Two-trocar laparoscopic varicocelectomy: cost-reduction surgical technique.
OBJECTIVE
To describe the technique of two-trocar laparoscopic varicocelectomy and compare it with the standard three-trocar laparoscopic technique in terms of effectiveness, morbidity, and cosmesis.


METHODS
Two matched groups of patients with left varicocele were recruited. Each group included 30 patients. One group underwent three-trocar and the other two-trocar laparoscopic varicocelectomy. The results of the two approaches were compared.


RESULTS
No significant differences were found in terms of mean hospital stay or morbidity between the two-trocar and three-trocar techniques. A significant difference was found in the operative time and proportion of patients needing postoperative parenteral narcotic analgesia in favor of the two-trocar technique. In both approaches, the previously infertile patients had a significant improvement in sperm count and motility (P <0.05). Cosmetically, the trocar wound scars were aesthetically superior using the two-trocar technique.


CONCLUSIONS
No significant difference was found between two-trocar and three-trocar laparoscopic varicocelectomy in terms of effectiveness and morbidity. The cost of an extra 5-mm disposable trocar in the three-trocar technique and the improved cosmesis after the two-trocar technique have made us prefer the latter technique.
Al-Hunayan
Adel
A
Division of Urology, Department of Surgery, Mubarak Teaching Hospital, Kuwait University Faculty of Medicine, Safat, Kuwait. alhunayan@hsc.edu.kw
Abdulhalim
Hamdy
H
Kehinde
Elijah O
EO
El-Barky
Ehab
E
Al-Awadi
Khaleel
K
Al-Ateeqi
Awni
A
D000328:Adult; D003365:Costs and Cost Analysis; D004867:Equipment Design; D006801:Humans; D020706:Laparoscopes / Q000191:economics*; D010535:Laparoscopy / Q000191:economics*; D008297:Male; D013525:Surgical Instruments / Q000706:statistics & numerical data; D013521:Urologic Surgical Procedures, Male / Q000191:economics / Q000295:instrumentation; D014646:Varicocele / Q000191:economics* / Q000601:surgery*