Spleen removal (splenectomy)
An operation to remove the spleen, usually because it is damaged, diseased, enlarged or causing a blood problem; afterwards you need lifelong steps to reduce the risk of serious infection.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- Splenectomy removes the spleen because it is damaged, diseased, enlarged or causing a blood problem; sometimes only part is removed.
- You can live without a spleen, but you are left with a lifelong, higher risk of serious, fast-moving infection.
- Lifelong precautions matter: vaccinations, often long-term antibiotics, carrying medical ID, and seeking help quickly if you become unwell.
- Ask whether keyhole or open surgery is planned, what infection precautions you will need, and what the long-term plan is.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your surgeon will give you advice for your situation.
Removes a damaged, diseased or badly enlarged spleen
The condition can be managed without surgery, for example with medicines for some blood disorders.
You recover in hospital with pain relief; some people go home the same day after keyhole surgery, but a stay of several days is common. You are encouraged...
A clear, written infection plan: vaccinations, antibiotics, medical ID and what to do if feverish.
You recover in hospital with pain relief; some people go home the same day after keyhole surgery, but a stay of...
Wounds settle and pain eases. You build up gentle activity but avoid heavy lifting and strenuous exercise. You...
Most people gradually return to normal activities and work over this time, sooner after keyhole and later after...
Infection precautions continue for life: keeping vaccinations up to date, taking antibiotics as advised, carrying...
What is spleen removal (splenectomy)?
The spleen sits under the left ribs and helps fight infection and filter the blood. Splenectomy is an operation to remove it. It may be done because the spleen is damaged (for example after an injury), enlarged, diseased, or because removing it helps a blood condition such as certain types of low platelet count or anaemia. Sometimes only part of the spleen is removed.
The operation can often be done by keyhole surgery (laparoscopy) through several small cuts, which usually means a quicker recovery. A larger single cut (open surgery) is used when keyhole surgery is not suitable, in some emergencies, or when the spleen is very large.
You can live without a spleen because the liver and other tissues take over most of its jobs. The important trade-off is that you are left with a lifelong, higher risk of serious infection. Because of this, vaccinations, often a course or long-term low-dose antibiotics, and clear plans for illness and travel become part of life afterwards.
This guide is about the operation and living without a spleen. It does not replace the advice of the team treating the condition that led to surgery.
Types & techniques
There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.
Keyhole vs open splenectomy
| Point | Keyhole | Open |
|---|---|---|
| Cuts | Several small cuts | One larger cut |
| Recovery | Usually quicker | Usually longer |
| Hospital stay | Often shorter | Often several days |
| When used | Many planned cases | Emergencies, very large spleen, or if keyhole unsuitable |
The approach depends on the reason for surgery, the size of the spleen and the surgeon's assessment. Keyhole surgery is sometimes converted to open during the operation if needed.
Preparing for your surgery
- Have vaccinations updated before planned surgery where possible; you usually need pneumococcal, Hib/meningococcal and annual flu vaccines.
- Discuss the reason for surgery and whether keyhole, open or partial removal is planned.
- Tell the team about all medicines, especially blood thinners and steroids, and any allergies.
- Follow instructions on stopping or adjusting medicines and on not eating or drinking before the operation.
- Stop smoking beforehand if you can, as it helps healing and reduces chest complications.
- Plan for several weeks of lighter activity and arrange help at home and a lift after discharge.
- Make sure you understand the lifelong infection precautions and have a plan for vaccines, antibiotics and medical ID.
What happens
The operation is done under general anaesthetic, so you are asleep. In keyhole surgery, the surgeon makes several small cuts, inflates the tummy with gas to create space, and removes the spleen with a camera and instruments, taking it out through one of the cuts. In open surgery, the spleen is removed through a single larger cut.
The blood vessels to the spleen are sealed before it is removed. The operation usually takes between one and three hours, depending on the approach and the reason for surgery.
Afterwards you wake up in recovery. Some people go home the same day after keyhole surgery, but a stay of several days is common, and longer after open surgery or in an emergency. You usually need vaccinations and antibiotics organised around the operation if they have not been given already.
Is this operation right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- The condition can be managed without surgery, for example with medicines for some blood disorders.
- The person is too unwell for a planned operation and needs stabilising or a different approach first.
- Removing the spleen is not expected to help the underlying problem.
- The balance of lifelong infection risk against benefit is unfavourable, especially in young children where the spleen's role is greater.
Delay surgery if…
- There is an active infection that should be treated first (for non-emergency surgery).
- Vaccinations have not been given and there is time to give them before planned surgery.
- Blood thinners or other medicines need adjusting beforehand.
- The blood condition is unstable and needs optimising first.
- Fasting or pre-operative instructions have not been followed.
Alternatives to discuss
- Medical treatment of the underlying condition, such as drugs for immune low-platelet conditions.
- Watchful waiting or monitoring for some stable conditions.
