When the spleen is not massively enlarged and complete architectural histology is not critical, the spleen can now be safely removed by laparoscopy, avoiding a large incision. With experience, thorough exploration for accessory spleens in hematologic disease can be accomplished and the precaution of preliminary splenic artery embolization is no longer considered necessary. The "hanging spleen" technique with the patient in the right lateral decubitus position (kidney rest raised) is depicted in the following images. After the initial umbilical camera port (30 or 45 degree scope) is placed, additional ports are placed below the margin of the rib cage. The last posterior axillary line port is placed after the splenic flexure of the colon is mobilized.