Treatment of teenage varicocele by transumbilical mini pure single-port laparoscopic Palomo's surgery: a report of 78 cases / 国际外科学杂志

Objective To evaluate the clinical superiority of transumbilical mini pure single-port laparoscopic Palomo's surgery on the treatment of primary teenage varicocele.Methods All operations were successfully completed using mini pure single-port laparoscopic Palomo's surgery.Its clinical effects were evaluated by the operative time,blood loss volume,intra-or post-operative complications,and hospital stay.Six to eighteen months after surgery,follow-up was made in 78 patients.Results All the operations were successful.The operation time was 5-15 (mean 8) minutes,the intra-operative loss blood was 1-5 (mean 1.5) mL,and the post-operative hospital stay was 2-4 (mean 3) days.No intra-operative or post-operative complications happened.Sperm analysis of 95％ patients came back to normal in 6-18 months.Conclusions The transumbilical mini pure single-port laparoscopic Palomo's technique has more obvious superiority and it is worthy of clinical application and generalized widely.

Surgical Repair of Varicocele: a Comparative Study of the Retroperitoneal Approach of Palomo, the Modified Palomo Technique and the Microsurgical Inguinal Approach of Ivanisseivich's Technique / 대한비뇨기과학회지

PURPOSE: We wanted to compare our experience and results with three different methods of treatment for varicocele. MATERIALS AND METHODS: Between January 1995 and December 2005, 154 patients with varicocele were retrospectively assigned into three groups according to the method of treatment. Group 1 included 73 patients who were treated by the retroperitoneal approach of Palomo's technique. Group 2 consisted of 37 patients who were treated by the retroperitoneal approach and who also underwent the internal spermatic artery preserving technique, and in group 3, 44 patients were treated by the microscopic inguinal approach of Ivanissevich's technique. We analyzed the operation time, recurrence, complications, the effect of surgical treatment and the results according to the surgical techniques. RESULTS: The mean operative time of group 3 was significantly longer among the three groups. The recurrence rate at follow-up was not significantly different among the three groups. The recurrence rate increased progressively with the increase of varicocles size from grade I to grade III for all the groups. The overall incidence of postoperative complications was significantly lower among the patients in group III. The postoperative spermiogram showed an increase in motility and sperm count for all the groups. There were no differences in the three techniques for resolution of pain, the duration of recovery and the spermiogram results. CONCLUSIONS: There was no significant difference in the rate of relapse after the surgery between the three different treatment techniques, and the factors involved in relapse were more related to the size and severity of the varicocele. Microsurgical varicocelectomy had a disadvantage of a prolonged operation time. However, there was a low rate of postoperative complications for all three techniques.

Modified Inguinal Palomo Technique in Surgical Repair of Varicocele / 대한비뇨기과학회지

PURPOSE: A varicocele is the most common correctable cause of infertility in men. Conventional techniques of varicocele repair are associated with substantial risks of hydrocele formation, varicoele persistence and recurrence. The inguinal approach with classic Palomo technique was used to be simplified the procedure and to get the same good results with the Palomo technique. MATERIALS AND METHODS: From March 1990 to March 1997, we experienced surgical corrections of 54 patients with varicocele(A mean age 20.3 years) The most of patients were left-sided(96.3%). Until March 1996, surgical correction with Palomo(6 patients) and modified Palomo(13 patients) technique by retroperitoneal approach and Ivanissevich techrique(20 patients) by inguinal approach have been performed, and since April 1996, Palomo technique(15 patients) with inguinal approach has been performed, in which the entire vascular pedicle is ligated superior to the entrance of the was deferens through the inguinal incision. RESULTS: The postoperative recurrences in the modified Palomo technique occurred In two of the 13 patients(15%) and in the Ivanissevich technique in three of the 20 patients(15%). But there were no recurrences In the retroperitoneal Palomo and modified inguinal Palomo techniques. The modified inguinal Palomo technique was completed within 45.3minutes in mean duration, but the standard retroperitoneal Palomo technique within 55.2minutes, modified Palomo technique within 57.2minutes and Ivanissevich technique within 51.4minutes. There was no varicocele recurrence, hydrocele and atrophy of testis in modified inguinal Palomo techniques. CONCLUSIONS: The modified inguinal Palomo technique was easily approachable and relatively fast in our experience and had no recurrence.