Surgery for Hairy Cell Leukemia

Hairy cell leukemia can cause abnormal B lymphocytes to collect in the spleen, an immune system organ that aids in filtering the blood. This can cause the spleen to become enlarged or even rupture, leading to pain and bleeding. For this reason, NYU Langone doctors may surgically remove the spleen, a procedure called a splenectomy.

A splenectomy does not cure hairy cell leukemia. However, ridding the body of the abnormal cells in the spleen can help to normalize levels of red and white blood cells, as well as platelets, in the bloodstream.

Because other therapies often succeed in treating the abnormal B lymphocytes collected in the spleen, doctors don’t perform splenectomy as often as they used to. If the procedure is done, there is no need for a transplant or other therapy to compensate for the loss of the organ because the spleen is not essential to keeping you alive, as organs such as the brain and lungs are.

Surgical Approaches

When a splenectomy is performed, our surgeons use minimally invasive techniques whenever possible to avoid making a large incision in the abdomen. Minimally invasive approaches, such as laparoscopy and robot-assisted surgery, can reduce scarring and shorten recovery time in the hospital, compared with open surgery.

Laparoscopic Surgery

During laparoscopic surgery, a doctor makes several small incisions in the abdomen to remove the spleen. He or she places a laparoscope, a tube with a tiny camera on the end, through one incision. The camera creates images of the spleen and surrounding structures. The doctor places small surgical tools through the remaining incisions and removes the spleen.

After the procedure, your doctor monitors you in the hospital for a few days.

Robotic-Assisted Surgery

Doctors at NYU Langone’s Robotic Surgery Center may use an advanced surgical system to perform a splenectomy. This system consists of tiny surgical instruments mounted on three robotic arms. An additional arm holds a video camera that creates magnified, three-dimensional images on a computer monitor, which guides the surgeon during the procedure.

The surgical tools and camera are inserted through small incisions in the abdomen. The surgeon controls these instruments and the camera from a console in the operating room.

Robotic surgery provides doctors with an excellent view of the spleen and the surrounding structures. Because the technique is minimally invasive, the hospital stay may be only a few days.

Open Surgery

Open surgery involves making a long incision in the abdomen over the spleen. This type of procedure may be necessary in people who have scarring of the abdominal tissues from previous surgery or very enlarged spleens, making minimally invasive techniques challenging.

Open surgery may require a stay in the hospital of up to a week so doctors can monitor your recovery and manage any pain.

Infection Prevention

Although people can live without a spleen, the risk of infection may increase after the organ is removed because it is part of the body’s immune system. Our doctors can help you avoid infection by making sure you receive immunizations for certain conditions, such as meningitis, which affects the covering of the brain and spinal cord, and pneumonia, an infection of the lungs.

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