Name of the Procedure:

Laparoscopy, surgical, with ligation of spermatic veins for varicocele

• Common name(s): Laparoscopic varicocelectomy

Summary

Laparoscopic varicocelectomy is a minimally invasive surgical procedure used to treat varicoceles, which are enlarged veins in the scrotum. This procedure involves using a small camera and specialized instruments to tie off the affected veins.

Purpose

Varicoceles can cause pain, swelling, and infertility. The goals of laparoscopic varicocelectomy are to alleviate symptoms, prevent further complications, and improve fertility.

Indications

• Persistent scrotal pain or discomfort
• Infertility associated with varicocele
• Testicular atrophy (shrinkage)
• Presence of a palpable varicocele

Preparation

• Fasting for at least 8 hours before the procedure
• Stopping certain medications as advised by the healthcare provider
• Undergoing pre-op assessments, such as blood tests and a physical examination

Procedure Description

1. The patient is placed under general anesthesia.
2. Small incisions are made in the abdomen.
3. A laparoscope (a thin tube with a camera) is inserted through one of the incisions to visualize the surgical area.
4. Special surgical instruments are inserted through other incisions to access the spermatic veins.
5. The affected veins are identified and ligated (tied off) to stop the abnormal blood flow.
6. Instruments are removed, and incisions are closed with sutures.

Duration

Approximately 1-2 hours.

Setting

Performed in a hospital or surgical center.

Personnel

• Surgeon
• Anesthesiologist
• Surgical nurses
• Surgical technologists

Risks and Complications

• Infection
• Bleeding
• Injury to nearby structures, such as the intestines or bladder
• Hydrocele formation (fluid accumulation around the testicle)
• Recurrence of varicocele
• Anesthesia-related complications

Benefits

• Relief from pain and discomfort
• Improved fertility outcomes
• Reduced risk of testicular atrophy

Recovery

• Instructions for pain management and wound care
• Limiting physical activity for several weeks
• Follow-up appointments to monitor healing
• Expected recovery time: 1-2 weeks for initial recovery, with gradual return to normal activities

Alternatives

• Open surgical varicocelectomy
  • Pros: Direct visualization of affected veins
  • Cons: Larger incision, longer recovery time
• Percutaneous embolization
  • Pros: Non-surgical, quicker recovery
  • Cons: May not be as effective as surgery in some cases

Patient Experience

• During the procedure: Under general anesthesia, the patient is unconscious and does not feel pain.
• Post-procedure: Mild to moderate pain managed with medication, some swelling and bruising at incision sites.
• Full recovery: Gradual return to normal activities, including work and exercise. Avoid heavy lifting and strenuous activities during the healing phase.