Some studies have suggested that LS for splenomegaly was associated with longer operation times, more blood loss, and higher intraoperative and postoperative complication rates than LS for normal-sized spleens (13). In addition, in some cases of splenomegaly, conversion is inevitable because of a requirement for an intact specimen for pathologic examination or because of serious hypervascularization and dense adhesion as the result of massive size (14, 15). Targarona et al. (14) indicated that the conversion rate was correlated with the spleen weight: for spleens weighing 400 - 1000 g, it was 0, but it rose to 25% for weights > 1000 g and to 75% for weights > 3000 g. In their LS group, conversions to laparoscopy-assisted splenectomy occurred in four patients (25%), including one case (spleen weight of 1600 g) for which pathologic examination determined a sarcoma and three cases of complicated procedures due to spleen weight > 3000 g (16). The median splenic weight in our HALS group was 800 (480-2110)g; we did not have any conversion to OS.