A 35-year-old man was referred from hematology for laparoscopic splenectomy to achieve better control of thrombotic thrombocytopenic purpura that was refractory to medical management. Ports were placed as depicted (three 12 mm and umbilical camera port) and the patient's left side was rotated up 45 degrees.
There were adhesions (no prior surgery) between the omentum and the left upper quadrant parietal peritoneum above the splenic flexure of the colon. These were lysed with cautery scissors.
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