This technique uses the lateral splenic attachments to suspend the spleen and gravity to retract the stomach and pancreas. In the right lateral decubitus position, one camera and three instrument ports are placed. The splenic and short gastric vessels are sequentially divided. The spleen is placed into a bag, morcellated, and removed through the umbilical incision. We have successfully used this approach with both normal and enlarged spleens, in all sizes of children.