Zh. Alshareef et al., LAPAROSCOPIC LIGATION OF VARICOCELES - AN ANATOMICALLY SUPERIOR OPERATION, Annals of the Royal College of Surgeons of England, 75(5), 1993, pp. 345-348
Since December 1991, 25 consecutive symptomatic male patients with 26
varicoceles were treated by laparoscopic ligation of internal spermati
c veins under general anaesthesia. Twenty-one patients had either scro
tal discomfort or painful swelling and four patients presented with in
fertility. The mean follow-up period is 5 months (range 3 weeks to 9 m
onths). The procedure has provided a satisfactory outcome in 19 out of
21 patients (90.5%) with scrotal symptoms. Of the four patients prese
nting with infertility due to oligospermia, three had significantly el
evated sperm counts at 3 months which resulted in one pregnancy. So fa
r there has been no recurrence of the varicocele. The main potential a
dvantage of the laparoscopic approach is better visualisation of the a
natomy, especially the testicular artery and the collateral venous cir
culation at the level of the internal inguinal ring. In addition to be
ing less invasive with implied benefits, the endoscopic procedure has
enabled identification of multiple veins in 22 out of 26 (84.6%) varic
oceles in our series.