Ergonomic varicocele ligation: Laparoscopic intracorporeal knot-tying

Abstract

Introduction/aim Many surgical and radiological techniques have been introduced for treating varicoceles. The goal of surgical treatment of varicocele is to occlude the refluxing venous drainage to the testis while
maintaining the normal testicular function. The aim of this study was to present our initial experience in laparoscopic varicocele treatment using intracorporeal knot-tying with available laparoscopic instruments.

Materials and methods A retrospective file review of the patients who were treated with laparoscopic intracorporeal knot-tying between May 2010 and July 2014 was carried out. The patients were evaluated as regards age, symptoms, and clinical grade of varicocele. All patients were diagnosed through physical examination and color Doppler ultrasound, which measured the diameter of spermatic veins and retrograde flow in spermatic veins after the Valsalva maneuver.

Results The mean operative time was 35± 8 min. There was no intraoperative complication, and all patients had uneventful postoperative courses. Patients were discharged from hospital on the same day after surgery. No recurrent varicocele, testicular atrophy, postoperative hydrocele, or ematoma were observed.

Conclusion Our preliminary results indicate that laparoscopic varicocele ligation carried out with intracorporeal knot-tying is safe and effective and produces cosmetically better results. Therefore, it is a suitable procedure in both pediatric and adolescent patients.

Keywords: ergonomics, intracorporeal knot-tying, laparoscopic varicocelectomy