- Partial splenectomy to preserve some spleen function in selected cases.
- Other procedures, such as embolisation, in specific situations.
- Specialist haematology review before deciding on surgery.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Anaesthetic choices
The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.
Benefits
- Removes a damaged, diseased or badly enlarged spleen
- Can stop dangerous bleeding from an injured spleen
- Can improve some blood conditions, such as certain causes of low platelets or anaemia
- May reduce symptoms caused by a very large spleen, such as discomfort or early fullness
- Keyhole surgery, when suitable, usually allows a quicker recovery
Risks & complications
- Pain and tiredness for some weeks as you recover
- Shoulder-tip discomfort after keyhole surgery from the gas used
- Bruising and scars at the cut sites
- Needing to organise and keep up with vaccinations and antibiotics
- Bleeding during or after the operation, sometimes needing a transfusion or return to theatre
- Wound or chest infection
- Injury to nearby organs such as the stomach, pancreas or bowel
- Blood clots in the legs or lungs
- Keyhole surgery being converted to open during the operation
- Overwhelming post-splenectomy infection (OPSI) — a rare but life-threatening, fast-moving infection
- A collection of fluid or infection under the left diaphragm
- A long-term raised platelet count or clotting problems
- Serious complications of general anaesthesia
The most important long-term risk is overwhelming post-splenectomy infection (OPSI): rare, but it can develop very fast and be life-threatening. The risk is highest in the first couple of years but lasts for life. This is why vaccinations, often long-term antibiotics, carrying medical ID and seeking help urgently if you feel unwell are so important. Children, older adults and people with a weak immune system are at higher risk. Ask exactly what your infection plan is.
Published figures to discuss
Operative risks depend heavily on whether surgery is planned or emergency, the size of the spleen, the approach used and the person's health. Infection risk afterwards depends on age, the reason for surgery and how well precautions are followed. The figures below are broad anchors because risk differs greatly between trauma, blood disorders, cancer and planned benign surgery.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Overwhelming post-splenectomy infection (OPSI) | Rare overall, often quoted around 0.1–0.5% per year, but lifelong and potentially rapidly fatal | Risk is higher in children, older adults and people with a weak immune system; vaccines and antibiotics reduce but do not remove it. Reported mortality once it occurs is high. | Post-splenectomy sepsis: a review of the literature (PMC)pmc.ncbi.nlm.nih.govPublished figure |
| Conversion from keyhole to open surgery | Uncommon in planned benign cases, but higher with a very large spleen, trauma, bleeding or dense scarring | More likely with a very large spleen, bleeding or scarring; discussed as part of consent. | Post-splenectomy sepsis: a review of the literature (PMC)pmc.ncbi.nlm.nih.govSource-linked context |
| Blood clots after surgery | Recognised; portal/splenic-vein thrombosis is reported in low single digits to over 10% in some screened series | Early movement and clot-prevention measures are used; a raised platelet count can occur afterwards. | Post-splenectomy sepsis: a review of the literature (PMC)pmc.ncbi.nlm.nih.govPublished figure |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
Recovery — what to expect, and when
Recovery from the operation usually takes a few weeks, quicker after keyhole surgery and longer after open or emergency surgery. The bigger long-term change is learning to live safely without a spleen, with lifelong infection precautions.
- Tiredness and soreness around the cuts for some weeks
- Shoulder-tip ache for a day or two after keyhole surgery
- Gradually building up activity rather than returning to everything at once
- Getting used to new routines for vaccinations, antibiotics and medical ID
Aftercare
- Take pain relief as advised and move around gently to reduce the risk of clots and chest infection.
- Avoid heavy lifting and strenuous activity until your surgeon says it is safe.
- Keep wounds clean and dry and follow any dressing advice.
- Keep all recommended vaccinations up to date, including boosters and the annual flu vaccine.
- Take antibiotics exactly as advised; many people need them long term or for life.
- Carry medical ID (such as a card or bracelet) saying you have no spleen, and tell any clinician treating you.
- Seek urgent medical help if you develop a fever, chills or feel unwell, and get advice before travel, especially to areas with malaria.
- Vaccination record up to date and boosters diarised
- Antibiotics and a plan for how long to take them
- Medical ID card or bracelet stating you have no spleen
- A clear plan for what to do if you develop a fever or feel unwell
- Travel and malaria advice if you plan to travel
- GP informed and surgical follow-up arranged
Scars and how they heal
Keyhole surgery usually leaves several small scars that fade over time. Open surgery leaves one larger scar, often below or across the upper tummy, which is more noticeable. Scars are firm and pink at first and usually settle over months. Sun protection can help them fade.
