SlideShare a Scribd company logo
1 of 14
REASONS FOR REMOVAL OF SPLEEN

SPLENIC MASSES
BENIGN (HEMANGIOMAS)
MALIGNANT (HEMANGIOSARCOMAS)

BLOAT
GASTRIC DILATATION and VOLVULUS

TRAUMATIC RUPTURE
TOTAL SPLENECTOMY TECHNIQUE
  Incise the left paramedian or median line in
        the cranial abdominal quadrant

If large spleen (neoplasm) is observed, incision
      may reach from the xiphoid cartilage
                  to the pubis.

      Abdominal incision should be large
           enough for the spleen
             to be adequately
            be exposed and be
                  removed.
TOTAL SPLENECTOMY TECHNIQUE



 Before removing the spleen, check the surrounding
organs first for evidences of metastases. The greater
omentum must partially or totally removed (spleen is
          closely adherent to this structure)
IF NO TUMOR (CONGESTION/ TORSION)

1-2 ml of 1/1000 epinephrine solution
can be injected (slowly) in the splenic
   artery after the torsion has been
               corrected.

          Ligate the splenic
                artery
            immediately
IF THERE IS TUMOR

 Epinephrine administration is not
advice. (cause contraction of tumor
      cells to the portal veins)

   Major veins should be ligated
          immediately to
      avoid hematogenous
            metastases.
TOTAL SPLENECTOMY TECHNIQUE

 Surgeon must either ligate each vessel doubly or ligate
 the gastric side and apply hemostat to the splenic side
and some several minute vessels can be ligated together
              and mass ligation is not advice

 Splenic artery must be divided between ligatures with
gastrosplenic omentum. The smaller vessels are divided
      between ligatures starting at one end of the
         hilus and proceeding to the other. The
                 splenic vein is ligated
                           last
For total splenectomy, double ligate and transect all vessels at the
  splenic hilus. If possible, preserve the short gastric branches
                   supplying the gastric fundus.
TOTAL SPLENECTOMY TECHNIQUE

Prior to closing the abdominal incision, all
 ligatures must be properly inspected to
     avoid bleeders and hemorrhage.

After removing the ruptured spleen, other
    viscera must be inspected also for
   evidence of bleeders. If there is, it
           must be controlled.
TOTAL SPLENECTOMY TECHNIQUE
 If tumor is removed, inspect for the
   other organs that has metastatic
lesions before closing the abdominal
                cavity

     IV should be discontinued
      when the patient appear
         to have recovered
             from shock
TOTAL SPLENECTOMY TECHNIQUE
Most dogs and cats go home a day or
two after surgery. An iron supplement
  may be needed to help the body
     recover from any blood loss.
Antibiotics will likely be prescribed as
  will some sort of analgesia (pain
        relief) for the recovery
                 period.
RULE OF THE TUMB
1. PREOPERATIVE EVALUATION
2. ADMINISTRATION OF FLUIDS
   AND BLOOD
3. OXYGENATION
4. DOUBLE LIGATION
5. CONTINUES SUTURE PATTERN
6. SYNTHETIC
   MONOFILAMENT
   ABSORBABLE SUTURE
RULE OF THE TUMB
7. LIGATURES NEAR SPLEEN
8. LIGATE SEPARATELY SPLENIC
    VEIN AND ARTERY
9. MASS LIGATION FOR NEOPLASM
10. AVOID LIGATING SHORT GASTRIC
    VESSLES
Total splenectomy

More Related Content

What's hot

What's hot (20)

Incisional hernia
Incisional herniaIncisional hernia
Incisional hernia
 
Right hemicolectomy
Right hemicolectomyRight hemicolectomy
Right hemicolectomy
 
Open Pyelolithotomy
Open PyelolithotomyOpen Pyelolithotomy
Open Pyelolithotomy
 
Open appendectomy
Open appendectomyOpen appendectomy
Open appendectomy
 
Whipple's procedure - Indications, Steps, Complications
Whipple's procedure - Indications, Steps, ComplicationsWhipple's procedure - Indications, Steps, Complications
Whipple's procedure - Indications, Steps, Complications
 
gastrectomy.pptx
gastrectomy.pptxgastrectomy.pptx
gastrectomy.pptx
 
Parastomal hernia ppt
Parastomal hernia pptParastomal hernia ppt
Parastomal hernia ppt
 
