Laparoscopic varicocele treatment

At present, varicose veins are a common disease with a high incidence rate, and are often seen in middle-aged and elderly people. Today, we will focus on introducing one of the diseases - varicocele. The incidence of varicocele is close to one-fifth of the male population, and the vast majority of them occur on the left side of the body, which is close to four-fifths of the total incidence. However, according to clinical experience, there are also many patients with bilateral disease. Although varicocele is different from cancer and is frightening, it is definitely a disease that cannot be ignored, because the disease is often accompanied by testicular atrophy and sperm production disorders.

Varicose vein varicocele is caused by kidney tumor or other retroperitoneal tumor. Varicose vein varicocele caused by compression is called symptomatic or secondary varicocele.

The most advanced technology for varicocele -- minimally invasive surgery for varicocele under microscope

1. Microscopic minimally invasive surgery for varicocele is the most advanced and sophisticated surgery for varicocele. Compared with open, laparoscopic, percutaneous puncture and other surgical methods, microscopic surgery has obvious advantages:

2. Accurately identify and protect the testicular artery and its branches, the cremaster artery and its branches, and reduce the incidence of testicular atrophy and azoospermia after surgery;

3. Exposure of the testicles during surgery allows for visual observation of all testicular reflux veins, including the internal spermatic vein, external spermatic vein, levator testis vein, vas deferens vein, gubernaculum vein, etc., and accurate identification and cutting of the internal spermatic vein and gubernaculum vein can be performed, effectively preventing the recurrence of varicose veins;

In addition, exposing the testicles during surgery helps to detect often overlooked microtesticular tumors and epitesticular/vas deferens obstruction; lymphatic duct misligation is reduced, and the incidence of postoperative hydrocele is reduced. Advocates of open surgery believe that after the testicular artery is misligated, the vas deferens artery and levator testis artery can still ensure testicular blood supply, which is enough to prevent testicular atrophy. However, anatomical studies have found that the diameter of the testicular artery at the high ligation of the spermatic cord vein is larger than the sum of the diameters of the latter two, and it is a true testicular blood supply artery. The impact of misligation is far greater than that of misligation that may occur during microsurgery.

In general, microsurgery is safe, reliable, and has fewer complications, and is gradually being accepted and adopted by people.

Minimally invasive surgery for varicocele under microscope

Microscopic varicocelectomy is the safest surgery for varicocelectomy. The lymphatic arteries and vas deferens can be clearly seen under the microscope. There are two different incisions for surgery:

(I) Inguinal approach:

1. Supine position, oblique incision above the inguinal groove;

2. Cut the external oblique muscle lamina and levator testis muscle, open the inguinal canal, free the spermatic vein cluster, and carefully separate each branch of the spermatic vein, usually 3 to 4 branches;

3. Lift the varicose vein, then ligate it and remove the middle section, paying attention to protecting the vas deferens, testicular artery and lymphatic vessels.

4. After ensuring that there is no venous leakage, the spermatic cord is reinserted, the levator testis fascia and external oblique muscle fascia are sutured, the external ring opening is reconstructed (only big enough to accommodate the little finger), and the skin is sutured.

(II) Retroperitoneal approach:

1. Supine position, make a 3-5 cm long incision at the inner ring;

2. Incise the external oblique muscle membrane and bluntly separate the internal oblique muscle, transverse abdominal muscle, and transverse abdominal fascia.

3. Push the peritoneum inward to expose the spermatic veins. Be careful not to push the spermatic cord inward when pushing the peritoneum, which will make it difficult to find the spermatic vein. The thick internal spermatic vein is usually one, but can be as many as 3 to 4.

4. Carefully separate each vein, then ligate it and remove the middle section. Pay attention to protecting the spermatic artery and try to avoid damage or puncture.

5. Check for venous leakage and close the incision in layers.

Through the above introduction, experts remind male friends to pay attention to their health, especially the various adverse symptoms caused by varicocele. Therefore, if you are diagnosed with varicocele, you must not avoid seeing a doctor. You must go to the hospital in time and cooperate with the doctor to take effective measures for treatment and recover as soon as possible.