A 4-hole approach was applied, with the right lateral position selected, and the splenic hilar vessels were treated intraoperatively with ultrasonic knife and ligasure, or the primary or secondary splenic tissues were treated with Endo-GIA clamping in fractions, depending on the case. 17 cases of laparoscopic total splenectomy for traumatic splenic rupture were performed, and the splenic hilar vessels were treated with fractional absorbable clamping in 12 cases; the primary splenic tissues were treated with Endo-GIA in 4 cases, and the secondary splenic tissues were treated with Endo-GIA in 1 case. In 11 cases of total laparoscopic splenectomy for idiopathic thrombocytopenic purpura (ITP), the splenic hilar vessels were treated with fractionated absorbable clamps in 6 cases, the secondary splenic hilum was treated with Endo-GIA in 4 cases, and the primary splenic hilum was treated with Endo-GIA in 1 case. 4 cases of splenomegaly for portal hypertension, 1 case was treated with Endo-GIA, and 3 cases were treated with Endo-GIA. GIA was used to treat the primary splenic tissues in 4 cases of portal hypertension, and Endo-GIA was used to treat the secondary splenic tissues in 3 cases. In all patients, the splenic colon ligament, splenogastric ligament, and splenorenal ligament were dissected first, the spleen was fully freed, the tail of the pancreas was freed and pushed away from the splenic hilum, then the splenic hilum vessels were treated, and finally the splenic diaphragmatic ligament and the first branch of the short stomach vessels were treated. In patients with portal hypertension splenomegaly and hypersplenism, splenic artery ligation is required after treatment of the splenogastric ligament. In patients with traumatic splenic rupture, the laparoscopic splenic vessels are gradually separated from the bottom up, and the splenic tissues can also be treated with Endo-GIA for severe bleeding; in patients with ITP, the laparoscopic splenic tissues are treated as in traumatic splenic rupture, and the splenic arteries can be treated with separate ligation of splenic arteries and veins, or with Endo-GIA, and pre-treatment of splenic arteries is not a necessary step during surgery; in patients with portal hypertension splenomegaly and hypersplenism, preoperative It is necessary to perform three-dimensional reconstruction of splenic hilar vessels to fully understand the splenic arteriovenous course and the length of the secondary splenic tissues, the distribution and course of the varicose vessels, to assess the possibility of laparoscopic resection before surgery, and to ligate the splenic artery intraoperatively to reduce the risk of surgery, and to use Endo-GIA to clamp the primary or secondary splenic tissues according to the intraoperative separation of the splenic tissues; the lower splenic tissues can be treated first, and if the lower splenic tissues are short and closely related to the tail of the pancreas and are difficult to separate, the The superior splenic tissues should be treated first. In portal hypertension, the splenic vein is thick and the vein wall is thin, so separation of the splenic tis is prone to rupture and hemorrhage, and it needs to be separated without blindness. Combining different diseases of the spleen with the characteristics of splenic tissues anatomy, different methods of splenic tissues management can be adopted to safely perform laparoscopic splenectomy.