Lymphatic sparing, laparoscopic varicocelectomy: a new surgical technique

Several surgical options are available for managing varicoceles. Although conventional surgery offers good surgical results, the most common long-term complication of surgery is the development of hydroceles, thought to be due to interruption in the lymphatic outflow from the subservient testis. The authors describe a new technique of in vivo methylene blue mapping of testicular lymphatic vessels at laparoscopy, allowing these vessels to be spared during laparoscopic varicocelectomy. This novel method of in vivo staining of lymphatic vessels should prevent damage to the lymphatic system and avoid the late development of hydroceles. A prospective multicenter trial is currently underway to evaluate the medium- and long-term results.