Blue Patent Lymphography Prevents Hydrocele After Laparoscopic Varicocelectomy: 10 Years of Experience

Abstract

Laparoscopic LS varicocelectomy using isosulfan blue is preferable to laparoscopic Palomo repair that does not preserve the lymphatics. It has a significantly lower incidence of postoperative hydroceles and still maintains a low incidence of persistence/recurrence.

Treatment of Varicocele in Children and Adolescents: A Systematic Review and Meta-analysis from the European Association of Urology/European Society for Paediatric Urology Guidelines Panel

“…A total of 47 NRSs (seven prospective and 40 retrospective) including 9672 patients met the inclusion criteria. The comparison parameters were variable, including open versus laparoscopy [21][22][23]30,32,34,38,41,42,46,51,62,63], laparoscopy or open surgery versus sclerotherapy/embolization [18,30,[54][55][56], laparoscopic or open artery sparing versus non-artery sparing [25,29,42,43,52,56,59,61,62], and lymphatic sparing versus nonsparing [27,36,49,60].…”

“…When looking into the NRSs, in parallel with the RCT outcomes, the number of hydrocele complications was decreased by performing lymphatic sparing surgery in the reported series [27,28,36,41,47,49,50,60].…”

Common urological problems in children: inguinoscrotal pathologies

“…Lymphatic or artery-sparing techniques are preferred by some as they decrease the postoperative hydrocoele rate. 64,65 Radiological embolisation of the testicular vein is another option.…”

Laparoscopy in non-palpable testis and varicocele

“…Bu nedenle işlem sırasında skrotal olarak intradartos içine boya maddeleri (Patent Blue V veya izomeri Isosulfan Blue, Indigo Carmine) enjekte edilerek lenfatiklerin görünür hâle gelmesi sağlanmaktadır. Bu yöntemin lenfatikleri haritalamada etkinliği %70-80 civarındadır (43)(44)(45) . Çocuk ve adölesanlarda açık Palomo tekniği (220 hasta) ile laparoskopik Palomo (434 hasta) tekniğinin karşılaştırıldığı randomize kontrollü bir çalışmada tunika albuginea altına metilen mavisi enjekte edilerek lenfatiklerin korunduğu durumda Palomo'nun çok daha etkili olduğu raporlanmıştır (46).…”