Laparoscopic Management of Varicocele Using Bipolar Cautery Versus Open High Ligation Technique: A Randomized, Clinical Trial

Abstract

The aim of this investigation was to compare laparoscopic management of varicocele using bipolar cautery with open high ligation technique. A total of 100 patients were operated on for left-sided varicoceles. To evaluate the clinical efficiency of the treatment, the patients were divided randomly into two groups. A laparoscopic varicocelectomy (LV) was performed on 50 patients, and an open varicocelectomy (OV) was performed on 50 patients. Outcome data examined operating time, relapse rate, presence of hydrocele, wound complications, postoperative length of stay, and pain control. In both groups, the operations were performed with the preservation of lymphatics and artery with ligation of the veins in the retroperitoneum above the internal inguinal ring. The operative time was 17.2 +/- 9.8 minutes in LV versus 31.02 +/- 12.8 minutes; in OV (P = .00). In LV versus OV, relapse rates were 8% versus 4% (P > 0.05), hydrocele occurrence was 14% versus 24% (P > 0.05), and wound complication was 0.00% versus 6%. Hospital stay was an average of 12 hours in both groups. Postoperative analgesic use was 3.6 +/- 0.4 mg in LV versus 3.5 +/- 0.5 mg in OV (P > 0.05). The clinical efficacy of LV using bipolar cautery is superior to traditional OV.