Retroperitoneoscopic varicocelectomy in children and adolescents

Comparison of different ligation techniques in laparoscopic varicocelectomy*

“…In addition, the testicular artery, which is often distinctly separated from the internal spermatic veins, had not yet branched out and was often distinctly separate from the internal spermatic veins (13,14). In our series, there was no statistical difference among groups in the number of ligated veins.…”

Electrocoagulation Versus Clips in Laparoscopic Varicocelectomy in Boys

“…7 Cobellis indicated 6.2% hydrocele in the group of 97 patients who had ligated both spermatic vessels, using diatermy. 8 In our study, we have stated a total of 13.8% (4 patients) of hydrocele after ligation of spermatic vessels when using clips and 23.7% (9 patients) using diatermy. During varicocelectomy, using diatermy, the spermatic vessels are coagulated and very often, in addition to this, comes the coagulation of lymph vessels, which are located next to the spermatic vein and artery.…”

Percutaneous retrograde endovascular occlusion for pediatric varicocele

“…This proportion compares favorably with studies of percutaneous sclerotherapy or embolization [23][24][25]. Higher success rates have been reported with the classical or modified Palomo technique and or with microsurgical techniques [10,12,14]. However, these methods require general anesthesia in children and are associated with surgical-site complications and postoperative hydrocele [10].…”

“…The classical Palomo technique consists in complete retroperitoneal ligation of the internal spermatic veins and artery [4,[10][11][12] via an open approach or a retroperitoneal or transperitoneal laparoscopic approach [4, [10][11][12]14,21]. Failure rates have ranged from 0.9% to 11.2% [12,14,21]. The spermatic artery-sparing Palomo procedure, Ivanissevich procedure, subinguinal technique, and microsurgical technique have been associated with recurrence rates ranging from 0.6% to 37% [10].…”

“…Classical surgical procedures are the Palomo and Ivanissevich techniques [4,[10][11][12]. Other surgical procedures include laparoscopic complete distal spermatic pedicle ligation, transinguinal microsurgical varicocelectomy, and Tauber's antegrade sclerotherapy [4,10,[13][14][15][16][17][18]. Although effective, all these procedures require general anesthesia in children and involve spermatic cord mobilization, which may cause intraoperative complications [4,18].…”