Zampieri Nicola
Woman and Child Hospital, Azienda Ospedaliera Universitaria Integrata, Department of Pediatric Surgery, Paediatric Fertility Lab, University of Verona Piazzale A. Stefani 1, Verona, Italy.
Am J Clin Exp Urol. 2020 Aug 15;8(4):101-105. eCollection 2020.
Varicocele is one of the most frequent andrological diseases in adolescents; laparoscopic varicocelectomy is a good option. The aim of this study is to investigate, report and evaluate surgical outcomes of laparoscopic technique in pediatric age using percutaneous instruments.
We report our experience with a new technique for varicocelectomy. I.R.B. approved the study. Patients with varicocele and testicular hypotrophy age between 9 and 16 years underwent laparoscopic varicocelectomy using a single transumbilical port for camera and 2 laparosocpic 2.5 mm percutaneous instruments. After dissection of lymphatic vessels and artery, veins were coagulated using monopolar hook. After the procedure a standard umbilical closure was performed using resorbable stiches, without suture into the percutaneous accesses. All patients underwent 2 controls visit at 3 and 6 months after surgery.
During the study period (April 2018-October 2019) 25 patients were treated; all patients were treated by the same surgeon. There were no cases of recurrence nor hydrocele. All patients reported a good post-op activity without pain and a good cosmetic result.
This first small series report a new technique for varicocelectomy; our study demonstrate that this technique is safe without complications and it is associated with good cosmetic results.
精索静脉曲张是青少年最常见的男科疾病之一;腹腔镜精索静脉高位结扎术是一种不错的选择。本研究的目的是调查、报告和评估使用经皮器械的腹腔镜技术在儿童期的手术效果。
我们报告了一种精索静脉高位结扎术新技术的经验。本研究经机构审查委员会批准。年龄在9至16岁之间、患有精索静脉曲张和睾丸发育不良的患者接受了腹腔镜精索静脉高位结扎术,使用一个经脐单孔作为摄像头通道,以及2个2.5毫米的腹腔镜经皮器械。在分离淋巴管和动脉后,使用单极电钩凝固静脉。手术后,使用可吸收缝线进行标准的脐部缝合,经皮穿刺部位不缝合。所有患者在术后3个月和6个月进行了2次随访。
在研究期间(2018年4月至2019年10月),共治疗了25例患者;所有患者均由同一位外科医生治疗。没有复发和鞘膜积液的病例。所有患者术后活动良好,无疼痛,美容效果良好。
这篇首次发表的小样本系列报道了一种精索静脉高位结扎术的新技术;我们的研究表明,该技术安全无并发症,且美容效果良好。