Because No. 10 LN dissection with splenectomy would increase operative morbidity and mortality rather than improving prognosis, laparoscopic spleen-preserving No. 10 LN dissection is safe and feasible for patients with advanced proximal gastric cancer. Based on our experiences, we gradually explored a set of procedural operation steps called Huang’s 3-step maneuver. The first step is dissection of LNs in the inferior pole region of the spleen; second, the LNs in the region of the splenic artery trunk were cleaned; third, LNs in the superior pole region of the spleen were cleaned. After that, the laparoscopic spleen-preserving splenic hilar lymphadenectomy was completed.
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