).

DISTAL PANCREATECTOMY
DISTAL PANCREATECTOMY

THE PANCREAS IS EXPOSED AND FREED FROM THE ADJACENT ORGANS. THE TAIL (DISTAL) HALF OF THE PANCREAS IS REMOVED. THE BLOOD VESSELS THAT GO TO THE SPLEEN PASS THROUGH THE PANCREAS. AS A RESULT THE SPLEEN ALSO SOMETIMES NEEDS TO BE REMOVED.

DRAINAGE PERI-ANAL ABSCESS
DRAINAGE PERI-ANAL ABSCESS

AN INCISION IN THE SKIN NEXT TO THE ANUS TO DRAIN PUS.

ERCP
ERCP

ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY, INVOLVES PASSING A FLEXIBLE ENDOSCOPE (DUODENOSCOPE) THROUGH THE MOUTH AND STOMACH TO THE FIRST PART OF THE BOWEL CALLED THE DUODENUM.

FEMORAL HERNIA REPAIR (OPEN)
FEMORAL HERNIA REPAIR (OPEN)

AN OPERATION TO REPAIR AN AREA OF WEAKNESS IN THE MUSCLES WHICH FORM THE LOWER FRONT OF THE STOMACH (IN THE GROIN REGION).

GASTROSCOPY
GASTROSCOPY

AN ENDOSCOPIC EXAMINATION OF THE STOMACH.

HAEMORRHOIDECTOMY
HAEMORRHOIDECTOMY

AN OPERATION TO REMOVE COMPLICATED HAEMORRHOIDS (PILES).

INCISIONAL HERNIA REPAIR (LAPAROSCOPIC/OPEN)
INCISIONAL HERNIA REPAIR (LAPAROSCOPIC/OPEN)

AN OPERATION TO REPAIR AN AREA OF WEAKNESS IN AN AREA WHERE PREVIOUS MUSCLE CLOSURE HAS BEEN PERFORMED (AFTER AN ABDOMINAL OPERATION).

INGUINAL HERNIA REPAIR (OPEN/LAPAROSCOPIC)
INGUINAL HERNIA REPAIR (OPEN/LAPAROSCOPIC)

AN OPERATION TO REPAIR AN AREA OF WEAKNESS IN THE MUSCLES WHICH FORM THE LOWER FRONT OF THE STOMACH (IN THE GROIN REGION).

LAPAROSCOPIC CHOLECYSTECTOMY (GALL STONES)
LAPAROSCOPIC CHOLECYSTECTOMY (GALL STONES)

REMOVAL OF GALLBLADDER BY MEANS OF MINIMALLY INVASIVE “KEY-HOLE SURGERY”.

LIVER BIOPSY
LIVER BIOPSY

THE DOCTOR WILL TAKE A VERY SMALL PIECE OF YOUR LIVER (ABOUT 1/50,000TH OF YOUR LIVER) TO SEND FOR FURTHER TESTS.

LIVER RESECTION
LIVER RESECTION

THE SURGICAL REMOVAL OF PART OF THE LIVER.

PERCUTANEOUS ENDOSCOPIC GASTROSTOMY
PERCUTANEOUS ENDOSCOPIC GASTROSTOMY

A PEG IS A WAY OF INTRODUCING FOOD, FLUIDS AND MEDICINES DIRECTLY INTO THE STOMACH BY PASSING A THIN TUBE THROUGH THE SKIN AND INTO THE STOMACH.

PILONIDAL ABSCESS/SINUS EXCISION
PILONIDAL ABSCESS/SINUS EXCISION

AN ELLIPTICAL INCISION IS MADE REMOVING THE AFFECTED SKIN AND INVOLVED TISSUE OVER THE BUTTOCK CLEFT.

SMALL BOWEL RESECTION
SMALL BOWEL RESECTION

SURGERY TO REMOVE A PART OF YOUR SMALL BOWEL.

SPLENECTOMY (LAPAROSCOPIC/OPEN)
SPLENECTOMY (LAPAROSCOPIC/OPEN)

AN OPERATION TO REMOVE THE SPLEEN.

STOMA CREATION/CLOSURE
STOMA CREATION/CLOSURE

A STOMA IS AN OPENING ANYWHERE ALONG THE LENGTH OF THE BOWEL TO THE EXTERIOR SKIN SURFACE TO CREATE AN ARTIFICIAL ANUS.

TOTAL PANCREATECTOMY
TOTAL PANCREATECTOMY

REMOVING YOUR WHOLE PANCREAS, YOUR DUODENUM, A SMALL PORTION OF YOUR STOMACH, THE GALLBLADDER AND PART OF YOUR BILE DUCT, YOUR SPLEEN AND MANY OF THE SURROUNDING LYMPH NODES.

UMBILICAL HERNIA REPAIR (OPEN)
UMBILICAL HERNIA REPAIR (OPEN)

AN OPERATION TO REPAIR AN AREA OF WEAKNESS/SWELLING OF THE NAVEL (BELLY BUTTON).

WHIPPLE’S (PANCREATICODUODENECTOMY)
WHIPPLE’S (PANCREATICODUODENECTOMY)

THIS IS A MAJOR OPERATION TO REMOVE THE HEAD OF THE PANCREAS.