Lymphatic sparing laparoscopic Palomo varicocelectomy for varicoceles in children: intermediate results.
OBJECTIVE
Varicocele is a relatively rare disorder in children that can lead to testicular atrophy and infertility. The ideal surgical treatment for varicoceles is still a matter of controversy because of the frequency of postoperative complications. Here, we report our series of children who underwent lymphatic sparing laparoscopic Palomo varicocelectomy.


METHODS
A total of 46 boys, 9 to 14 years old, underwent laparoscopic repair for varicoceles between January 2002 and December 2007. All of them had a left-sided varicocele. The varicocele was diagnosed by physical examination and Doppler ultrasonography. The laparoscopic procedure included obligatory dissection and preservation of the lymphatic vessels, followed by double ligation of the spermatic vessels. Follow-up for these children included physical examination and Doppler ultrasonography.


RESULTS
Lymphatic sparing laparoscopic Palomo varicocelectomy was feasible in all 46 (100%) of the children. Mean operative time was 34.2 minutes (range, 25-42 minutes). There were no intraoperative complications. One patient recurred because of incomplete ligation of spermatic vein. Mean follow-up was 20 months (range, 7-32 months). Hydrocele formation, testicular atrophy, and testicular hypertrophy were not observed postoperatively. However, 2 preoperative hypotrophic testes were noted with 10.4% and 12.5% decreases in size.


CONCLUSIONS
Our study reveals that lymphatic sparing laparoscopic Palomo varicocelectomy in children is safe, effective, and the reliable treatment of pediatric varicocele. However, long-term follow-up is required to best characterize ultimate outcome.
Tong
Qiangsong
Q
Department of Pediatric Surgery, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Hubei 430022, China. qs_tong@hotmail.com
Zheng
Liduan
L
Tang
Shaotao
S
Du
Zhiyong
Z
Wu
Zehua
Z
Mei
Hong
H
Ruan
Qinglan
Q
D000293:Adolescent; D002648:Child; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008026:Ligation; D008297:Male; D011183:Postoperative Complications / Q000601:surgery; D012008:Recurrence; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D014646:Varicocele / Q000000981:diagnostic imaging / Q000601:surgery*