Two trocar laparoscopic varicocelectomy: approach and outcomes

Area of Science:

• Pediatric Surgery
• Urology
• Minimally Invasive Surgery

Background:

• Management of pediatric varicoceles remains debated.
• Open surgical methods have historically shown 2-6% recurrence and low complication rates.
• A modified laparoscopic technique is presented for clinically significant varicoceles.

Purpose of the Study:

• To evaluate a modified 2-port laparoscopic varicocelectomy technique.
• To assess the efficacy and safety of this laparoscopic approach in pediatric patients.

Main Methods:

• A 2-port, 5-mm laparoscopic varicocelectomy was performed on pediatric patients with clinically significant varicoceles.
• The Harmonic scalpel was used for vessel fulguration in a non-artery sparing technique.
• Supraumbilical and contralateral lower quadrant trocar placement was utilized.

Main Results:

• Ten varicoceles in 9 pediatric patients were successfully treated.
• Average operative time was 53 minutes, with all patients discharged same-day.
• No recurrence or hydrocele formation was observed at 6-week follow-up; all patients were asymptomatic.

Conclusions:

• The 2-port laparoscopic varicocelectomy is comparable to open surgery for recurrence and complications.
• This laparoscopic technique may offer advantages in operative time, recovery, and cosmesis.
• The procedure is readily mastered without requiring microsurgical expertise.