Torsion testis - Operative chat
Torsion testis - Operative chatTorsion testis - Operative chat
Torsion testis - Operative chat
 
Management of duodenal trauma
Management of duodenal traumaManagement of duodenal trauma
Management of duodenal trauma
 
Open appendectomy
Open appendectomyOpen appendectomy
Open appendectomy
 
TAPP : tips,tricks & technique
TAPP : tips,tricks & techniqueTAPP : tips,tricks & technique
TAPP : tips,tricks & technique
 
Component seperation technique for the repair of very large ventral hernias
Component seperation technique for the repair of very large ventral hernias Component seperation technique for the repair of very large ventral hernias
Component seperation technique for the repair of very large ventral hernias
 
Safe laparoscopic cholecystectomy finale
Safe laparoscopic cholecystectomy finaleSafe laparoscopic cholecystectomy finale
Safe laparoscopic cholecystectomy finale
 
Open right hemicolectomy/ step by step/ operative surgery
Open right hemicolectomy/ step by step/ operative surgeryOpen right hemicolectomy/ step by step/ operative surgery
Open right hemicolectomy/ step by step/ operative surgery
 
EXTENDED TOTALLY EXTRA-PERITONEAL REPAIR {eTEP}
EXTENDED TOTALLY EXTRA-PERITONEAL REPAIR {eTEP}EXTENDED TOTALLY EXTRA-PERITONEAL REPAIR {eTEP}
EXTENDED TOTALLY EXTRA-PERITONEAL REPAIR {eTEP}
 
Surgical incisions
Surgical incisionsSurgical incisions
Surgical incisions
 
Bowel anastomosis
Bowel anastomosisBowel anastomosis
Bowel anastomosis
 
Fundoplication and heller's myotomy
Fundoplication and heller's myotomyFundoplication and heller's myotomy
Fundoplication and heller's myotomy
 
Resection & anastomosis of boweL its complications PRANAYA PPT
Resection & anastomosis of boweL its complications PRANAYA PPTResection & anastomosis of boweL its complications PRANAYA PPT
Resection & anastomosis of boweL its complications PRANAYA PPT
 
Component separation technique for a very large abdominal wall hernia
Component separation technique for a very large abdominal wall herniaComponent separation technique for a very large abdominal wall hernia
Component separation technique for a very large abdominal wall hernia
 

Viewers also liked

Spleen.. Dr.banez surgery
Spleen.. Dr.banez surgerySpleen.. Dr.banez surgery
Spleen.. Dr.banez surgery
MD Specialclass
 
Presentation1.pptx, spleen
Presentation1.pptx, spleenPresentation1.pptx, spleen
Presentation1.pptx, spleen
Abdellah Nazeer
 

Viewers also liked (20)

Splenectomy
SplenectomySplenectomy
Splenectomy
 
Laparoscopicsplenectomy
LaparoscopicsplenectomyLaparoscopicsplenectomy
Laparoscopicsplenectomy
 
pre and post operative management of paediatric Splenectomy patients
pre and post operative management of paediatric Splenectomy patientspre and post operative management of paediatric Splenectomy patients
pre and post operative management of paediatric Splenectomy patients
 
Spleen
SpleenSpleen
Spleen
 
Spleen.. Dr.banez surgery
Spleen.. Dr.banez surgerySpleen.. Dr.banez surgery
Spleen.. Dr.banez surgery
 
Spleen
SpleenSpleen
Spleen
 
Laparoscopic Splenectomy
Laparoscopic SplenectomyLaparoscopic Splenectomy
Laparoscopic Splenectomy
 
Spleen anatomy
Spleen anatomySpleen anatomy
Spleen anatomy
 
Laparoscopic splenectomy
Laparoscopic splenectomyLaparoscopic splenectomy
Laparoscopic splenectomy
 
Role of spleenectomy in itp
Role of spleenectomy in itpRole of spleenectomy in itp
Role of spleenectomy in itp
 
Indications for splenectomy
Indications for splenectomyIndications for splenectomy
Indications for splenectomy
 
ANATOMY OF SPLEEN AND IT'S APPLIED ASPECT
ANATOMY OF SPLEEN AND IT'S APPLIED ASPECTANATOMY OF SPLEEN AND IT'S APPLIED ASPECT
ANATOMY OF SPLEEN AND IT'S APPLIED ASPECT
 
