With the increasing use of minimal access surgery and radiological image-guided procedures, we foresee a more integrated approach to the patient combining the skills of the surgeon and interventional radiologist. We have established a combined interventional radiology and surgical suite, known as Image Guided Therapy (IGT), which functions fully as a minimal access surgery operating room and an interventional radiology facility. IGT permits concomitant or sequential surgical and radiological procedures to be performed during the same anesthetic. To illustrate the value of this approach, we present the case of a 17 year old boy with non-Hodgkins lymphoma who presented with splenomegaly and severe thrombocytopenia associated with episodes of spontaneous bleeding. The patient's pre-operative platelet count was 7,000 and was resistant to repeated platelet infusions. Given that this patient was at very hight risk for intraoperative bleeding, the patient underwent preoperative embolization of his splenic artery in the IGT suite. After embolization was confirmed radiologically, the patient was transfused with several units of platelets to increase his platelet count above 50,000. A laparoscopic splecectomy was then performed with minimal blood loss on the same operating table during the same anesthetic. The patient recovered uneventfully from the procedure, requiring no post-operative blood products and was discharged home in good condition. The use of the integrated surgical and radiologic IGT suite permits combined procedures to be performed under one anesthetic, in sequence, without moving the patient, thus enhancing patient safety and improving outcome.