<prompt> During splenectomy in ITP, platelet infusion is givenImmediately after ligating dplenic veinImmediately after removal of spleenAfter incisionNext day of surgery  <response>: Indications for splenectomy: 1. Relapsed severe cases after treatment with steroids - for 6 weeks 2. Girls attaining menarche 3. ITP persisting even after 6-9 months refractory to treatment 4. In 2nd trimester pregnancy, with platelet count 10000mm3 and severe bleeding problems 5. Recurrence after stoppingtapering steroids 6. Profound GI bleed and intracranial bleed Surgery During surgery and in emergency, fresh blood transfusions or platelet transfusions are required. Sometimes the anti-platelet immune response is temporarily blocked by IgG transfusion so to allow the platelet count to rise at the time of surgery or in cases of severe bleeding or in pregnancy. Accessory spleen should be identified and removed. In 7 days platelet count raises to more than 100000 cu mm. Laparoscopic approach is ideal in elective splenectomy for ITP. Ref: SRB;s manual of surgery,3 rd ed, pg no 607 