Splenectomy
A splenectomy is an operation to remove your spleen (part of the immune system). Some people with lymphoma need a splenectomy. Without a spleen, it's harder for your body to fight infections. This information tells you about the spleen. It tells you why you might need a splenectomy, and outlines precautions you might need to take after having one.
On this page
What is the spleen and what does it do?
How can lymphoma affect the spleen?
Why might I need my spleen removed (a splenectomy)?
What happens before, during and after a splenectomy?
What happens after a splenectomy?
What longer-term precautions should I take after a splenectomy?
Frequently asked questions about a splenectomy and lymphoma
What is the spleen and what does it do?
The spleen is part of your lymphatic system (part of the immune system). It helps to protect your body against infection. It does this by filtering bacteria and viruses from your bloodstream. It also makes white blood cells and antibodies.
The spleen is behind your ribcage on the left side of your body, just behind your stomach. It lies below the sheet of muscle that separates your chest from your tummy (diaphragm).
Some people with lymphoma need to have their spleen removed.
You can read more about the job of the spleen in our frequently asked questions section.
How can lymphoma affect the spleen?
Lymphoma can make your spleen work harder than usual. For example, if your lymphoma:
- is in your bone marrow, your spleen might work harder to take on the bone marrow’s usual role of making new red blood cells.
- causes autoimmune haemolytic anaemia, where your body (mostly your spleen) starts destroying its healthy red blood cells as well as those that are damaged.
If lymphoma cells build up in your spleen, it makes it swell (enlarge) – known as splenomegaly.
If this happens, more red blood cells and platelets than usual fit inside it. These red blood cells are filtered too quickly from the bloodstream. As a result, you might develop anaemia (low red blood cell count) and/or thrombocytopenia (low platelet count).
Symptoms of an enlarged (swollen) spleen
Sometimes, an enlarged spleen doesn’t cause any symptoms. However, you might get:
- pain in the top left side of your tummy, behind your ribs – where your spleen is
- a feeling of being full soon after eating
- anaemia, which can make you feel very tired
- shortness of breath, particularly when doing light physical activity that would not usually make you feel short of breath
- more infections than usual
- bleeding or bruising more easily than usual.
Tell your doctor if you experience any of these symptoms.
Why might I need my spleen removed (a splenectomy)?
In general, doctors avoid doing a splenectomy if at all possible.
You might need to have your spleen removed so that doctors can see if there is lymphoma in your spleen. The soft, mushy texture of the spleen means that it isn’t possible to just take a sample from it (biopsy). This is because the cells would become crushed and would not give doctors any useful information.
In some cases, they look at your spleen to work out which lymphoma type you have.
Another reason you might have your spleen removed is if you’ve had treatments for anaemia or thrombocytopenia that haven’t worked well. Taking out the spleen can help boost your red cell count and/or platelet count. This is because the spleen will no longer be there to filter blood cells out of your bloodstream.
What happens before, during and after a splenectomy?
A splenectomy is done under general anaesthetic. Your surgeon will talk to you about the surgery. Mostly, it’s done as keyhole (laparoscopic) surgery, but it can also be done as open surgery. You can read more about these types of surgery below and in our frequently asked questions section. The Royal College of Surgeons of England also has information about different types of surgery.
Your consultant should explain why a splenectomy is a suitable treatment option for you. They should tell you about the benefits and risks of possible complications. You can read more about these in our frequently asked questions section.
Before a splenectomy
Before you have a splenectomy, you have a pre-op assessment appointment where:
- your surgeon talks to you about the procedure
- unless it’s being done as an emergency, you are usually recommended to have some vaccinations in the weeks before a splenectomy
- you have some tests to check that you are well enough to have the operation
- the anaesthetist talks to you about the anaesthetic you will have before the operation and the pain relief you might have afterwards.
Tell your surgeon at your pre-op assessment appointment if you do not have someone to help care for you once you go home.
You should also be told about the possible complications of having a splenectomy. Your medical team keep checks on you during your recovery so that they can take action early if you show potential signs of complications. You can read more about the potential risks in our frequently asked questions section.
