Varicocele is a frequently-encountered disease in young men which results from dilatation of the pampiniform plexus. It comprises about 30% of major etiologic of male infertility. The treatment usually consists of ligation of the spermatic vein
approached by the route of the inguinal or high retroperitoneal access; the so-called classical methods. Laparoscopic varicocelectomy, as a new modality of treatment of varicocele, has been known to provide various merits as compared to the
classical
methods. These include fewer complications, shorter hospitalization and postoperative convalescent period, low recurence rate, better availability in the adolescent age, better chance of preserving the internal spermatic artery and unique
accessibility
in bilateral cases. We hereby report 11 clinical cases of varicocele in which transperitoneal ligation of the internal spermatic vein just obore the internal inguinal ring under laparoscopic guidance were performed at Dong-A Medial Center.
The patients aged from 12 to 39 years old with a mean of 20.6 years. The location of the disease were left in 10 cases and bilateral in 1. The degree of varicocele were grade II in 4 cases and grade III in 8. Past history revealed 2 cases of
recurrence.
The operative indication in the pediatric age were scrotal pain in 1 child, 3 with a discrepancy in the size of the tescicles, and in adults, 2 with infertility, 1 with pain, 4 varicoceles associated with scrotal mass. The mean duration of the
operation
were 54 minutes. We performed preoperative semen analysis in 4 adult patients and the results showed normal in 2 cases and oligospermia & hypomotility of sperm in 2 cases. The postoperative complications observed were 1 case of shoulder pain and
1
pneumoscrotum.
Follow up evaluation made by physical examination and ultrasonographic imaging and the second semen analysis showed improvement of the disease in all patients, although the duration of observatory period was relatively short. In conclusion,
transperitoneal laparoscopic varicocelectomy is a feasible modality of treatment that can replace the classical open varicocelectomy.
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