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HALS had a significantly reduced conversion rate (p 0.01). In two studies that compared HALS and OS (n = 66), HALS showed a decrease in LOS of 4.5days (p 0.01) and increase of 44min in operative time (p 0.01), while OS had a significantly higher blood loss of 448cc (p = 0.01). No differences were found in the complication rate. LS is a safe approach for splenomegaly, with clear clinical benefits. HALS has a lower conversion rate. Higher-quality confirmatory trials with standardized splenomegaly grading are needed before d