The Impact of Internal Spermatic Artery Ligation during Laparoscopic Varicocelectomy on Recurrence Rate and Short Post Operative Outcome

Abstract

Laparoscopic varix ligation with ISA ligation has lower recurrence rate than laparoscopic varix ligation without ISA ligation and may provide better varicocele related pain control with no increase in hydrocele or testicular atrophy rate. We recommend ISA ligation routinely during laparoscopic varix ligation.

Is the laparoscopic Palomo procedure for pediatric varicocele safe and effective?

“…This technique seems to have a fairly low incidence of postoperative hydrocele. On the other hand, although data regarding recurrence rate are not homogeneous, the incidence of postoperative recurrent varicocele seems to be higher in these patients [13,14,23].…”

“…The mean age at operation was 13 ± 1.98 years (range, [9][10][11][12][13][14][15][16][17][18]. Thirty-eight of 41 patients (93%) had a left-sided varicocele, and three (7%) had bilateral varicocele.…”

“…Moreover, in young children this procedure must be accomplished under sedation or general anesthesia [8,22,31]. ISA sparing techniques have a low incidence of postoperative hydrocele but a high recurrence rate [13,22]. Although Ivanissevich and Palomo procedures can be complicated by postoperative hydrocele, these techniques are effective as indicated by their very low recurrence rates [7,12,25] (Figs.…”

“…1 and 2). Testicular atrophy is an extremely rare complication in all surgical procedures [7,13,22,25].…”

“…Both mass ligation of the spermatic vessels and selective ligation of the enlarged veins with ISA preservation are feasible via a laparoscopic approach [9,17,20,29,33]. Whatever treatment or approach is chosen, postoperative complications are fairly common and include hydrocele, recurrence, persistence, and testicular atrophy [7,8,13,22,25].…”