Laparoscopic varicocelectomy in the adolescent male

Franco, Israel

doi:10.1007/s11934-004-0026-6

Cited by 18 publications

(14 citation statements)

References 21 publications

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“…Success with diverse surgical procedures such as the Palomo retroperitoneal approach (1949) [3], Ivanissevich inguinal approach (1960) [4], and the more recent antegrade sclerotherapy [5], retrograde embolization, microsurgical, retroperitoneoscopic and laparoscopic procedures has been reported [6e10]. Since the first description in 1988 [11], the laparoscopic varicocele ligation procedure has become the most popular surgical method for treating this condition in children [12,13]. The aim of the present retrospective study is to evaluate our results treating varicocele in children and adolescents by the high ligation laparoscopic approach, in comparison to those of other published reports.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Palomo varicocele surgery: Lessons learned after 10years’ follow up of 156 consecutive pediatric patients

Méndez-Gallart¹,

Casasnovas²,

Estevez-Martinez³

et al. 2009

Journal of Pediatric Urology

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Section: Introductionmentioning

confidence: 99%

Laparoscopic Palomo varicocele surgery: Lessons learned after 10years’ follow up of 156 consecutive pediatric patients

Méndez-Gallart¹,

Casasnovas²,

Estevez-Martinez³

et al. 2009

Journal of Pediatric Urology

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“…Hydrocele formation is related to failure to preserve the lymphatic vessels associated with the spermatic cord. Franco suggests complication rates are relatively low for LVL except for the hydrocele rate, which has been similar to that encountered with the open Palomo approach in case of adolescent male [6]. Kandary, et al [7], compared open Ingunal, laparoscopic and subinguinal microscopic (SMV) approach.…”

Section: Hydrocele Formationmentioning

confidence: 79%

Outcome of laparoscopic varicocelectomy with mass ligation technique for symptomatic varicocele

Islam¹,

Islam²,

Sarkar³

et al. 2019

Arch Surg Clin Res

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Background: Varicocele therapy is a controversial issue. No single approach is adopted as the best therapeutic option. Testes get blood supply from testicular artery, cremasteric artery and artery to the vas deference. So ligation of testicular artery in the abdomen do not cause ischemia to the testis. This was already demonstrated in many studies. Classical Palomo varicocelectomy also consists of open ligation of testicular vessels in the retroperitoneum. En mass ligation of testicular vein and artery is technically easy and fast in laparoscopic varicocelectomy (LV). Chance of missing some veins are also less. Henceforth recurrence is also less. Recurrence and post-operative complications are high when only testicular vein is ligated by laparoscopy in the retroperitoneum. We wanted to see the outcome of laparoscopic varicocelectomy by mass ligation technique.Methods: 56 patients of symptomatic varicoceles were included in the study from the outpatient services. Symptomatic varicoceles of grade 2 to grade 3 were operated from January 2012 till January 2019 over a period of 7(seven) years in Jahurul Islam Medical college Hospital. The patients were selected for dull pain and ugly veins not for infertility. All were operated by laparoscopy with en-mass ligation of testicular vein and artery in the retroperitoneum. They were followed up for a period of six months after surgery. We collected all the data in a retrospective manner. Results:The average operation time was 27±3 minutes. Average post-operative hospital stay was 32±7 hours. There were no technical failures requiring conversion to open varicocelectomy. There was no incidence of hydrocele formation nor testicular atrophy. One patient of bilateral varicocele had 50% reduction of his varicocele. We considered this a recurrence. All other patient had complete reduction of varicocele. One patient developed hemo-peritoneum due to dislodgement of hemo-clip, which required laparotomy. He did not require any further surgery for his varicocele. Conclusion:Laparoscopic varicocelectomy with mass ligation technique is safe, effective, less time consuming and easy to perform. Recurrence and post-operative complications are minimum. Plastic hemo-lock should be used rather than titanium heom-clip for ligation of testicular vessels. There is no incidence of testicular atrophy or any adverse effect on testis.

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“…In laparoscopic surgery, the varicocelectomy can be performed by the intraperitoneal, preperitoneal, or lumbotomy approach. 31 When varicocelectomy is performed using either the open or the laparoscopic approach, surgeons may opt to adopt the mass ligation technique or the arteryand/or lymphatic-sparing technique.…”

Section: Discussionmentioning

confidence: 99%