Dr Deepak Varma Gastro Surgeon Cochin

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Liver and Spleen Surgery

Spleen Surgery

The spleen is a small organ located just under the rib cage on the left side of the abdomen. Functionally the spleen helps fight infections in the body and filters the damaged and old cells from the system. It is basically part of the immune system. Surgical removal of the spleen is called laparoscopic splenectomy. A spleen removal surgery is done when the spleen is damaged or diseased.

Reasons And Indications For Splenectomy

  • Cyst or abscess in the spleen
  • Thrombosis of the blood vessels to the spleen (clotting of blood vessels)
  • Blood cell disorders such as hereditary elliptocytosis, idiopathic thrombocytopenia purpura, thalassemia, hereditary spherocytosis and some haemolytic anaemias.
  • Other tumors and cancers affecting the spleen, which is very rare
  • Hypersplenism
  • Leukaemia
  • Sickle cell anaemia
  • Trauma or injury to the spleen

Liver and Spleen Surgery


  • The operation is done under general anaesthesia
  • Choice of surgery is normally laparoscopic splenectomy due to its myriad advantages to patient recovery
  • An open spleen removal will require a cut to be made right in the middle of the belly or on the left side of the belly below the ribs. The spleen is then identified and removed.
  • During laparoscopic splenectomy, three or four small cuts are made in the body
  • A laparoscope is inserted through one of the ports
  • Gas is insufflated into the belly to enable the surgeon to visualize the organs and work freely
  • The spleen is removed with the help of the scope and other associated laparoscopic instruments

Liver Surgery

Different disorders of the liver require different operations. Liver resection surgery is indicated when primary liver cancer or secondary liver cancer is detected.

Liver Resection Surgery

Partial Hepatectomy
When part of the liver is removed, it is called partial hepatectomy. The volume of liver resected depends on the circumstances. It can either be a hemi-hepatectomy where one half of the liver is removed or a segmentectomy where only a small section of the liver is removed. The gall bladder may also be eliminated along with it due to the common border between the two organs. Liver resections should be performed in experienced centers as these are highly complex operations, which can cause serious complications. Liver resections require specialized instruments like CUSA to reduce blood loss.

Two-Stage Liver Surgery
A two-stage liver surgery is done when cancer is detected on both sides of the liver or if there is functional damage to the liver. This requires two operations. First a partial hepatectomy is done to remove a tumour from one side of the liver. This may even be done in combination with a tumour ablation or primary tumour removal. The patient is allowed to recover for a few months after this surgery. The liver regrows during this period and the tumors on the other side of the liver are removed at a second operation.

We conducts a well-organized and detailed patient assessment to gauge the working of the liver. All treatment plans are drafted only after a thorough analysis of patient situation.

Authored by Dr. Deepak Varma, MBBS, MS (General Surgery)

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