| || |
Operations to remove various parts of the body are common. But they raise an important question: Aren't those body parts there for a reason? Don't you need those things?
Harvard Medical School Commentary
| ||Medical Myths || |
Last reviewed October 23, 2012
By Robert H. Shmerling, M.D.
Beth Israel Deaconess Medical Center
Do you still have your appendix? How about your tonsils? Operations to remove various parts of the body are common. But they raise an important question: Aren't those body parts there for a reason? Don't you need those things?
There is both truth and fiction to the idea that we have a lot of unnecessary body parts. That's because some are truly unnecessary and others are useful but not essential. Still, others may play an important role temporarily and can be replaced by other parts of the body or by an artificial replacement courtesy of modern medicine.
Read on to learn which body parts you might consider truly useless, which parts may have been important at some point during evolution but now just take up space (waiting for disease to afflict them), and those parts you might want to think twice about before you part ways.
Back to top
Truly Unnecessary Body Parts
Although you might want to keep these if given the choice (if only to avoid the risk of surgery), here's a partial list of body parts you can do quite well without:
- Appendix This organ is about the size of your little finger and hangs from the lower right side of your large intestine (also called the colon). For reasons that aren't clear, this part of the intestinal tract sometimes becomes blocked, infected or inflamed. (The word "appendicitis" means inflammation of the appendix.) That's when it changes from a body part you didn't know you had and isn't serving any known purpose to a major risk to your health. And that's when it must be removed right away; otherwise, it may rupture, causing a life-threatening infection.
- Tonsils Tonsils are like specialized lymph nodes and are filters for bacteria and viruses. They are located in the back of the throat, just to the sides and behind the uvula, which dangles above them. Removal is recommended for people with repeated bouts of bacterial throat infections, such as strep throat, a condition common in children. The tonsils tend to shrink with age, which is one reason that infections, swelling and inflammation (tonsillitis) are less common and problematic in adults. Once removed, other lymphoid tissue (including the lymph nodes) can take over the job of the tonsils.
- Adenoids These are similar to the tonsils but they sit in the back of the nose where the nasal passages meet the mouth and throat. Adenoids can also become inflamed, infected and swollen. So when the tonsils are removed, the adenoids are generally removed at the same time. The combined procedure is called "tonsillectomy and adenoidectomy." As with the tonsils, other lymphoid tissue takes over when the adenoids are gone.
- Gall bladder The gall bladder sits just under the liver in the upper right part of the abdomen. It's also called the "cholecyst." ("Chol-" refers to bile, from the Greek, khole; cyst is a sac or bladder.) The role of the gall bladder is to store bile that is made in the liver and to release bile into the digestive tract when needed to help digest fatty foods. Cholecystectomy (removal of the gall bladder) may be necessary if the gall bladder becomes inflamed, a condition called cholecystitis. Infection may complicate cholecystitis making the removal of the gall bladder an emergency. In other situations, the inflammation goes away with rest and antibiotics so a cholecystectomy can be delayed or even avoided. The most common cause of gall bladder trouble is a gall stone (a hardened collection of bile) that blocks the tube through which bile is secreted into the intestinal tract. That's when it becomes a health threat and it must be removed. About 1% of people who have had their gall bladders removed have diarrhea because bile is now flowing directly into the digestive tract instead of being stored in the gallbladder for use "as needed."
- Uterus This organ has a single purpose: to support the growth of a baby until it is ready for delivery. Once a woman has all the children she wants, the uterus can be removed without ill effects. Although the uterus may not be essential for life, some women describe problems with sexual or urinary function after the surgery. Because of this (and because all surgery comes with a risk of complications), a hysterectomy should only be done when there is a good reason. Common reasons include painful or excessive menstruation, fibroids (benign growths that cause bleeding) or cancer.
- Thymus gland Although adults can live perfectly well without a thymus gland, it is quite important in the development and maturation of the immune system in a developing fetus and newborn. The thymus gland sits behind the breastbone, high in the upper chest. After puberty, it gradually shrinks in size until it's nearly undetectable in an older person. Surgery to remove the thymus is called thymectomy and may be recommended if the thymus becomes cancerous or a person develops myasthenia gravis, a disease marked by abnormal immune function.
- Spleen This is another organ that is made up of lymphoid tissue. It filters the blood, removing infectious organisms, aging blood cells and anything else traveling through the blood that doesn't belong there. Sometimes, it seems to be overly active and begins removing cells that are needed. For example, idiopathic thrombocytopenic purpura (ITP) may develop when platelets, the blood cells responsible for clotting and the prevention of excessive bleeding, are removed from circulation. With few platelets left in the bloodstream, bruising and bleeding may be life-threatening. Although medications can help, removal of the spleen (called splenectomy) may cure the condition. In addition to ITP, trauma (including sports injuries and car accidents) is a common reason the spleen must be removed. People who lack a spleen are more prone to certain infections, so a number of vaccinations are recommended (when time allows) before splenectomy.
Back to top
The Bottom Line
I've heard people say you only use 10% of your brain or that half of the body's organs are not really crucial to life. These are myths, at least from the evidence I can find. While it is true that we have many body parts that can be safely removed and others with excess capacity, it's generally best to keep the parts you were born with if you can.
There was a time when pediatricians routinely recommended tonsillectomies for healthy children. I was one of those children! Now that's considered unnecessary. So, think twice before offering to give up a body part. It's one thing to donate a kidney to someone who needs it or to have your appendix removed because it's about to burst. But, it is worth asking the question we began with: Don't I need that? Our understanding does change over time. The tonsil is "discredited" as a vital organ now, but maybe we'll discover that it has an important function. Maybe then I'll wish I had mine back.
Back to top
Robert H. Shmerling, M.D. is associate physician at Beth Israel Deaconess Medical Center and associate professor at Harvard Medical School. He has been a practicing rheumatologist for over 20 years at Beth Israel Deaconess Medical Center. He is an active teacher in the Internal Medicine Residency Program, serving as the Robinson Firm Chief. He is also a teacher in the Rheumatology Fellowship Program.