Optical magnification and Doppler ultrasound probe for varicocelectomy

Varicocelectomy is usually considered a simple urologic operation. However, it is most frequently difficult to visualize and identify the 0.5 mm internal spermatic artery and tiny lymphatic channels when cutting and ligating the internal spermatic veins. The internal spermatic artery and tiny lymphatic channels can be damaged easily, cut, or ligated during this procedure. This occurs surprisingly more often than is realized by the surgeon. By introducing optical magnification or the operating microscope at the time the veins are identified, the surgeon can easily find and dissect off adherent lymphatics or the internal spermatic artery with some microsurgical instruments, and thereby preserve these vessels rather than cut or damage them inadvertently. The sterile Doppler probe also can be utilized to help identify and confirm the location of the internal spermatic artery if it is not easily found in the spermatic cord.