Related Experiment Video
Updated: May 27, 2026
Microscopic Varicocelectomy under Local Anesthesia as the Treatment of Varicocele
Published on: October 25, 2024
Dye-assisted lymphatic-sparing laparoscopic varicocelectomy in children
John-Paul Capolicchio1, Mohamed El-Sherbiny, Alex Brzezinski
1Division of Urology, Montreal Children's Hospital, McGill University Health Center, Montréal, QC, Canada. jp.capolicchio@muhc.mcgill.ca
Introduction:
The ideal method for varicocelectomy in children remains controversial. We present our experience with dye-assisted lymphatic-sparing laparoscopic varicocelectomy (LSLV) in children, which overcomes the limitations of previously described techniques.
Materials And Methods:
Twenty-five consecutive LSLVs were performed on children with a mean age of 15 years over a 4-year period. Varicocele grade was 3 in 21 cases and grade 2 in 4. Indications for intervention were hypotrophy in 12, pain in 11 cases and family preference in 2. A scrotal injection of lymphatic dye was utilized to spare at least one lymphatic and the remaining spermatic vessels were divided.
Results:
Lymphatic sparing was accomplished in all cases. Operative time varied from 30 to 140 min (mean 85 ± 26). No perioperative complications were noted. On average follow-up of 13 months a residual varicocele was noted in 2 cases, with no hydrocele and resolution of pain. Mean testicular volume difference diminished from 33% pre to 18% postoperatively.
Conclusion:
This multi-surgeon experience demonstrates that dye-assisted LSLV is easily accomplished with promising results. It appears that preservation of a single spermatic lymphatic vessel is sufficient, although in some cases a second dye injection is required to visualize the lymphatics.
