Umbilical laparoendoscopic single site surgery versus inguinal varicocelectomy for bilateral varicocele: A comparative study

Abstract

Abstract:We aimed to determine the efficacy of umbilical laparoendoscopic single site surgery (LESS) bilateral varicocelectomy on the basis of a comparative study versus open inguinal bilateral varicocelectomy. We enrolled 39 patients who underwent bilateral varicocelectomy with predetermined surgical indications at two hospitals with either the LESS (n = 19) or the open inguinal approach (n = 20). Operative time, operation-related pain (10-point visual analog pain scale), catch-up growth of the testes, semen parameters, and complications after surgery between the LESS group and the open group at 3 months after surgery were compared. Operative times were 46.8 and 72.8 min (P < 0.001) in the LESS and open surgery groups, respectively. Patients in the LESS group reported lower surgery-related pain than those in the open surgery group at 3 months (2.5 vs 1.2, P = 0.029). A significant improvement in terms of semen concentration, motility, catch-up growth of the bilateral testes was observed in both groups, although no significant differences were detected between the groups. Postoperative complications were also similar between the two groups. LESS varicocelectomy required a shorter operative time than inguinal varicocelectomy for bilateral cases. In addition, the LESS procedure showed less postoperative pain and cosmetic benefits with similar seminal outcomes. Thus, LESS for patients undergoing bilateral varicocelectomy represents a promising surgical approach.

Laparoendoscopic single-site surgery versus conventional laparoscopic varicocele ligation in men with palpable varicocele: A randomized, clinical study

“…Results of LESS for varicocele ligation have been reported [10,11], but its use for this procedure is not widely accepted because of the limited range of motion and clashing of instruments that occurs when using only a single incision [12]. There are no available data that compare LESS varicocele ligation (LESS-VL) and CTL-VL to assess these benefits and concerns.…”

Single incision transumbilical laparoscopic varicocelectomy versus the conventional laparoscopic technique: A randomized clinical study

“…Previous two studies [12,13] comparing SIL-V and CTL-V reported that the two groups were comparable regarding postoperative pain at day 1. Park et al [23] concluded that SIL-V was found to cause less pain than open inguinal varicocelectomy in cases of bilateral disease.…”

Laparoendoscopic Single-Site Surgery with a Single Channel Versus Conventional Laparoscopic Varicocele Ligation: A Prospective Randomized Study

“…Compared with SMV, however, laparoscopic varicocelectomy is a safe, cost-effective and has the additional advantage of undergoing bilateral varicocelectomy. 6,16 With the application of laparoscopic surgery, less pain, shorter convalescence, and improved cosmesis have been achieved. 13 As an extension of conventional laparoscopy, natural orifice translumenal endoscopic surgery (NOTES) and LESS surgery have been introduced.…”

“…16,21 Recent meta-analyses and study have shown that preservation of the internal spermatic artery during high ligation may not be suggested because of a higher recurrence rate, a lower hydrocele formation rate, the lower proportion of sparing spermatic artery, and similar clinical outcomes of semen analysis. 6,22,23 Patients in the LESS(sc) group experienced significantly less pain than those in the CTL group at 6 and 24 hours after surgery.…”