Abstract
Purpose
Several surgical approaches have been used for varicocelectomy. We report single port varicocelectomy using SILS™ (Covidien, Norwalk, CT) multiple access port.
Case
The greade III varicocele patient was 23 years old and placed in supine position. About 2 cm vertical skin incision was made in a crease just lateral to the umbilicus and SILS™ port was placed with three 5-mm trocars. Incision to posterior peritoneum from the point 3 cm superior to the internal inguinal was made by needle holder with a broken 15th blade tip. The testicular vessels were exposed. The lymphatic vessels and testicular artery were identified and separated from the testicular vein with flexible laparoscopic instruments and conventional rigid instruments. Three testicular veins were clipped with hemoclips (EndoClip , Autosuture, Norwalk, CT). Posterior peritoneum was repaired with 4-0 vicryl with one side of 5 mm Hem-o-lok clip (Weck Research,Triangle Park, NC). Than the distal end of suture site was also closed with Hem-o-lok.
Results
The whole procedure was completed with no complication. The operative time was 85 minutes, and blood loss was minimal. The patient was discharged 2 days after the operation. Left scrotal pain and vein engorgement was disappeared.
Conclusions
Our single port varicocelectomy method is a safe and effective alternative to conventional method. This will provide minimally invasive surgical option for varicocele and we can expect more potential cosmetic benefit and less morbid.
ARTICLE INFO
ARTICLE INFO Available at: www.brazjurol.com.br/videos/march_april_2015/Bae _395_396video.htm
Int Braz J Urol. 2015; 41 (Video #2): -6: 395-6
EDITORIAL COMMENT
AuthorshipThis video demonstrates the incredible versatility of single port laparascopy, and its implementation in the management in varicoceles. It allows the patient a quicker recovery, while still providing resolution of the pathology. We applaud the authors for their novel and innovative way of managing a very common urologic problem seen by most Urologists. With further improvement in the technology of minimally invasive therapies, the management of many more urologic diseases will become easier and hopefully more efficient and precise.
Daniel R. Martinez, MD
Clinical Instructor
Sexual Medicine Fellow
Department of Urology
Morsani College of Medicine,
University of South Florida, USA
E-mail: dmartine@health.usf.edu
Publication Dates
-
Publication in this collection
Mar-Apr 2015
History
-
Received
10 Jan 2015 -
Accepted
20 Feb 2015