Some people feel anxious about having a splenectomy. We’re here to support you if you’d like to talk about any aspect of lymphoma or how you’re feeling. We also have a range of health and wellbeing resources that you might find helpful. The Royal College of Anaesthetists also have information to help prepare your mind for surgery.
Tests to check that you are well enough to have the operation
Before your operation, you have tests to make sure you are well enough for surgery.
Blood tests are done before a splenectomy to check:
- your blood cell counts
- your blood group, in case you lose a lot of blood (which can sometimes happen during a splenectomy) and need a blood transfusion
- blood clotting, kidney and liver functioning.
Doctors also do an electrocardiogram (ECG), which records the rhythm and electrical activity of your heart. This is to check that you are fit enough to have general anaesthetic for the operation.
In some cases, you might be referred to a high-risk anaesthetic clinic in preparation for surgery. An example is if you have other medical conditions that your healthcare professionals should be aware of when planning your surgery and how best to help your recovery.
Vaccinations before a splenectomy
If your splenectomy is planned (and not done as an emergency operation), you are usually recommended to have some vaccinations in the weeks before it. This is to lower your risk of becoming unwell due to infections afterwards.
The vaccinations you might be asked to have include those to help protect against meningitis, flu, pneumonia, measles, mumps and rubella and chickenpox. You might also be advised to have the COVID-19 vaccination.
During a splenectomy
A splenectomy can be done by either laparoscopic (keyhole) or open surgery. Both types are done under general anaesthetic.
Splenectomy by laparoscopic (keyhole) surgery
With laparoscopic surgery, your surgeon uses a tool called a laparoscope – this is a thin instrument with a light and mini camera on the end. The laparoscope helps the surgeon see inside your tummy (abdomen) without making a large cut (incision) – instead, the cut is very small. You can read more about the procedure in our frequently asked questions section.
Laparoscopic surgery takes longer than open surgery. However, it often causes less bleeding and pain. Recovery is often quicker.
Occasionally, laparoscopic surgery isn’t possible – for example, if your spleen is too large or bleeds too much. Although laparoscopic surgery might be planned, there is a possibility that your surgeon might need to switch to open surgery during the operation. They will talk to you about this possibility before your surgery.
Splenectomy by open surgery
With open surgery, your surgeon makes a cut (incision) into your body to take out your spleen. You have to stay in hospital for a few days to recover. There is more detail about the procedure in our frequently asked questions section.
I felt very nervous about having keyhole surgery, but I was assured that recovery would be very quick. I was also told that I’d be in partial remission from my lymphoma afterwards, so it was sensible to go ahead. I actually ended up feeling quite positive about it. Although keyhole had been planned for me, my surgeon ended up having to do my splenectomy as open surgery. My recovery was quite quick and I was back to work in 6 weeks.
What happens after a splenectomy?
Before the day of your splenectomy, you should be given information about what to expect afterwards. You will also be told about how to care for yourself at home and any safety precautions to take. This includes about how to lower your risk of infection and knowing the signs and symptoms of overwhelming post-splenectomy infection (OPSI).
If your splenectomy is done with laparoscopic surgery, you would usually stay in hospital at least overnight to check your recovery. However, you might be allowed to go home later the same day.
After open surgery, you stay in hospital for a few days to check your recovery and blood circulation. Depending on how your incision is closed, you might have your surgical staples (skin clips) or stitches removed after a week or two.
Will I need pain relief?
Most people feel some pain or discomfort in their lower tummy area after a splenectomy. Your doctor will prescribe pain relief medication. If you still feel pain after taking pain relief medication, tell a member of your medical team. They might prescribe a different type of pain relief or a higher dose. There is more information about this in our frequently asked questions section.
When can I eat and drink as normal?
You will be given information about eating and drinking after a splenectomy. In general:
- you start off with liquids once you recover from a general anaesthetic
- you slowly build up to eating solid foods later that day or the next morning
- in some rare cases, you might be asked not to eat or drink anything for a while, except for water (to fast) – you have a small tube that goes through your nose to empty your stomach. An example of when this might happen would be if your spleen is very large and has become stuck to your stomach.
How do I care for myself at home?
