The surgeon's left (non-dominant) hand was placed into the abdominal cavity through the device. The 10-mm 30˚ laparoscope was placed at the inferior or superior crease of the umbilicus depending on the spleen size and location. The 10-mm main operating port was in the midclavicular line at the level of the umbilicus. Carbon dioxide was insufflated continuously with 13 mmHg for constant pneumoperitoneum. An intraabdominal exploration for accessory spleen was the first step. LigaSure was used as above. With the assistance of the intraabdominal hand, the inferior pole and medial splenogastric ligament were dissected first, and then the splenorenal ligament and superior pole of the splenophrenic ligament were dissected. Then, the splenic vascular pedicule was separated from the pancreatic tail by finger dissection. The splenic artery and splenic vein were either ligated with LigaSure or silk (00) and sectioned or dissected with an endo vascular stapler (Endo-GIA).