A hand-assisted laparoscopic procedure allows the surgeon to insert the non-dominant hand into the abdomen, and helps to recover the tactile sensation. For a massively enlarged spleen, this technique overcomes difficulty in conventional laparoscopic splenectomy. The advantages of minimally-invasive surgery can still be preserved. We describe our preliminary experience in hand-assisted laparoscopic splenectomy. Methods: The data of 5 patients who presented with splenomegaly and underwent

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... isted laparoscopic splenectomy between April 2000 and January 2004 were reviewed retrospectively for analysis. Results: The mean age was 45.4 6.6 years, and the hospital stay was 6.6 1.0 days. The splenic length and weight averaged 20.6 5.9 cm and 1084.2 647.8 g. The operative time and blood loss averaged 218.2 40.2 minutes and 220 166.1 ml. There was no conversion to open splenectomy. No mortality or morbidity was noted in our series. Conclusion: Hand-assisted laparoscopic splenectomy is a safe and feasible procedure, even in our initial experience. It helps in exploration of the surgical field and handling of a fragile spleen, especially in patients with massively enlarged spleens. Although another incision is necessary, the advantages of laparo-scopic surgery are still retained.