Splenic Trauma by Doctor Saleem
Splenic Trauma by Doctor Saleem Splenic Trauma by Doctor Saleem
Splenic Trauma by Doctor Saleem
 
Open lateral internal sphincterotomy
Open lateral internal sphincterotomyOpen lateral internal sphincterotomy
Open lateral internal sphincterotomy
 
Diseases Of Wbc
Diseases Of WbcDiseases Of Wbc
Diseases Of Wbc
 
Post operative pain management
Post operative pain managementPost operative pain management
Post operative pain management
 
Farm structures ppt.editeddddddddd
Farm structures ppt.editedddddddddFarm structures ppt.editeddddddddd
Farm structures ppt.editeddddddddd
 
Lymphoma
LymphomaLymphoma
Lymphoma
 
Pancreatic pseudocysts
Pancreatic pseudocystsPancreatic pseudocysts
Pancreatic pseudocysts
 
Presentation1.pptx, spleen
Presentation1.pptx, spleenPresentation1.pptx, spleen
Presentation1.pptx, spleen
 

Similar to Total splenectomy

Enterocutaneous fistulas ppt
Enterocutaneous fistulas pptEnterocutaneous fistulas ppt
Enterocutaneous fistulas ppt
Prabha Om
 
Enterocutaneous fistulas ppt
Enterocutaneous fistulas pptEnterocutaneous fistulas ppt
Enterocutaneous fistulas ppt
Prabha Om
 

Similar to Total splenectomy (20)

Intestinal obstruction in small animals
Intestinal obstruction in small animalsIntestinal obstruction in small animals
Intestinal obstruction in small animals
 
Enterocutaneous fistulas ppt
Enterocutaneous fistulas pptEnterocutaneous fistulas ppt
Enterocutaneous fistulas ppt
 
Enterocutaneous fistulas ppt
Enterocutaneous fistulas pptEnterocutaneous fistulas ppt
Enterocutaneous fistulas ppt
 
LAP ANTERIOR RESECTION-STEP BY STEP Operative Surgery.pptx
LAP ANTERIOR RESECTION-STEP BY STEP Operative Surgery.pptxLAP ANTERIOR RESECTION-STEP BY STEP Operative Surgery.pptx
LAP ANTERIOR RESECTION-STEP BY STEP Operative Surgery.pptx
 
Operative steps in open appendicectomy
Operative steps in open appendicectomyOperative steps in open appendicectomy
Operative steps in open appendicectomy
 
OPEN ANTERIOR RESECTION-STEP BY STEP Operative Surgery.pptx
OPEN ANTERIOR RESECTION-STEP BY STEP Operative Surgery.pptxOPEN ANTERIOR RESECTION-STEP BY STEP Operative Surgery.pptx
OPEN ANTERIOR RESECTION-STEP BY STEP Operative Surgery.pptx
 
8 abdominal cavity surgery helpexams.ppt
8 abdominal cavity surgery helpexams.ppt8 abdominal cavity surgery helpexams.ppt
8 abdominal cavity surgery helpexams.ppt
 
Minimally invasive and endoscopic management of benign prostatic
Minimally invasive and endoscopic management of benign prostaticMinimally invasive and endoscopic management of benign prostatic
Minimally invasive and endoscopic management of benign prostatic
 
Drains-1-1.pptx
Drains-1-1.pptxDrains-1-1.pptx
Drains-1-1.pptx
 
ELECTIVE SPLENECTOMY.pptx
ELECTIVE SPLENECTOMY.pptxELECTIVE SPLENECTOMY.pptx
ELECTIVE SPLENECTOMY.pptx
 
Pres 8
Pres 8Pres 8
Pres 8
 
indication for splenectomy
indication for splenectomyindication for splenectomy
indication for splenectomy
 
Enterocutaneous fistulas
Enterocutaneous fistulasEnterocutaneous fistulas
Enterocutaneous fistulas
 
Enterocutaneous fistulas
Enterocutaneous fistulasEnterocutaneous fistulas
Enterocutaneous fistulas
 
Intravenous urogram ( Sandip Gautam )
Intravenous urogram ( Sandip Gautam )Intravenous urogram ( Sandip Gautam )
Intravenous urogram ( Sandip Gautam )
 
