脾脏外科历经百年争议，脾脏从“可弃器官”走向功能保全。单孔腹腔镜脾部分切除术（SILPS）革新了保脾手术的范式——依托脾脏分段血供的解剖特性，以单一隐蔽切口实现精准部分切除，在极致微创中守护免疫与循环稳态。然而，狭窄视野下的操作精准度、陡峭的学习曲线与器械物理极限，仍构成技术推广的“三重门”。未来，机器人辅助与智能导航或将成为破局之钥，推动脾外科迈入“毫米级”精准时代，在切除与保留的永恒博弈中续写新章。

Spleen surgery has experienced a hundred years of controversy from "disposable organs" to functional preservation. Single-incision laparoscopic partial splenectomy (SILPS) has revolutionized the paradigm of spleen-preserving surgery. Based on the anatomical characteristics of segmental blood supply of the spleen, precise partial splenectomy can be achieved by a single concealed incision, maintaining immune and circulatory homeostasis in minimally invasive surgery. However, surgical precision in limited visual field, steep learning curve and physical limitation of surgical instruments are major barriers preventing its clinical application. In the future, robot-assisted and intelligent navigation will probably resolve these challenges, pushing spleen surgery into the era of "millimeter-level" precision and shedding light on the balance between resection and preservation.