Your surgeon will give guidance on how to look after yourself at home. If you go home on the day of your operation, someone should stay with you for at least the first 24 hours after the operation. This is so that they can help take care of you and help with any tasks while you rest. Tell your surgeon at your pre-op assessment if you do not have someone to offer such support, so that they can arrange for you to stay in hospital if necessary.
Blood clots and chest infections
To help reduce the risk of getting a blood clot or chest infection, you might be given breathing and leg exercises to do at home. You might also have blood-thinning injections for a week or more after your operation. Your surgeon or anaesthetist will talk to you about this on the day of your surgery and will teach you how to inject yourself.
How do I look after my wound?
It takes time for your wound to heal after a splenectomy. You will be given information about how to look after the area and keep the wound clean.
Dressings are usually kept on for 5 days, to help keep the area dry. You will have a scar where any incisions are made. These will gradually fade.
If you notice any redness, swelling or oozing around your wound(s), or if you develop a temperature of 38°C or above, contact your GP or hospital straightaway – you might need antibiotics.
Day-to-day activities after a splenectomy
It usually takes a few weeks to recover after a splenectomy. Generally, doctors recommend moving around as soon as possible after your operation.
Your surgeon will talk to you about safety precautions to take now that you do not have a spleen.
Talk to your surgeon or nurse about when you can expect to get back to your day-to-day activities, including exercise, and when you can drive. Many people go back to most of their usual day-to-day activities within a week.
- If you work, your doctors might encourage you to take 2 weeks off after a splenectomy. Depending on what you do, you they might suggest building back up to your full range of tasks over about 4 to 6 weeks.
- If you drive, tell your insurers about your operation. Many insurers ask that you do not drive for 2 weeks after a splenectomy operation.
We have separate information about day-to-day living. This tells you about some of the support that might be available to you if lymphoma affects your usual activities.
What longer-term precautions should I take after a splenectomy?
Your surgeon will talk to you about safety precautions to take now that you do not have a spleen. If you’ve had chemotherapy, your risk of infection is higher after a splenectomy than it would otherwise be. This is because both chemotherapy and the lymphoma itself affect your immune system.
- Be aware of the general symptoms and signs of infection – know who to contact if you need medical attention.
- Know the signs and symptoms to look out for of overwhelming post-splenectomy infection (OPSI) – contact a member of your medical team straightaway if you notice any.
- Carry a splenectomy card – in the case of a medical emergency, this tells people that you don’t have a spleen. These are available for free on the UK government website. You can also buy medical alert ID and jewellery with this information on.
- Have any vaccinations your medical team recommend – these are likely to include the annual flu and COVID-19 vaccination, and those to protect against respiratory syncytial virus RSV (depending on your age) and shingles.
Overwhelming post-splenectomy infection (OPSI)
If you don’t have a spleen, there is a small risk of developing overwhelming post-splenectomy infection (OPSI). This can be life-threatening. The risk of OPSI is highest in the first 2 to 3 years after your surgery but it never goes away completely.
Symptoms of OPSI include:
- fever (a body temperature above 38°C or 100.4°F)
- chills
- muscle aches and pains
- headache
- diarrhoea
- vomiting
- tummy pain.
Antibiotics
After a splenectomy, you usually need to take low-dose antibiotics each day to help prevent you from developing infections. This continues for at least 2 years after the operation – however, in many cases, people take them for the rest of their life. You will be given written information about any antibiotics you need.
You might also be given a course of extra antibiotics to keep at home. This is in case of suspected infection and you need them quickly. Your doctor will give you information about this. If you have any questions about your antibiotics, speak to your GP or medical team.
I have to take two penicillin antibiotic tablets every day for the rest of my life. I don’t seem to get many infections, maybe because people are careful and don’t come and see me if they’ve got a cold or any infections.
Travelling to another country
If you are planning a trip to another country, talk to your doctor. Ask them about any risks you should be aware of and any travel vaccinations you might need. For example, without a spleen, you are at a higher risk of getting malaria (a very serious tropical disease spread by some mosquitoes). Your doctor can advise you about which anti-malaria tablets are suitable for you.
We have more information about travelling safely outside the UK.
Frequently asked questions about splenectomy and lymphoma
The spleen helps to protect you from infection. It does this by filtering bacteria and viruses from your bloodstream. It also makes white blood cells and antibodies.