Ureteric injury (1)
Ureteric injury (1)Ureteric injury (1)
Ureteric injury (1)
 
Dr Anisha Rectal prolapse.pptx
Dr Anisha Rectal prolapse.pptxDr Anisha Rectal prolapse.pptx
Dr Anisha Rectal prolapse.pptx
 
Dr Anisha Rectal prolapse.pptx
Dr Anisha Rectal prolapse.pptxDr Anisha Rectal prolapse.pptx
Dr Anisha Rectal prolapse.pptx
 
Rectal prolapse surgical approaches
Rectal prolapse  surgical approachesRectal prolapse  surgical approaches
Rectal prolapse surgical approaches
 
Ureteric injury ppt Dr. Neha Jain, JNMCH, AMU, Aligarh
Ureteric injury ppt Dr. Neha Jain, JNMCH, AMU, AligarhUreteric injury ppt Dr. Neha Jain, JNMCH, AMU, Aligarh
Ureteric injury ppt Dr. Neha Jain, JNMCH, AMU, Aligarh
 

More from humanupgrade velasquez (20)

Name that animal game
Name that animal gameName that animal game
Name that animal game
 
Guidelines for the National SAVER ID
Guidelines for the National SAVER IDGuidelines for the National SAVER ID
Guidelines for the National SAVER ID
 
Donn
DonnDonn
Donn
 
Canine heartworms
Canine heartwormsCanine heartworms
Canine heartworms
 
1003127 heart-worm
1003127 heart-worm1003127 heart-worm
1003127 heart-worm
 
18931
1893118931
18931
 
Heartworm
HeartwormHeartworm
Heartworm
 
Feline heartworms
Feline heartwormsFeline heartworms
Feline heartworms
 
Saver
SaverSaver
Saver
 
Yellow corn
Yellow cornYellow corn
Yellow corn
 
Types of farming
Types of farmingTypes of farming
Types of farming
 
Tannery
TanneryTannery
Tannery
 
Swine industry in the philippines~aeroul berro
Swine industry in the philippines~aeroul berroSwine industry in the philippines~aeroul berro
Swine industry in the philippines~aeroul berro
 
Soy industry
Soy industrySoy industry
Soy industry
 
Native chicken production in the philippines
Native chicken production in the philippinesNative chicken production in the philippines
Native chicken production in the philippines
 
Copra cake
Copra cakeCopra cake
Copra cake
 
Copra
CopraCopra
Copra
 
Carabao ni neneng
Carabao ni nenengCarabao ni neneng
Carabao ni neneng
 
Mahogany farming
Mahogany farmingMahogany farming
Mahogany farming
 
tuna industry
tuna industrytuna industry
tuna industry
 

Recently uploaded

Russian Escort Service in Delhi 11k Hotel Foreigner Russian Call Girls in Delhi
Russian Escort Service in Delhi 11k Hotel Foreigner Russian Call Girls in DelhiRussian Escort Service in Delhi 11k Hotel Foreigner Russian Call Girls in Delhi
Russian Escort Service in Delhi 11k Hotel Foreigner Russian Call Girls in Delhi
kauryashika82
 
Activity 01 - Artificial Culture (1).pdf
Activity 01 - Artificial Culture (1).pdfActivity 01 - Artificial Culture (1).pdf
Activity 01 - Artificial Culture (1).pdf
ciinovamais
 
Beyond the EU: DORA and NIS 2 Directive's Global Impact
Beyond the EU: DORA and NIS 2 Directive's Global ImpactBeyond the EU: DORA and NIS 2 Directive's Global Impact
Beyond the EU: DORA and NIS 2 Directive's Global Impact
PECB
 
1029 - Danh muc Sach Giao Khoa 10 . pdf
1029 -  Danh muc Sach Giao Khoa 10 . pdf1029 -  Danh muc Sach Giao Khoa 10 . pdf
1029 - Danh muc Sach Giao Khoa 10 . pdf
QucHHunhnh
 
Making and Justifying Mathematical Decisions.pdf
Making and Justifying Mathematical Decisions.pdfMaking and Justifying Mathematical Decisions.pdf
Making and Justifying Mathematical Decisions.pdf
Chris Hunter
 

Recently uploaded (20)

Presentation by Andreas Schleicher Tackling the School Absenteeism Crisis 30 ...
Presentation by Andreas Schleicher Tackling the School Absenteeism Crisis 30 ...Presentation by Andreas Schleicher Tackling the School Absenteeism Crisis 30 ...
Presentation by Andreas Schleicher Tackling the School Absenteeism Crisis 30 ...
 
