MR 02. Application of umbilical hole laparoscopy in the treatment of bilateral varicocele

Objective: To evaluate the clinical significance of the umbilical hole laparoscopic spermatic vein ligation in the treatment of bilateral varicocele.

Methods: Forty-two patients with bilateral varicocele received bilateral ligation using laparoscopic techniques from January 2010 to September 2010. They included 20 cases of the umbilical hole laparoscopic group and 22 of the conventional laparoscopic group The blood loss, testicular artery salvage, operation length, time to ambulation after surgery, time to intestinal function recovery and hospital stay were compared in the two groups with semen quality measured before and one year after the procedures. Four clinic visits were made at one month, three months, six months and one year after surgery to evaluate the incisions and presence of complications related to the scrotum, spermatic cord and testis. Patients were asked to report mitigation of discomfort feelings such as scrotum dragging.

Results: All surgeries were successful in both groups without any event of severe complications. There was no difference in the blood loss [(5±1) mL/ (5±1) mL, t=–0.452, P>0.05], operation duration [(41±7) min/ (39±3) min, t=0.686, P>0.05], time to intestinal function recovery [(11+1) h/ (11+2), t=–1.631, P>0.05] or postoperative hospital stay [(3.1+0.7) d/ (3.4+0.7), t=–1.447, P>0.05] between the two groups. One patient in the hole laparoscopic group required analgesics (5.0%), less than that (seven, 31.8%) in the conventional laparoscopic group, which was significantly different (χ²=4.886, P<0.05). Patients who received the umbilical hole laparoscopic procedure were almost "scarfree". All patients completed the incision satisfaction survey one year after the surgery, and statistical analysis revealed significant difference between the two groups (χ²=7.636, P<0.01).

Conclusions: The umbilical hole laparoscopic surgery provides comparable effect in bilateral spermatic vein ligation to traditional laparoscopic surgery while being less invasive and more aesthetic. It is a promising approach that worth promoting.