Indigo Carmine Dye-Assisted Lymphatic-Sparing Laparoscopic Palomo Varicocelectomy In Children

The ideal method for varicocelectomy in children remains controversial. We present
our experience with dye-assisted lymphatic-sparing laparoscopic varicocelectomy (LSLV) in children, which overcomes the limitations of previously described techniques.
Materials and methods : Five consecutive LSLVs were performed over a period of three
years on children with a mean age of twelve years. The varicocele grade was three in one
case and grade 2 in four cases, respectively. A left subdartos injection of 2 ml of Indigo carmine dye was done using a 25-gauge needle at ten minutes before an operation. A scrotal injection of lymphatic dye was utilized to spare at least one lymphatic and the remaining spermatic vessels were divided. Results : Lymphatic-sparing was accomplished in all cases.
No peri-operative complication was noted.We spared one lymphatic channel in one patient
(20%) and two channels in four patients (80%). There were no cases of hydrocele or
residual varicocele. Conclusion : Dye-assisted LSLV is easily accomplished with an excellent surgical outcome and sparing one or two lymphatics appears to be sufficient to avoid secondary hydrocele.