title: Dye-assisted lymphatic-sparing laparoscopic varicocelectomy in children.
abstract: BACKGROUND
  The ideal method for varicocelectomy in children remains controversial. We present our experience with dye-assisted lymphatic-sparing laparoscopic varicocelectomy (LSLV) in children, which overcomes the limitations of previously described techniques.
  
  
  METHODS
  Twenty-five consecutive LSLVs were performed on children with a mean age of 15 years over a 4-year period. Varicocele grade was 3 in 21 cases and grade 2 in 4. Indications for intervention were hypotrophy in 12, pain in 11 cases and family preference in 2. A scrotal injection of lymphatic dye was utilized to spare at least one lymphatic and the remaining spermatic vessels were divided.
  
  
  RESULTS
  Lymphatic sparing was accomplished in all cases. Operative time varied from 30 to 140 min (mean 85 ± 26). No perioperative complications were noted. On average follow-up of 13 months a residual varicocele was noted in 2 cases, with no hydrocele and resolution of pain. Mean testicular volume difference diminished from 33% pre to 18% postoperatively.
  
  
  CONCLUSIONS
  This multi-surgeon experience demonstrates that dye-assisted LSLV is easily accomplished with promising results. It appears that preservation of a single spermatic lymphatic vessel is sufficient, although in some cases a second dye injection is required to visualize the lymphatics.
authors.affiliation: Division of Urology, Montreal Children's Hospital, McGill University Health Center, Montréal, QC, Canada. jp.capolicchio@muhc.mcgill.ca
authors.forename: John-Paul
authors.initials: JP
authors.lastname: Capolicchio
authors.forename: Mohamed
authors.initials: M
authors.lastname: El-Sherbiny
authors.forename: Alex
authors.initials: A
authors.lastname: Brzezinski
authors.forename: Waleed
authors.initials: W
authors.lastname: Eassa
authors.forename: Roman
authors.initials: R
authors.lastname: Jednak
mesh_terms: D000293:Adolescent; D002648:Child; D004396:Coloring Agents / Q000493:pharmacokinetics; D006801:Humans; D007267:Injections / Q000379:methods; D010535:Laparoscopy / Q000379:methods*; D008208:Lymphatic System / Q000378:metabolism / Q000601:surgery*; D008297:Male; D061646:Operative Time; D011183:Postoperative Complications / Q000517:prevention & control; D012187:Retroperitoneal Space / Q000601:surgery; D012394:Rosaniline Dyes / Q000493:pharmacokinetics; D012611:Scrotum; D013085:Spermatic Cord / Q000601:surgery; D014646:Varicocele / Q000601:surgery*
chemical_list: D004396:Coloring Agents; D012394:Rosaniline Dyes; C025484:iso-sulfan blue; C008769:sulfan blue