In children with sickle cell disease (SCD), the spleen is altered early in life and may also be the site of serious complications such as acute splenic sequestration (ASS) or hypersplenism. When such complications occur, surgical removal of the spleen, or splenectomy, may be necessary. Laparoscopic splenectomy can be sometimes challenging, especially if the spleen is large, and if the patient has received many red blood cell transfusions, resulting in an increased number of lymph nodes hiding the pedicle. Laparoscopic splenectomy can be performed using two approaches: the anterior approach starting with the dissection of the splenic pedicle and the posterior approach starting with the dissection of the splenic ligament, followed by a posterior dissection of the pedicle once the spleen has fallen in the right hypochondrium. For these two approaches, the patient position and port placements using a Xi Da Vinci Robot are very different, requiring you to prepare and plan your procedure.