Ruptured variceal bleeding from the lower esophageal fundoplication remains the most serious complication threatening the lives of patients with portal hypertension. Although endoscopic sclerotherapy or vascular ligation and TIPSS are currently optional treatments, many patients recur or require emergency surgery for rehemorrhage, and their mortality rate is greatly increased. The mortality rate can be as high as 30% to 50%. Most patients with cirrhotic portal hypertension are in poor general condition and are theoretically more suitable for minimally invasive surgery to reduce surgical trauma and postoperative complications. With the maturation of laparoscopic techniques and the use of instruments such as ultrasonic knife, ligature speed vascular closure system (Ligasure) lumpectomy linear cutting anastomosis (Endo-GIA), this type of surgery can be performed successfully. Animal experiments have been shown to be safe and feasible. However, the clinical management of bleeding tendencies, giant spleen and massive collateral circulation remains a difficult aspect of completely laparoscopic portal oddity dissection. The indications for laparoscopic surgery are essentially the same as for open surgery, while a history of surgery in the upper abdomen, significant peripleural inflammation, and grade C patients remain contraindications to laparoscopic surgery. Intraoperative bleeding is a more serious complication of laparoscopic menchiectomy and a major cause of intermediate open surgery, and the prevention of bleeding from the fragile varices during operation becomes a key to the success or failure of the operation and must be taken seriously. We usually use Ligasure to separate the short gastric vessels, which can be safely disconnected for vessels less than 7 mm, and can safely close even vessels up to 12 mm in diameter. In addition to varicose veins, the splenic tissue is brittle and fragile and difficult to grasp, which is also the reason for bleeding during the operation. The bleeding is mainly concentrated in the superior pole of the spleen and the splenic hilum, which is in close proximity to the short gastric vessels and is deep enough to allow for proper adjustment of the body position for optimal exposure. In one case in this group, the upper pole of the spleen was inadvertently torn during the treatment of the short gastric artery, and bleeding was nearly 1000 ml. Laparoscopic portal vein dissection must completely dissect the vessels around the cardia, especially the high esophageal branch and the left subphrenic vein are sometimes incompletely treated because of the difficulty of exposure and insufficient revealing, which becomes the cause of postoperative upper gastrointestinal rebleeding. When dissecting and dissecting the high esophageal branch, it should be done along the right side of the cardia and up the right posterior part of the lower esophagus. For safety, it is better to dissect 5 cm or more above the cardia so that the few deep and hidden ectopic high esophageal branches will not be missed. The left subphrenic vein may enter the left muscular layer of the lower esophagus either singly or as a branch and should be treated exactly. At the end of the procedure, we usually remove the spleen in pieces by dragging the specimen bag containing the giant spleen under a small right upper abdominal incision, aspirating the blood from the spleen with a suction device, and then cutting the spleen into pieces. The spleen can also be removed by a subxiphoid incision through the white line into the abdomen. In a few cases, postoperative perforation of the gastric wall can result from impaired blood supply to the gastric wall, which is a serious complication of surgery and must be taken seriously. We believe that the safe distance of the heat source must be ensured at least 2 mm when applying Ligasure or ultrasonic knife intraoperatively, and the vessels should be properly freed and fully exposed to prevent adjacent tissue damage when dissecting them. Small omental hypertrophy, bleeding during separation of the gastric coronary vein, also has the risk of affecting the gastric blood supply if blind suturing is performed, and must be avoided. Hand-assisted laparoscopic splenectomy + portal vein dissection has been reported at home and abroad. Although controlling the splenic hilum during hand-assisted is relatively easy to handle for bleeding, it will occupy space and obviously affect the surgical field, thus affecting the smooth operation of the whole operation. Completely laparoscopic surgery has a clear view, less trauma, less pain, rapid recovery of the patient’s physiological function, and savings in instrumentation costs. However, tacit cooperation of assistants is required intraoperatively. The preliminary results of this group show that complete laparoscopic splenectomy + portal vein dissection is technically safe and feasible, with definite efficacy and the advantages of minimally invasive surgery and broad application prospects.