LAPAROSCOPIC SIMULTANEOUS LIGATION OF INTERNAL AND EXTERNAL SPERMATICVEINS FOR VARICOCELE

The conventional treatment of varicocele consists of interruption of r eflux in the internal spermatic vein either by open retroperitoneal hi gh Ligation, an open inguinal approach or percutaneous embolization. R ecently, high ligation of the internal spermatic vein has been perform ed via laparoscopy. We previously suggested that ligation of the inter nal spermatic vein alone is not adequate, and a comparative study has shown that our method of trans-inguinal ligation of the internal and e xternal spermatic (cremasteric) veins yields better surgical results. A laparoscopic version of this operation is described, which was perfo rmed in 25 patients for 31 ligations (6 bilateral cases). Short-term r esults (followup at 3 months) have shown that the procedure is safe an d effective (no complications, 24-hour hospitalization and 1 case of p ersistence due to a technical error). This procedure seems to be an at tractive alternative to our trans-inguinal combined approach especiall y if bilateral ligation is necessary.