ObjectiveTo investigate clinical application value of totally laparoscopic splenectomy via anterior approach. MethodsThe clinical data of 26 consecutive patients underwent totally laparoscopic splenectomy via anterior approach from March 2012 to June 2015 in this hospital were analyzed retrospectively. There were 11 males and 15 females. These patients included 2 cases of traumatic spleen ruptures, 4 cases of idiopathic thrombocytopenic purpuras, 1 case of hereditary spherocytosis, 3 cases of splenic cysts, 5 cases of autoimmunity hemolytic anemias, 2 cases of splenic hemangioma, 1 case of hematolymphangioma, 8 cases of cirrhosis portal hypertensions. The operative time, intraoperative bleeding, postoperative time to out-of-bed activity, the first flatus/bowel motion time, complications, and hospital stay were analyzed retrospectively. ResultsTwenty-six patients were successfully carried out totally laparoscopic splenectomy via anterior approach. The average operation time was 93 min (72-120 min). The average blood loss was 60 mL (10-80 mL). The postoperative time to out-of-bed activity was 24 h. The first flatus/bowel motion time was 2-3 d. The average hospital stay was 7 d (6-9 d). The postoperative pancreatic fistula (Grade A) occurred in 1 patient, who recovered well on day 6 by postoperative drainage management. After 5-32 months of following-up, all patients recovered smoothly without any long-term complications. ConclusionThe preliminary results of limited cases in this study show that totally laparoscopic splenectomy via anterior approach is feasible, safe, and minimally invasive.