Discharge Instructions for Laparoscopic Splenectomy (Child)

Your child had a splenectomy. This is surgery to remove the spleen from the upper left belly area (abdomen). The spleen filters blood and helps the body fight infection. For this procedure, your child’s surgeon made 3 or 4 small cuts (incisions) in your child’s belly. Tiny surgical tools were inserted through these incisions. This method lets your child recover from surgery more quickly and with less discomfort. Here's what you need to know about caring for your child at home.

Incision care

• Check your child’s incisions daily for redness, swelling, discharge, pain, or separation of the skin.

• Follow the surgeon's directions on when your child can take a bath or shower.

• Make sure you or your child washes the incision sites gently. Use mild soap and warm water. Pat them dry.

• If tape strips are over the wound, don't pull them off. Let them come off on their own. You may trim any edges that have peeled off.

Activity

• Ask the surgeon when it will be safe for your child to lift things or get back to normal activities.

• Remember, your child will be a little unsteady on their feet for a few days after getting home from the hospital.

• Don’t allow your child to lift anything heavier than 3 pounds. This is to prevent straining the incisions.

• Give your child a break from chores. Your child shouldn’t push a vacuum or mow the lawn until the healthcare provider says it’s OK to do so.

• Give your child pain relievers as directed. Don't give aspirin and ibuprofen.

• If your child gets constipated, talk with your child's provider. Pain medicines can cause constipation. Adding fiber to your child's diet and giving them a stool softener can often help.

Taking precautions about infections

• Check your child’s temperature every day for 1 week after the surgery.

• Make sure your child takes all the antibiotics prescribed after surgery—even if they feel better. Your child needs the antibiotics to keep from getting an infection.

• Get medical care for your child even for mild illnesses. This includes sinus problems or colds. Remember, your child is more likely to get an infection without a spleen.

• Make sure your child is up to date on all vaccines. Talk with your child’s healthcare provider about any vaccines your child may need.

• Be sure to tell all your child's healthcare providers that your child does not have a spleen.

• Think about getting a medical ID (identification) bracelet for your child. It should say that your child does not have a spleen.

Follow-up

Follow up with your child's healthcare provider, or as advised.

When to call your child's healthcare provider

Call your child's healthcare provider right away if any of the following occur:

• Fever of 101°F (39°C) or higher, or as directed by your child's healthcare provider (see information below).

• Shaking chills

• Dizziness or lightheadedness

• Any abnormal bleeding

• Pain in or around the incision site

• Warmth, swelling, pus, or redness at or around the incision site

• Incision site that opens up or pulls apart

• Belly pain that gets worse

• Vomiting

Fever in children after splenectomy

Children without a spleen are more likely to get an infection. Follow your healthcare provider's specific directions.

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For babies and toddlers, be sure to use a rectal thermometer the correct way. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for correct use. If you don’t feel comfortable taking a rectal temperature, use another way. When you talk to your child’s healthcare provider, tell them which way you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Baby younger than 3 months old:

• Ask your child’s healthcare provider how you should take the temperature.

• Rectal or forehead temperature of 100.4°F (38°C) or higher, or as directed by the provider.

• Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider.

Child age 3 months or older:

• Temperature by any method of 101° or higher, or as directed by your child's healthcare provider.