Modified Inguinal Palomo Technique in Surgical Repair of Varicocele

Lee, Jae Hyun; Na, Yong Gil; Yoon, Yool Ro

Abstract

PURPOSE: A varicocele is the most common correctable cause of infertility in men. Conventional techniques of varicocele repair are associated with substantial risks of hydrocele formation, varicoele persistence and recurrence. The inguinal approach with classic Palomo technique was used to be simplified the procedure and to get the same good results with the Palomo technique.
MATERIALS AND METHODS
From March 1990 to March 1997, we experienced surgical corrections of 54 patients with varicocele(A mean age 20.3 years) The most of patients were left-sided(96.3%). Until March 1996, surgical correction with Palomo(6 patients) and modified Palomo(13 patients) technique by retroperitoneal approach and Ivanissevich techrique(20 patients) by inguinal approach have been performed, and since April 1996, Palomo technique(15 patients) with inguinal approach has been performed, in which the entire vascular pedicle is ligated superior to the entrance of the was deferens through the inguinal incision.
RESULTS
The postoperative recurrences in the modified Palomo technique occurred In two of the 13 patients(15%) and in the Ivanissevich technique in three of the 20 patients(15%). But there were no recurrences In the retroperitoneal Palomo and modified inguinal Palomo techniques. The modified inguinal Palomo technique was completed within 45.3minutes in mean duration, but the standard retroperitoneal Palomo technique within 55.2minutes, modified Palomo technique within 57.2minutes and Ivanissevich technique within 51.4minutes. There was no varicocele recurrence, hydrocele and atrophy of testis in modified inguinal Palomo techniques.
CONCLUSIONS
The modified inguinal Palomo technique was easily approachable and relatively fast in our experience and had no recurrence.