This video demonstrates a technique for single-port laparoscopic varicocelectomy using both transperitoneal and preperitoneal approaches.
Section Editor’s note: ‘Y’tube, a new video section of UrologyTimes.com, is a resource for urologists and other clinicians who focus on men’s health. ‘Y’tube covers surgical aspects of a variety of men’s health issues with the ultimate goal of accumulating a library of videos to serve as a reference. Here, three leading groups demonstrate varicocelectomy techniques. All make use of a microdoppler and delicate dissection to identify, isolate, and preserve the testicular artery. Two of the videos demonstrate the subinguinal approach to the varicocele. We have found this to result in less pain and quicker recovery for patients. The third video demonstrates a single-port approach to a laparoscopic varicocelectomy and use of a microdoppler in the laparoscopic setting.
In this video, we describe our technique for single-port laparoscopic varicocelectomy using both transperitoneal and preperitoneal approaches. While subinguinal microscopic varicocelectomy is preferred by some due to low rates of recurrence and secondary hydrocele, laparoscopic varicocelectomy has been demonstrated to be effective and may be preferred in cases of reoperative surgery or bilateral varicoceles. We present transperitoneal and preperitoneal single-port laparoscopic varicocelectomy as a feasible alternative to traditional laparoscopic varicocelectomy with the advantage of improved cosmesis.
Dr. Hotaling: This video from the group at NYU demonstrates a single-port laparoscopic approach to varicocelectomy. While the laparoscopic approach is not commonly performed by reproductive urologists, it is employed frequently by pediatric urologists. Novel aspects of this video include use of the doppler probe in the laparoscopic setting, something that has not been routinely employed in pediatric centers and could likely be easily adopted by urologists. Dr. Alukal illustrates the anatomic principles of this procedure well and demonstrates that the principles of open surgery can be adequately translated to laparoscopic procedures.
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