Dye assisted lymphatic sparing subinguinal varicocelectomy. A prospective randomized study

Ellatif, Mohamed E. Abd; Nakeeb, Ayman El; Shoma, Ashraf; Abbas, Ashraf; Askar, Waleed; Noman, Nashat

doi:10.1016/j.ijsu.2011.07.430

Cited by 11 publications

(5 citation statements)

References 18 publications

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“…Studies have shown that dyeassisted lymphatic-sparing techniques have lower hydrocele rates. [37][38][39] Although none of our patients required surgery for hydrocele, it has been reported that repeated aspirations of hydrocele fluid are not curative and that Jaboulay hydrocelectomy is often necessary. 36 It was also found that the mean time to detect palpable varicocele was 2 years after operation.…”

Section: Discussionmentioning

confidence: 75%

Varicocele Surgery: 10 Years of Experience in Two Pediatric Surgical Centers

Niyogi

Singh

Zaman

et al. 2012

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Section: Discussionmentioning

confidence: 75%

Varicocele Surgery: 10 Years of Experience in Two Pediatric Surgical Centers

Niyogi

Singh

Zaman

et al. 2012

Journal of Laparoendoscopic & Advanced Surgical Techniques

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“…Several surgical techniques via high retroperitoneal, inguinal, microsurgical inguinal, and laparoscopic approaches have been reported, but with no most ideal treatment 2345. Although some reports indicated that the microsurgical varicocelectomy may be lead to a lower incidence of postoperative hydrocele formation, the operating time is considerably longer than that for other procedures 1112.…”

Section: Discussionmentioning

confidence: 99%

“…There are several treatment options including percutaneous embolization, inguinal varicocelectomy, subinguinal microscopic varicocelectomy, and laparoscopic varicocele ligation. However, the ideal treatment for varicocele is still controversial 2345. Laparoscopic varicocele ligation is regarded in recent years as a safe, effective, and minimally invasive method with the similar results to that of others 26…”

Section: Introductionmentioning

confidence: 99%

Prospective randomized comparison of transumbilical two-port laparoscopic and conventional laparoscopic varicocele ligation

Zhang¹,

Yang²,

Long³

et al. 2017

Asian J Androl

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We have established a novel method named transumbilical two-port laparoscopic varicocele ligation (TTLVL) for varicocele, which is still needed to evaluate. In this study, 90 patients with left idiopathic symptomatic varicoceles of grades II–III according to the Dubin grading system were randomly assigned to TTLVL (n = 45) and conventional laparoscopic varicocele ligation (CLVL) (n = 45). The demographic, intraoperative, postoperative, and follow-up data were recorded and compared between the two groups. All the procedures in the two groups were completed successfully with no intraoperative complications and no conversions to open surgery. No significant difference was found in the operative time, resuming ambulation, bowel recovery, postoperative hospital stay, and postoperative resolution of scrotal pain between the two groups (P > 0.05). However, the postoperative mean visual analog pain scale scores for TTLVL group were all less at 24 h, 48 h, 72 h, and 7 days postoperatively compared to CLVL (P = 0.001, 0.010, 0.006, and 0.027, respectively). The mean patient scar assessment questionnaire score in postoperative month 3 was 29.7 for TTLVL group compared with 32.1 for CLVL group (P < 0.001). There was no testicular atrophy observed in both groups during the follow-up period. The study shows that TTLVL is a safe, feasible, and effective minimally invasive surgical alternative to CLVL for the treatment of varicocele. Compared with CLVL, TTLVL may decrease postoperative pain and improve the cosmetic outcomes.

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“…M.E. Abd Ellatif проведено лімфатичне мапування інтраопераційно і отримано успішніші післяопераційні результати, ніж після застосування виключно субінгвінальної мікрохірургічної варикоцелектомії [1].…”

Section: результати дослідження та їх обговоренняunclassified

Microsurgical subinguinal varicocelectomy in children and adolescents. Modified technique with lymphatic vessel contrast enhancement

Dihtiar¹,

Vernihora²,

Boyko³

et al. 2023

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A varicocele is one of the most common causes of spermatogenesis and infertility disorders, which can be corrected. With the advent of high-quality optical operating systems, subinguinal microsurgical varicocelectomy has been added to the pediatric urologist’s arsenal. One of the most unresolved problems of using this operation in children is postoperative hydrocele and possible damage to the testicular artery due to its small size, which leads to testicular atrophy. To solve this problem, lymphatic vessel contrast with 1% methylene blue was used to verify lymphatic vessels and indirectly visualize the testicular artery. Purpose - to develop a modified technique of microsurgical subinguinal varicocelectomy with intraoperative contrast of lymphatic vessels in children; to evaluate the results of surgical treatment of varicocele using this technique. Materials and methods. The study included 65 boys aged 11 to 17 years with a confirmed diagnosis of grade III varicocele and recurrent testicular pain or testicular hypotrophy. Patients were randomized into 2 clinical groups for classical or modified varicocelectomy. The success of treatment was evaluated after 6 months. The Group I included 34 patients who underwent classical subinguinal microsurgical varicocelectomy; the Group II included 31 patients who underwent modified surgery. Results. No cases of complications and recurrence of the disease in the late postoperative period were recorded in the group using the modified technique, while in the group with the standard technique, such cases were detected in 17.6% of patients. In addition, it was found that intraoperative contrasting of lymphatic vessels made it possible to clearly identify the testicular artery in all cases in the group with the modified technique, while in the group with the standard technique it was visualized only in half of the cases. No intraoperative complications, hypersensitivity, or allergies were noted during the operation. Conclusions. A modified varicocele treatment with intraoperative lymphatic vessel contrast may be more effective and safe for patients with this disease due to vein visualization, as the artery and ductus deferens remain the only unchanged structures due to the use of a compression test and lymphatic vessel contrast. The study was conducted in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent was obtained from the patients for the research. No conflict of interests was declared by the authors.

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Dye assisted lymphatic sparing subinguinal varicocelectomy. A prospective randomized study

Abstract: Subinguinal varicocelectomy using combination of optical magnification and lymphatic staining (methylene blue) offers simple and quick preservation of the draining lymphatic vessels and avoids secondary hydrocele formation. ClinicalTrials.gov ID: NCT01259258.

Cited by 11 publications

References 18 publications

Varicocele Surgery: 10 Years of Experience in Two Pediatric Surgical Centers

Varicocele Surgery: 10 Years of Experience in Two Pediatric Surgical Centers

Prospective randomized comparison of transumbilical two-port laparoscopic and conventional laparoscopic varicocele ligation

Microsurgical subinguinal varicocelectomy in children and adolescents. Modified technique with lymphatic vessel contrast enhancement

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