Pediatric surgery international · 2026
Indocyanine green fluorescence-guided transumbilical three-port laparoscopic suprainguinal varicocelectomy with testicular artery and lymphatic preservation for pediatric varicocele: a retrospective cohort study.
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Zhao Yang, Yang Yanpei, Zhang Xiaowei, Lu Kuan, Ma Lifei, Tao Tian, Zhou Xiaoguang, Tao Yuandong, Zhou Huixia
Аннотация
PURPOSE: To evaluate the technical feasibility and short-term perioperative and cosmetic outcomes of indocyanine green (ICG) fluorescence-guided transumbilical three-port laparoscopic suprainguinal varicocelectomy with testicular artery and lymphatic preservation in pediatric patients, and to describe changes in testicular volume and testicular volume discrepancy (TVD) at 6 months after surgery.
METHODS: A retrospective analysis was conducted on pediatric patients with varicocele who underwent surgical treatment at our institution between January 2023 and December 2024. All patients underwent ICG fluorescence-guided transumbilical three-port laparoscopic suprainguinal varicocelectomy with testicular artery and lymphatic preservation. Perioperative outcomes, postoperative complications, cosmetic outcomes, and ultrasonographic testicular-volume measurements were analyzed. Paired preoperative and 6-month postoperative testicular-volume measurements were compared.
RESULTS: All 42 procedures were completed laparoscopically without conversion or intraoperative complications. The median operative time was 26 min, median estimated blood loss was 2 mL, and postoperative hospital stay was 1 day. Lymphatic vessels were visualized and preserved in all patients. During a median follow-up of 11 months, no hydrocele, recurrent varicocele, testicular atrophy, or Doppler-detected venous reflux was observed. At 3 months, the median Vancouver Scar Scale score was 1; 31 patients (73.8%) were very satisfied and 11 (26.2%) were satisfied with the cosmetic outcome. At 6 months, mean ipsilateral testicular volume increased from 9.45 to 10.84 mL, while mean TVD decreased from 14.92% to 7.65%.
CONCLUSION: ICG fluorescence-guided transumbilical three-port laparoscopic suprainguinal varicocelectomy with testicular artery and lymphatic preservation was technically feasible in this retrospective cohort and was associated with favorable short-term perioperative and cosmetic outcomes.
METHODS: A retrospective analysis was conducted on pediatric patients with varicocele who underwent surgical treatment at our institution between January 2023 and December 2024. All patients underwent ICG fluorescence-guided transumbilical three-port laparoscopic suprainguinal varicocelectomy with testicular artery and lymphatic preservation. Perioperative outcomes, postoperative complications, cosmetic outcomes, and ultrasonographic testicular-volume measurements were analyzed. Paired preoperative and 6-month postoperative testicular-volume measurements were compared.
RESULTS: All 42 procedures were completed laparoscopically without conversion or intraoperative complications. The median operative time was 26 min, median estimated blood loss was 2 mL, and postoperative hospital stay was 1 day. Lymphatic vessels were visualized and preserved in all patients. During a median follow-up of 11 months, no hydrocele, recurrent varicocele, testicular atrophy, or Doppler-detected venous reflux was observed. At 3 months, the median Vancouver Scar Scale score was 1; 31 patients (73.8%) were very satisfied and 11 (26.2%) were satisfied with the cosmetic outcome. At 6 months, mean ipsilateral testicular volume increased from 9.45 to 10.84 mL, while mean TVD decreased from 14.92% to 7.65%.
CONCLUSION: ICG fluorescence-guided transumbilical three-port laparoscopic suprainguinal varicocelectomy with testicular artery and lymphatic preservation was technically feasible in this retrospective cohort and was associated with favorable short-term perioperative and cosmetic outcomes.