The spleen (Latin: Lien, Greek: Splen) is a large abdominal organ that belongs to the so-called "lymphatic system". It is located in the left upper abdomen near the stomach and pancreas and has three main functions:

- Maturation of special white blood cells (lymphocytes) to defend against foreign substances

- Storage location for other special white blood cells (monocytes)

- Filtration and breakdown of superannuated red blood cells



Before birth (late fetal development), the spleen also plays a role in the formation of blood cells.

Splenomegaly is an acute or chronic enlargement of the spleen. It is not an independent disease but only a symptom of another underlying disease. Splenomegaly can have a variety of causes, including infectious diseases (e.g. mononucleosis) or blood diseases (e.g. spherocytosis, sickle cell anemia, thalassemia, leukemia). If the spleen has increased significantly in size due to an illness, this can cause hyperfunction (a so-called hypersplenism syndrome), which leads to the spleen storing too many red blood cells or platelets and breaking them down so that there are too few of them in the blood over time. The spleen may then have to be removed.

The spleen can also be severely injured in accidents and bleed so much that the surgeon may have to perform emergency removal of the spleen in individual cases.

The surgical procedure in spleen surgery is very diverse. In principle, it is possible to remove the spleen completely (total splenectomy) or only part of it (subtotal splenectomy). Today, these procedures can be performed minimally invasively (laparoscopically), but depending on the underlying disease or the size of the spleen, spleen removal via open surgery may also be appropriate.

The first contact is usually made through an outpatient information meeting in our pediatric surgery outpatient clinic (see below for contact details). Please bring all existing examination results (e.g. ultrasound findings or reports from a specialized paediatrician (haematologist)) with you to the first outpatient information meeting

The treatment options will be presented and your questions discussed in detail during the first meeting. The ultrasound examination usually provides a good and reliable calculation of the size of the spleen (in cm and ml). In individual cases, so-called cross-sectional imaging (computer tomography or magnetic resonance imaging) can provide additional information. Imaging is primarily used by the pediatric surgeon to assess which surgical procedure (open or laparoscopic) is most suitable for your child.

We will then consult the appropriate specialized paediatrician at the MHH (e.g. haematologist or a physician who deals with metabolic diseases) to carefully examine the indication for surgery. We would like to discuss the need for splenectomy in a team (interdisciplinary) in order to operate only on those children for whom splenectomy is really necessary.

If there is an indication for splenectomy, we offer the following operations:


-total removal of the spleen (laparoscopic and open)

-partial removal of the spleen (laparoscopic and open)


We will discuss which procedure is best in each individual case (for your child) with you before the operation.


Splenectomy with three trocars ("multitrocar splenectomy")

The pediatric surgeon makes a small incision at the navel through which a thin tube (trocar) is inserted into the abdominal cavity. Air is blown into the abdominal cavity through the trocar and a camera is inserted (laparoscopy). This allows the entire abdomen to be inspected. Two or three further small (0.3 cm) incisions are then made in the abdominal wall under visualization and further working channels (trocars) are inserted into the abdomen. The spleen is located and the blood vessels supplying it are "boiled" with an electric hook or severed with a mechanical stapler. Finally, the spleen or part of the spleen is removed. The separated spleen is first placed in a plastic bag specially designed for this operation in the abdominal cavity and then removed directly via the trocar at the navel. The skin incision at the navel and the small skin incisions are then closed again.


Splenectomy via a single access at the navel
(synonyms: "Single-incision splenectomy", SILS, "single-port splenectomy")

In this surgical method, the pediatric surgeon inserts a special trocar (so-called "SILS-port") into the abdomen via the navel. The SILS port consists of a flexible rubber sleeve with 3 openings for inserting the laparoscopic instruments. The principle of splenectomy is the same as for splenectomy with three trocars, with the only difference that the additional trocars or skin incisions are omitted. As "only" the incision in the center of the navel is visible after the operation, some authors refer to this method as "scarless" surgery. Strictly speaking, a scar still remains, but it is usually cosmetically less prominent or more visible than with a splenectomy with three trocars.

Both procedures are performed in our Clinical Department with a high level of patient satisfaction. We will discuss which procedure is most suitable for your child with you before the operation as part of the detailed surgical consultation.

After the procedure, your child will initially remain in the recovery area, where you will be able to sit up in bed again. You will then be transferred to the normal ward. A few hours after the operation, your child will usually be able to eat again. After an uncomplicated splenectomy, an inpatient stay of 2-4 days in hospital is usually sufficient.

As a rule, you will not be seen again for a follow-up examination by us, but by the colleagues who referred you to us for surgery. However, if you still have questions regarding the operation itself or if we consider an earlier follow-up examination with us to be appropriate in individual cases, you can arrange an outpatient appointment at any time.