Indigo carmine dye-assisted lymphatic-sparing laparoscopic Palomo varicocelectomy in children.
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
Five consecutive LSLVs were performed over a period of three years on children with a mean age of twelve years. The varicocele grade was three in one case and grade 2 in four cases, respectively. A left subdartos injection of 2 ml of Indigo carmine dye was done using a 25-gauge needle at ten minutes before an operation. 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. No peri-operative complication was noted. We spared one lymphatic channel in one patient (20%) and two channels in four patients (80%). There were no cases of hydrocele or residual varicocele.


CONCLUSIONS
Dye-assisted LSLV is easily accomplished with an excellent surgical outcome and sparing one or two lymphatics appears to be sufficient to avoid secondary hydrocele.
Department of Pediatric Surgery and Pediatric Endoscopic Surgery, Tokushima University Hospital.
Hiroki
H
Ishibashi
Hiroki
H
Mori
Keigo
K
Yada
Mitsuo
M
Shimada
Tomoko
T
Sogami
Akira
A
Nii
D000293:Adolescent; D002648:Child; D004396:Coloring Agents / Q000008:administration & dosage; D006801:Humans; D015994:Incidence; D007203:Indigo Carmine / Q000008:administration & dosage; D007267:Injections; D010535:Laparoscopy / Q000379:methods*; D008208:Lymphatic System; D008297:Male; D059351:Organ Sparing Treatments / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014646:Varicocele / Q000601:surgery*
D004396:Coloring Agents; D007203:Indigo Carmine