A laparoscopic varicocele ligation was performed in 49 men with a clin
ically proven varicocele. Patients were treated predominantly on a day
case or overnight basis with minimal post-operative morbidity. Identi
fication of the testicular artery was aided by a laparoscopic Doppler
probe in the majority of patients and preserved in 39 cases. The varic
ocele persisted in 7 patients, 4 of whom have subsequently had an ingu
inal exploration confirming a missed testicular vein as the source. In
all 7 patients the artery was identified without the use of the Doppl
er probe, this being suggestive of misidentification of the vessels at
laparoscopy. The complications included 4 wound infections, 1 scrotal
haematoma and 1 vasal injury which necessitated an open vasovasostomy
. Laparoscopic varicocele ligation is a simple and safe technique, cau
sing minimal morbidity and enabling a rapid return to normal activity.
The success rate can be improved by accurate identification of the te
sticular vessels with the use of a laparoscopic Doppler probe.