The spleen’s jobs include:
- making new blood cells if your bone marrow (which usually makes blood cells) isn’t working as it should.
- filtering your blood to remove old or damaged red blood cells, which carry oxygen around the body
- filtering your blood to remove old or damaged platelets, which help in reducing bleeding and bruising
- storing a small supply of red blood cells and platelets to use in an emergency if you have a physical injury to the body.
Doctors can sometimes tell whether your spleen is enlarged by feeling your tummy. However, you might be referred for a blood test, CT scan or MRI scan to know for certain.
Having an anaesthetic brings some general potential risks and complications. There can also be risks from not moving around as much as usual in the days after an operation – particularly if you are in pain or if you had a drain or catheter.
- The potential complications of a splenectomy include internal bleeding, chest infection, wound infection and blood clots. These are all uncommon.
- More serious complications of a splenectomy are very rare. They include a severe reaction to anaesthetic, or damage to another organ or major blood vessel during the operation.
Your surgical team take care to lower the risk of complications during surgery.
With a splenectomy done by laparoscopic surgery:
- Your surgeon makes a few small cuts (incisions) in your tummy. Usually, these are no more than 1.5cm (just over half an inch) in length. They then put a thin surgical tool with a light and mini camera on the end (laparoscope) into one of the incisions so that they can see inside your tummy.
- The images from the laparoscope are magnified and sent to a TV screen to help guide your surgeon.
- Your surgeon also pumps gas into your tummy to make it easier to operate, which they let out after surgery.
- They use the other incisions to put tools in to remove your spleen.
- You might have a thin plastic tube (drain) coming out of your left side to drain away any blood or fluid.
- At the end of your surgery, your surgeon stitches up all incisions. They cover them with dressings. The stitches dissolve over time – often a few weeks, so you don’t need to have them taken out.
With a splenectomy done by open surgery:
- While you are under general anaesthetic, your surgeon makes an incision. Usually, this is underneath the bottom of your ribcage on the left, or straight down the middle of your tummy.
- At the end of the operation, the cut is closed, either with surgical staples (skin clips) or stitches. It is then covered with a dressing.
- When you wake up, you might have a thin plastic tube (drain) coming out of your left side to drain away any blood or fluid. You might also have a thin plastic tube coming out of your bladder (catheter) to drain your wee (urine), and a small plastic tube (drip) going into your arm.
- You have your surgical staples or stitches, taken out after a week or two.
- You stay in hospital for a few days to recover.
Your doctors can offer you pain relief if you need it after a splenectomy. You might be given pain relief:
- as tablets
- by a drip in your arm, through a small plastic tube next to the wound
- through a small plastic tube in your back.
The types of pain relief you have depend on factors that include the type of surgery you had (laparoscopic or open). If you still feel pain after taking pain relief medication, tell a member of your medical team. They might prescribe a different type of pain relief or a higher dose.
Trusted Information
-
GOV,UK, 2020. Chapter 7: Immunisation of individuals with underlying medical conditions. Accessed May 2025.
-
GOV.UK, 2022. Information for patients with an absent or dysfunctional spleen. Accessed May 2025.
-
Harris S. After splenectomy, clots join infection as potential risks. American College of Physicians, 2017. Accessed May 2025.
-
Luu S, et al. Post-splenectomy sepsis: preventative strategies, challenges, and solutions. Infection and Drug Resistance. 2019. 12:2839-2851
-
NHS, 2023. Spleen problems and spleen removal. Accessed April 2025.
-
NICE guideline [NG89] Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism. Accessed May 2025
-
Radiopaedia, 2025. Splenomegaly. Accessed May 2025.
-
Royal College of Anaesthetists, 2023. Chapter 2: Guidelines for the provision of anaesthesia services for the perioperative care of elective and urgent care patients. Accessed May 2025.
-
Royal College of Anaesthetists. Guidelines for the Provision of Anaesthetic Services. Accessed May 2025.
-
Tahir F, et al. Post-splenectomy Sepsis: A review of the literature. Cureus Journal of Medical Science. 2022, 12:2. Accessed May 2025.