⚠ Get urgent help if…
- A fever, chills or feeling suddenly very unwell — treat as an emergency and seek help immediately
- Spreading redness, swelling, heat or discharge from a wound
- Severe or worsening tummy pain or a swollen, hard tummy
- Breathlessness, chest pain, or a swollen, painful calf (possible clot)
- Heavy bleeding or feeling faint and lightheaded
- Being unable to keep fluids down or repeated vomiting
- Any illness while travelling in a malaria area — seek urgent advice
Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your surgeon gives you.
Results & realistic expectations
A good result means the spleen is removed safely, you recover from the operation, and any blood condition it was done for improves as expected. For an injured spleen, the operation can be life-saving.
Removing the spleen does not cure every condition, and for some blood disorders the benefit can be partial or wear off over time. The operation also leaves you with a lifelong, higher risk of serious infection, which is managed but not removed by vaccines and antibiotics. The team treating your underlying condition will explain what to expect.
Most people live a full life without a spleen because other organs take over its jobs. The key lasting change is the higher risk of serious infection, which never fully goes away, so vaccinations, antibiotic advice and prompt treatment of illness continue for life. For some blood conditions, the improvement after splenectomy can fade over time and needs ongoing review.
Combining with other procedures
Splenectomy is sometimes done at the same time as other abdominal surgery, or alongside treatment for the condition that led to it. If your spleen is being removed as part of a larger operation or a wider treatment plan, your team will explain how the parts fit together.
Follow-up & long-term care
You will usually have a surgical check after the operation and ongoing follow-up with the team managing the condition that led to surgery, for example a haematologist. Your GP records should clearly note that you have no spleen, so vaccinations and antibiotics are kept up and any illness is treated promptly.
- Keep vaccinations up to date, including pneumococcal boosters and the annual flu vaccine
- Take prophylactic antibiotics as advised, often long term or for life
- Carry medical ID and tell any clinician you have no spleen
- Have a plan for fever or illness, and seek urgent help early
- Get specific travel and malaria advice before trips abroad
Revision and secondary surgery reality
- For some blood conditions, the benefit of splenectomy can be partial or fade over time, needing ongoing treatment.
- Bleeding or another complication occasionally means a return to theatre.
- If accessory spleen tissue regrows in some conditions, further treatment may rarely be needed.
Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.
What good aftercare looks like
- A clear, written infection plan: vaccinations, antibiotics, medical ID and what to do if feverish.
- GP records flagged that you have no spleen, with vaccine boosters diarised.
- Surgical follow-up for wounds and recovery, plus ongoing haematology or specialist review where relevant.
- Specific travel and malaria advice before trips abroad.
- A named contact for urgent concerns and clear warning signs to act on quickly.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Whether the operation is keyhole or open, and its complexity
- Surgeon and anaesthetist fees
- Theatre time and any specialist equipment
- Length of hospital stay, which is usually longer after open surgery
- Vaccinations, antibiotics and follow-up care
- Care of the underlying condition that led to surgery
- The surgeon's and anaesthetist's fees
- Theatre, hospital stay and facility fees
- Whether keyhole or open surgery is planned, and what happens if it is converted
- Vaccinations and antibiotics around the operation
- Follow-up appointments and who provides long-term care
- What happens, and any extra cost, if complications occur or a longer stay is needed
On the NHS? Splenectomy is commonly done on the NHS when it is clinically needed, including as emergency surgery; private care may be used for speed, choice or a second opinion for non-urgent cases.
You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Not making clear that the higher infection risk is lifelong, not just temporary.
- Not having a concrete plan for vaccinations, antibiotics and medical ID before discharge.
- Over-promising that surgery will cure the underlying blood condition.
- Not discussing the chance that keyhole surgery may be converted to open.
- Not explaining travel and malaria precautions.
Marketing red flags
- Suggesting keyhole splenectomy is a 'minor' operation with no long-term consequences.
- Downplaying the lifelong infection risk or the need for vaccines and antibiotics.
- Promising a cure for a blood condition without involving haematology.
- Not mentioning the importance of medical ID and an illness plan.
Choosing a surgeon safely
- Check your surgeon is on the GMC Specialist Register for this area.
- Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
- You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
- Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good surgeon will welcome every one of these.
- Why is my spleen being removed, and is partial removal an option for me?
- Will it be keyhole or open surgery, and what makes that the right choice in my case?
- Which vaccinations do I need, and when, before and after surgery?
- Will I need antibiotics long term or for life, and what is the plan?
- What exactly should I do if I get a fever or feel unwell, now and in the future?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the surgeon who carries out my operation, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this operation not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Can I live a normal life without my spleen?
Will I have keyhole or open surgery?
Why do I need vaccinations and antibiotics afterwards?
What is OPSI and how worried should I be?
How long is the recovery?
Can I still travel abroad?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NHS — Spleen problems and spleen removal British Society for Haematology — Prevention and treatment of infection in patients with an absent or hypofunctional spleen Post-splenectomy sepsis: a review of the literature (PMC) Postoperative portal and splenic vein thrombosis after splenectomy — review (PMC)
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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