Not long ago, 81-year-old Mr. Liu was hospitalized for “old slow branch”, and his physical examination revealed low platelets, splenomegaly, and further examination revealed a huge hemangioma in his spleen, which might rupture and hemorrhage at any time. However, due to Mr. Liu’s poor cardiopulmonary function, many hospitals were afraid to accept him. Finally, he came to my outpatient clinic. After carefully asking about his medical history and checking the examination report, I decided to arrange for Mr. Liu to be hospitalized. After a series of examinations and repeated discussions in the department, I made a plan for Mr. Liu to undergo laparoscopic minimally invasive surgery to remove the splenic hemangioma. The surgery went smoothly and Mr. Liu was able to get out of bed on his own the day after the surgery. I. What is spleen tumor all about? As an immune organ of human body, spleen is rich in blood circulation and has a low incidence of tumor. According to statistics, the incidence of benign splenic tumors is about 0.14%, and the ultrasonographic incidence of splenic cysts is 1/1500. 1, spleen tumors benign and common splenic tumors are more rare tumors in clinic, and are divided into the following categories according to the source of tissue components – tumor-like lesions: including non-parasitic cysts, misshapen tumors, etc.; vascular tumors: Divided into benign (such as hemangioma) and malignant (such as hemangiosarcoma); lymphoid tumors: Hodgkin’s disease, non-Hodgkin’s disease, lymphoid lesions, etc.; non-lymphoid tumors: including lipomas, malignant fibroblastomas, malignant teratomas, etc.; and others: such as traumatic cystic pseudotumor, inflammatory pseudotumor. Splenic tumors are more benign than malignant, benign hemangiomas are the most common, and malignant tumors are more common in malignant lymphoma. Symptoms are atypical, easy to misdiagnose and miss diagnosis. Splenic tumor is not easy to be found in the early stage, and the clinical symptoms are atypical, so it is easy to misdiagnose and miss diagnosis. Common manifestations include discomfort, pain and compression symptoms such as abdominal distension, nausea, constipation, dyspnea, etc. Malignant tumors may have low fever, anemia, fatigue, malaise, emaciation and cachexia, etc. Rupture of splenic tumors may be manifested as sudden abdominal pain, peritonitis, and may be hemorrhagic shock or even death. If physical examination reveals splenomegaly, blood test reveals that platelets are lower than normal value, usually accompanied by the above symptoms, further examination should be carried out to exclude the possibility of splenic tumor. In addition, other conditions such as cirrhosis after hepatitis, schistosomal cirrhosis, and splenic vein embolism after pancreatitis can also lead to splenomegaly, which requires differential diagnosis. Second, minimally invasive technology brings hope for complex giant spleen surgery In terms of the choice of splenic surgical methods, there will be differences in the surgical methods used for different patients with different conditions, and different hospitals or doctors will also choose different methods according to their own technical characteristics and experience. In addition to splenic tumors that can be treated by laparoscopic resection, many patients with cirrhosis and portal hypertension combined with upper gastrointestinal bleeding or splenomegaly and hypersplenism can also be treated by laparoscopic surgery. 1, splenomegaly combined with fundal esophageal varices For patients with cirrhosis fundal esophageal varices, the risk of fundal esophageal vein rupture and bleeding during open surgery is high. Let’s say that a police officer is saving someone’s life when there is an untimely bomb next to him, which may explode at any time. At this point, the twisted vein can be dissected through minimally invasive surgery before removing the enlarged spleen. This is equivalent to defusing the untimely bomb before saving the life. Minimally invasive surgery by skilled and experienced physicians can also reduce the risk of bleeding to a lower level, bringing more hope to inoperable patients. 2, splenomegaly combined with liver failure part of the liver failure patients, the risk of open surgery is very high. After preoperative hepatoprotective treatment, some patients with class C function (liver failure) can also use minimally invasive surgery to reduce the risk of surgery. There is also hope that some patients can improve their liver function from C to B after surgery. C. Advantages of minimally invasive surgery for spleen disease Laparoscopic splenic tumor or giant splenectomy has the advantages of safety, less trauma, less pain, low complications, shorter hospitalization time, small abdominal wall scars, quicker recovery of intestinal function after surgery, and low chances of intestinal adhesion compared with open surgery. Accordingly, the surgeon’s technical requirements are also very high, not only the trauma is small, but also the complete removal of the tumor, especially malignant tumors, need to be removed completely and can not have residual, the surgeon must have a wealth of experience in order to grasp the scope of the resection, to grasp the “degree”. Now, the rapid development of science and technology, the doctor’s “weapons” are more and more advanced, high-definition lenses, three-dimensional imaging, 3D printing and other technical equipment, which allows doctors to lesions at a glance, so that the heart has a “number”, the hands of the “art”. “Art”. Many previously inoperable high-risk groups (advanced age, chronic diseases, etc.) can now be surgically treated, which undoubtedly brings new hope to more patients, bringing the dawn of life.