Department of Pediatric Surgery, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark.
Pediatr Surg Int. 2023 May 20;39(1):202. doi: 10.1007/s00383-023-05488-w.
To present our experience with robot-assisted laparoscopic varicocelectomy in a pediatric population.
We reviewed 49 consecutive cases performed by the same experienced surgeon. One-to-four veins were ligated at the internal ring of the inguinal canal, while the testicular artery and lymphatics were spared. Information on patient characteristics, surgical time, complications, and recurrences were collected.
Median patient age was 14 (range 10-17) years. Forty-eight had left-sided varicoceles and one had a bilateral varicocele. Forty-five were grade 3. All patients were referred due to discomfort/pain and 20 also had reduced testicular size. The median operating time from skin incision was 48 min (31-89 min) and the median console time was 18 min (7-55 min). Forty-seven patients were discharged the same day. Two patients experienced pain and problems urinating, respectively. These issues had resolved by the first post-operative day. There were no other complications, but at 6 months, eight recurrences were noted (16%). Scrotal complaints had subsided in all patients. Catch-up growth of the affected testicles was seen in 19/20 cases.
Robot-assisted laparoscopic varicocelectomy is feasible and safe in a pediatric population but with a relatively high recurrence rate.
介绍我们在小儿人群中开展机器人辅助腹腔镜精索静脉曲张手术的经验。
我们回顾了由同一位经验丰富的外科医生完成的 49 例连续病例。在腹股沟管内环处结扎 1 至 4 条静脉，同时保留睾丸动脉和淋巴管。收集患者特征、手术时间、并发症和复发等信息。
中位患者年龄为 14 岁（范围 10-17 岁）。48 例为左侧精索静脉曲张，1 例为双侧精索静脉曲张。45 例为 3 级。所有患者均因不适/疼痛就诊，20 例患者还伴有睾丸缩小。从皮肤切口到手术的中位操作时间为 48 分钟（31-89 分钟），控制台的中位时间为 18 分钟（7-55 分钟）。47 例患者当天出院。2 例患者分别出现疼痛和排尿困难，这些问题在术后第一天就已解决。无其他并发症，但在 6 个月时，发现 8 例复发（16%）。所有患者的阴囊不适均已缓解。在 20 例中有 19 例受影响的睾丸出现追赶生长。
机器人辅助腹腔镜精索静脉曲张手术在小儿人群中是可行且安全的，但复发率相对较高。
