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Laparoendoscopic single-site surgery versus conventional laparoscopic varicocele ligation in men with palpable varicocele: A randomized, clinical study

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Abstract

Objective

This study was designed to compare the outcomes of two different surgical techniques: conventional transperitoneal laparoscopic varicocele ligation (CTL-VL), and laparoendoscopic single-site varicocele ligation (LESS-VL), using transumbilical home-made single port device.

Methods

Our sample included 82 male patients with 92 clinically palpable varicoceles who underwent varicocelectomy. The patients were randomly allocated to one of two groups according to varicocele ligation technique. Early postoperative complications, hospital stay, time to return to work, degree of satisfaction, and semen parameters were assessed. A visual analogue scale (VAS) pain score that ranged from 0 to 10 and analgesia requirements during the postoperative course were used to evaluate postoperative pain.

Results

The operating room time and hospital stay of the two study groups were comparable, but time to return to normal activity was significantly shorter in the LESS group compared with the CTL group (P = 0.025). Both VAS and the postoperative use of analgesics were significantly lower during postoperative days 2 (P = 0.005) and 3 (P = 0.047) in patients who underwent LESS-VL compared with patients who underwent CTL-VL. Significant improvements in sperm count, motility, and morphology were observed in both groups (P < 0.001; at each of the variables in both groups), but the proportion of patients who showed improvement was not significantly different between the two groups.

Conclusions

This relatively small-scale study suggests that LESS-VL is a safe and effective alternative to CTL-VL that provides surgeons with a minimally invasive surgical option and the ability to hide the surgical incision within the umbilicus.

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Disclosures

Drs. Lee, Lee, Kim, and Ha have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Urology, Hanyang University College of Medicine, Seoul, Korea

    Seung Wook Lee & Joo Yong Lee

  2. Department of Anesthesiology and Pain Medicine, Hanyang University College of Medicine, Seoul, Korea

    Kyoung Hun Kim

  3. Department of Urology, St Mary’s Hospital, The Catholic University of Korea College of Medicine, 62 Yeouido-dong, Yeongdeungpo-gu, Seoul, 150-713, Korea

    U-Syn Ha

Authors
  1. Seung Wook Lee
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  2. Joo Yong Lee
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  3. Kyoung Hun Kim
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  4. U-Syn Ha
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Correspondence to U-Syn Ha.

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Lee, S.W., Lee, J.Y., Kim, K.H. et al. Laparoendoscopic single-site surgery versus conventional laparoscopic varicocele ligation in men with palpable varicocele: A randomized, clinical study. Surg Endosc 26, 1056–1062 (2012). https://doi.org/10.1007/s00464-011-1997-2

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  • DOI: https://doi.org/10.1007/s00464-011-1997-2

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