Laparoscopy in the management of pediatric varicoceles

The authors present their early experience with laparoscopic ligation of varicoceles in children.

Over a period of 30 months, 17 children underwent laparoscopic treatment of unilateral varicoceles (age range, 7 to 16 years). Nine underwent ligation of veins alone and eight (including four children who had recurrent varicoceles) underwent ligation of testicular veins and artery. In three patients, vas-associated veins were ligated in addition to the main testicular vessels.

The average operation time was 30 minuts (range, 14 to 75) and hospital stay, 11 hours (range, 4 to 22). There were no technical failures. Minor scrotal emphysema developed in one child, and a painful, tender swelling above the epididymis developed in another. At an average follow-up of 24 months (range, 6 to 30), all patients were asymptomatic and had marked reduction in the size of the varicoceles.

Further experience and long-term follow-up are clearly required before the efficacy of this procedure is established.