Russian Escort Service in Delhi 11k Hotel Foreigner Russian Call Girls in Delhi
Russian Escort Service in Delhi 11k Hotel Foreigner Russian Call Girls in DelhiRussian Escort Service in Delhi 11k Hotel Foreigner Russian Call Girls in Delhi
Russian Escort Service in Delhi 11k Hotel Foreigner Russian Call Girls in Delhi
 
Unit-IV- Pharma. Marketing Channels.pptx
Unit-IV- Pharma. Marketing Channels.pptxUnit-IV- Pharma. Marketing Channels.pptx
Unit-IV- Pharma. Marketing Channels.pptx
 
Activity 01 - Artificial Culture (1).pdf
Activity 01 - Artificial Culture (1).pdfActivity 01 - Artificial Culture (1).pdf
Activity 01 - Artificial Culture (1).pdf
 
Measures of Dispersion and Variability: Range, QD, AD and SD
Measures of Dispersion and Variability: Range, QD, AD and SDMeasures of Dispersion and Variability: Range, QD, AD and SD
Measures of Dispersion and Variability: Range, QD, AD and SD
 
Accessible design: Minimum effort, maximum impact
Accessible design: Minimum effort, maximum impactAccessible design: Minimum effort, maximum impact
Accessible design: Minimum effort, maximum impact
 
Código Creativo y Arte de Software | Unidad 1
Código Creativo y Arte de Software | Unidad 1Código Creativo y Arte de Software | Unidad 1
Código Creativo y Arte de Software | Unidad 1
 
Measures of Central Tendency: Mean, Median and Mode
Measures of Central Tendency: Mean, Median and ModeMeasures of Central Tendency: Mean, Median and Mode
Measures of Central Tendency: Mean, Median and Mode
 
APM Welcome, APM North West Network Conference, Synergies Across Sectors
APM Welcome, APM North West Network Conference, Synergies Across SectorsAPM Welcome, APM North West Network Conference, Synergies Across Sectors
APM Welcome, APM North West Network Conference, Synergies Across Sectors
 
Advanced Views - Calendar View in Odoo 17
Advanced Views - Calendar View in Odoo 17Advanced Views - Calendar View in Odoo 17
Advanced Views - Calendar View in Odoo 17
 
Beyond the EU: DORA and NIS 2 Directive's Global Impact
Beyond the EU: DORA and NIS 2 Directive's Global ImpactBeyond the EU: DORA and NIS 2 Directive's Global Impact
Beyond the EU: DORA and NIS 2 Directive's Global Impact
 
ICT Role in 21st Century Education & its Challenges.pptx
ICT Role in 21st Century Education & its Challenges.pptxICT Role in 21st Century Education & its Challenges.pptx
ICT Role in 21st Century Education & its Challenges.pptx
 
1029 - Danh muc Sach Giao Khoa 10 . pdf
1029 -  Danh muc Sach Giao Khoa 10 . pdf1029 -  Danh muc Sach Giao Khoa 10 . pdf
1029 - Danh muc Sach Giao Khoa 10 . pdf
 
Explore beautiful and ugly buildings. Mathematics helps us create beautiful d...
Explore beautiful and ugly buildings. Mathematics helps us create beautiful d...Explore beautiful and ugly buildings. Mathematics helps us create beautiful d...
Explore beautiful and ugly buildings. Mathematics helps us create beautiful d...
 
