Page 24 - Journal of Laparoscopic Surgery

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Shaukat Jeelani et al. 10.5005/jp-journals-10033-1339
RESEARCH ARTICLE

Laparoscopic versus open Varicocelectomy:

An Observational Study

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1 Shaukat Jeelani, Atif Naeem, Ishfaq A Gilkar, Javid A Peer, Umer Mushtaq
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ABSTRACT INTRODUCTION
Background: Varicocele is a collection of abnormally dilated, Varicocele is a collection of abnormally dilated, tortuous
tortuous veins. A clinical varicocele is found in about 15% of all veins. A clinical varicocele is found in about 15% of all
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adult males, up to 35% of men who present for infertility evalu- adult males, up to 35% of men who present for infertility
ation and as many as 81% of men with secondary infertility,
with a marked left-sided predominance. It is the most common evaluation, and as many as 81% of men with secondary
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correctable cause of male infertility. infertility, with a marked left-sided predominance. It
is the most common correctable cause of male infertil-
Methodology: This study was conducted in the postgraduate
department of surgery, Government Medical College, Srinagar ity. Several non-randomized studies have suggested that
for 2 years from December 2010 till May 2013. This was a repairing a clinically palpable varicocele in the presence
prospective study and a total of 100 patients with clinically of abnormal semen analysis results in improvement of
significant varicocele were included in this study. Patients were parameters and pregnancy rates. As most adolescent
divided into two groups. Group A comprised of 50 patients who varicoceles are asymptomatic and many are discovered
underwent open surgery, and group B comprised of 50 patients
who underwent a laparoscopic approach. on routine physical examination, therefore true incidence
of varicocele is much higher than expected. The introduc-
Results: In our series of 100 patients, the minimum age was tion of radiographic diagnostic studies and scrotal ultra-
10 and maximum was 50 years, eighty six had scrotal pain, 81
had testicular swelling and 25 patients presented with infertil- sound has allowed for improved diagnosis and further
ity, the operation time for laparoscopic varicocelectomy 48 characterization of varicocele. According to the criteria
minutes (mean) and in open surgery was 57 minutes (mean), proposed by the World Health Organization (WHO
We observed that postoperative analgesic requirement was 19853), varicoceles are categorized as grade I–when
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almost equal in both groups,average hospital stay of 35.6 the impulse of dilated veins appear over scrotal skin
hours and 50.6 hours were observed in laparoscopic and open
groups respectively. with Valsalva maneuver but without venous tortuosity.
Grade II–when a palpable tortuosity and an impulse are
Conclusion: In our study of 100 patients it was observed found with Valsalva maneuver. Grade III–when a pal-
that the results of laparoscopic varicocelectomy were com-
parable to open technique with minimum morbidity, shorter pable tortuosity without abdominal straining is noted
hospital stay and with the advantage of treating bilateral during the physical examination.
varicoceles without any additional incisions. Also, lapa- Different approaches have been applied for the treat-
roscopic varicocelectomy produces better overall patient ment of varicocele including open surgery, sclerotherapy
satisfaction and hence can be considered as a preferred and, recently, laparoscopy. In this study, we evaluated
surgical technique although sperm analysis results were the
same in both methods. and compared the operative time, sperm parameters
and complications in the postoperative period between
Keywords: Laparoscopic, Infertility, Varicocelectomy.
laparoscopic and conventional methods for high open
How to cite this article: Jeelani S, Naeem A, Gilkar IA, Peer ligation of varicocele.
JA, Mushtaq U. Laparoscopic versus open Varicocelectomy:
An Observational Study. World J Lap Surg 2018;11(2):76-80.
METHODOLOGY
Source of support: Nil
This study was conducted in the postgraduate depart-
Conflict of interest: None
ment of surgery, Government Medical College Srinagar
for 2 years from December 2010 till May 2013. This was
1 HOD, 2-5 Senior Resident a prospective study and a total of 100 patients with clini-
1-5 Department of General Surgery, Government Medical College cally significant varicocele were included in this study.
Srinagar, Jammu and Kashmir, India Patients were divided into two groups. Group A com-
Corresponding Author: Ishfaq A Gilkar, Senior Resident, prised of 50 patients who underwent laparoscopic surgery
Department of General Surgery, Government Medical College and group B comprised of 50 patients who underwent
Srinagar, Jammu and Kashmir, India. e-mail: drishfaqahmedgilkar an open approach. Majority of patients were in the age
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group ranging from 12 years to 36 years (average 24 years)
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