Laparoscopic varicocelectomy: a simple technique for clip ligation of the spermatic vessels.

Less invasive laparoscopic surgery is replacing the conventional open operation for the treatment of several conditions. We performed laparoscopic clamping of the internal spermatic vessels in 12 subfertile patients to treat varicocele of the testis. Seven operations were performed with the patient under general anesthesia, whereas a local anesthetic was used in the 5 most recent patients. The internal spermatic vessels were successfully clipped in all 12 patients. Postoperative physical examination with a Doppler stethoscope showed that the venous reflux had disappeared in all patients. Semen quality was improved in 7 patients with a followup of 3 to 10 months. Neither hydrocele nor testicular atrophy was observed postoperatively. Laparoscopic varicocelectomy was effective and minimally invasive, especially when performed with the patient under local anesthesia.