Ecological Succession. ( ECOSYSTEM, B. Pharmacy, 1st Year, Sem-II, Environmen...
Ecological Succession. ( ECOSYSTEM, B. Pharmacy, 1st Year, Sem-II, Environmen...Ecological Succession. ( ECOSYSTEM, B. Pharmacy, 1st Year, Sem-II, Environmen...
Ecological Succession. ( ECOSYSTEM, B. Pharmacy, 1st Year, Sem-II, Environmen...
 
psychiatric nursing HISTORY COLLECTION .docx
psychiatric  nursing HISTORY  COLLECTION  .docxpsychiatric  nursing HISTORY  COLLECTION  .docx
psychiatric nursing HISTORY COLLECTION .docx
 
Introduction to Nonprofit Accounting: The Basics
Introduction to Nonprofit Accounting: The BasicsIntroduction to Nonprofit Accounting: The Basics
Introduction to Nonprofit Accounting: The Basics
 
Unit-IV; Professional Sales Representative (PSR).pptx
Unit-IV; Professional Sales Representative (PSR).pptxUnit-IV; Professional Sales Representative (PSR).pptx
Unit-IV; Professional Sales Representative (PSR).pptx
 
Making and Justifying Mathematical Decisions.pdf
Making and Justifying Mathematical Decisions.pdfMaking and Justifying Mathematical Decisions.pdf
Making and Justifying Mathematical Decisions.pdf
 
Grant Readiness 101 TechSoup and Remy Consulting
Grant Readiness 101 TechSoup and Remy ConsultingGrant Readiness 101 TechSoup and Remy Consulting
Grant Readiness 101 TechSoup and Remy Consulting
 

Total splenectomy

  • 1.
  • 2. REASONS FOR REMOVAL OF SPLEEN SPLENIC MASSES BENIGN (HEMANGIOMAS) MALIGNANT (HEMANGIOSARCOMAS) BLOAT GASTRIC DILATATION and VOLVULUS TRAUMATIC RUPTURE
  • 3. TOTAL SPLENECTOMY TECHNIQUE Incise the left paramedian or median line in the cranial abdominal quadrant If large spleen (neoplasm) is observed, incision may reach from the xiphoid cartilage to the pubis. Abdominal incision should be large enough for the spleen to be adequately be exposed and be removed.
  • 4. TOTAL SPLENECTOMY TECHNIQUE Before removing the spleen, check the surrounding organs first for evidences of metastases. The greater omentum must partially or totally removed (spleen is closely adherent to this structure)
  • 5. IF NO TUMOR (CONGESTION/ TORSION) 1-2 ml of 1/1000 epinephrine solution can be injected (slowly) in the splenic artery after the torsion has been corrected. Ligate the splenic artery immediately
  • 6. IF THERE IS TUMOR Epinephrine administration is not advice. (cause contraction of tumor cells to the portal veins) Major veins should be ligated immediately to avoid hematogenous metastases.
  • 7. TOTAL SPLENECTOMY TECHNIQUE Surgeon must either ligate each vessel doubly or ligate the gastric side and apply hemostat to the splenic side and some several minute vessels can be ligated together and mass ligation is not advice Splenic artery must be divided between ligatures with gastrosplenic omentum. The smaller vessels are divided between ligatures starting at one end of the hilus and proceeding to the other. The splenic vein is ligated last
  • 8. For total splenectomy, double ligate and transect all vessels at the splenic hilus. If possible, preserve the short gastric branches supplying the gastric fundus.
  • 9. TOTAL SPLENECTOMY TECHNIQUE Prior to closing the abdominal incision, all ligatures must be properly inspected to avoid bleeders and hemorrhage. After removing the ruptured spleen, other viscera must be inspected also for evidence of bleeders. If there is, it must be controlled.
  • 10. TOTAL SPLENECTOMY TECHNIQUE If tumor is removed, inspect for the other organs that has metastatic lesions before closing the abdominal cavity IV should be discontinued when the patient appear to have recovered from shock
  • 11. TOTAL SPLENECTOMY TECHNIQUE Most dogs and cats go home a day or two after surgery. An iron supplement may be needed to help the body recover from any blood loss. Antibiotics will likely be prescribed as will some sort of analgesia (pain relief) for the recovery period.
  • 12. RULE OF THE TUMB 1. PREOPERATIVE EVALUATION 2. ADMINISTRATION OF FLUIDS AND BLOOD 3. OXYGENATION 4. DOUBLE LIGATION 5. CONTINUES SUTURE PATTERN 6. SYNTHETIC MONOFILAMENT ABSORBABLE SUTURE
  • 13. RULE OF THE TUMB 7. LIGATURES NEAR SPLEEN 8. LIGATE SEPARATELY SPLENIC VEIN AND ARTERY 9. MASS LIGATION FOR NEOPLASM 10. AVOID LIGATING SHORT GASTRIC VESSLES