One of the functions of the spleen is to remove old and damaged blood cells. Therefore, in children with a more severe form of Beta-Thalassemia, their spleen enlarges known as splenomegaly (picture #7, spleen indicated by blue crosshatch marks). Normally it should be roughly the size of a clenched fist. In addition to relieving abdominal discomfort, removing the enlarged spleen in these kids theoretically prolongs the period of time between needed blood transfusions. Unfortunately, this procedure only treats a symptom of the disease, and does not cure it. Therefore, we limit this procedure to those children who are truly symptomatic from their splenomegaly and require frequent transfusions. This week we removed very large spleens from two pretty small children (picture #8). We don’t have laparoscopic capabilities here at Salerno, so everything is done open. Having been doing primarily laparoscopic surgery at Wilford Hall, it has reminded me how much fun open surgery is as well. It is still quite challenging to get the enlarged organ out of a “relatively” small hole. (Thank you Dr. Nelson for all the spleen experience, as well as to those mentioned before for the pediatric experience). Having children in the hospital has also reminded me how much I truly love pediatric surgery (picture #9). I really can’t see me doing anything else long-term. Take care.