**8.1.2 Surgical procedures**

Nowadays, it is commonly accepted to try and preserve the spleen, when viable, during the procedure, to avoid post-splenectomy infectious complications.

It is necessary to be aware of this rare clinical pathology in order to avoid delaying surgical care, which could lead to splenic ischemia or even gastric ischemia.

Nevertheless, splenic ischemia after torsion is quite common and the rate varies from 43% to 65% of cases according to the series (Fiquet-François 2010; Romero et al, 2003).

Splenectomy will be the gold standard for major splenic ischemia, when there is splenic necrosis after torsion repair and the spleen is no longer viable.

Faced with a viable or almost viable spleen, the surgery should aim for splenic conservation. The surgery should focus on a fixation technique that will:


Taking all these elements into account we have proposed an approach by Laparoscopic Assisted Gastropexy (LAG)
