Mini-Laparoscopic Varicocelectomy Using a Knot-Tying Technique: A Preliminary Report
摘要
OBJECTIVE: To present our experience using pure laparoscopic intracorporeal knot tying to 1igate internal spermatic veins. MATERIALS AND METHODS: Between January 2002 and March 2004, 20 men underwent min-laparoscopic varicocelectomies. The mean patient age was 29.5 (range, 10 to 48) years. All varicoceles were detected clinically according to the World Health Organization classification and confirmed by scrotal color Doppler ultrasonography. The varicocele was on the left side in 11 (55%) and was bilateral in 9(45%). The surgical indications were scrotal pain in 14, infertility in 4, and both in 2. Three 2 or 3mm mini-laparoscopic ports were used for the operation. The internal spermatic veins were separated and ligated with intracorporeal knot tying. The internal spermatic artery and lymphatic vessels were carefully preserved. RESULTS: Mean operation time was 56±32(range, 25~100) minutes. All patients were discharged within 24 hours postoperatively. Neither immediate nor late procedure-related complications were noted. Of the 14 patients with scrotal symptoms, 12 were free of symptoms, and 2 had significant improvement. Of the 6 patients presenting with infertility, 4 (67%) had improvement in semen quality. Neither recurrent varicocele nor hydrocele was detected with a mean follow-up of 6.7 (range, 0.25-24) months. CONCLUSIONS: Our preliminary results revealed that a mini-laparoscopic varicocelectomy combined with preservation of the artery and lymphatic vessel is a safe and effective procedure.