Chonnam Med J.  2008 Dec;44(3):180-183. 10.4068/cmj.2008.44.3.180.

Early Experience of Bilateral Laparoscopic Varicocelectomy

• Choi SH
• Jeong HJ
• Seo IY

• KMID: 2172299
• DOI: http://doi.org/10.4068/cmj.2008.44.3.180

Abstract

The varicocele is the most common correctable cause of male infertility. Most studies report approximately 10% prevalence of bilateral varicoceles. The ideal method of varicocele treatment is still a matter of controversy. Laparoscopic varicocelectomy is also one of the surgical options that has recently gained popularity. From June 2004 to August 2006, three patients with bilateral varicoceles were treated with laparoscopy. The operation was performed with 3 trocars system through transperitoneal approach. The mean operative times was 61.7 minutes. There was no abnormal parameters in the postoperative semen analysis for 13.0 months of the mean follow-up. Our series supports that a laparoscopic approach to the bilateral varicoceles can be performed with short operating times, minimal operative morbidity, rapid convalescence, and a cosmetically pleasing result as small three incisions for trocars.

Keyword

Varicocele; Laparoscopy

MeSH Terms

Convalescence
Follow-Up Studies
Humans
Infertility, Male
Laparoscopy
Male
Operative Time
Prevalence
Semen Analysis
Surgical Instruments
Varicocele

Figure

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  Fig. 1 Positon of trocars with transperitoneal approach. A: 10 mm trocar. B, C: 5 mm trocar.

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  Fig. 2 The dilated vein was treated by Hem-o-lok clips and scissors.

Reference

1. Francis XS, Mark FB. Louis RK, Andrew CN, Alan WP, Alan JW, editors. Abnormalities of the testes and scrotum and their surgical management. Campbell-Walsh urology. 2007. 9th ed. Philadelphia: WB Sauders;3761–3798.

2. Turek PJ, Lipshultz LI. The varicocele controversies II ; Diagnosis and management. AUA Update Seriese. 1995. 14:114–119.

3. Jung DJ, Kim CS. Laparoscopic varicocelectomy. Korean J Urol. 1999. 40:1705–1709.

4. Sánchez-de-Badajoz E, Diaz-Ramirez F, Marin Matin J. Endoscopic treatment of varicocelectomy. Arch Esp Urol. 1988. 41:15–16.

5. Donovan JF, Winfield HN. Laparoscopic varix ligation with ND: YAG Laser. J Endourol. 1992. 6:165–171.

6. Enquist E, Stein BS, Sigman M. Laparoscopic versus subinguinal varicocelectomy: a comparative study. Fertil Steril. 1994. 61:1092–1096.

7. Dubin L, Amelar RD. Varicocele size and results of varicocelectomy in selected subfertile men with varicocele. Fertil Steril. 1970. 21:606–609.

8. Hirsch IH, Abdel-Meguid TA, Gomella LG. Postsurgical outcome assessment following varicocele ligation: laparoscopic versus subinguinal approach. Urology. 1998. 51:810–815.

9. Scherr D, Goldstein M. Comparison of bilateral versus unilateral varicocelectomy in men with palpable bilateral varicoceles. J Urol. 1999. 162:85–88.

10. Mcmanus MC, Barqawi A, Meacham RB, Furness PD 3rd, Koyle MA. Laparoscopic varicocele ligation: are there advantages compared with the microscopic subinguinal approach? Urology. 2004. 172:357–360.