Laparoscopic Varicocele Ligation

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Essential equipment: 

  • Two 5mm, one 12mm disposable trocars
  • One 5mm fenestrated grasping forceps
  • 5mm Maryland forceps
  • Scissors
  • 5mm clip appliers (Haem-o-Lok)

The technique of laparoscopic varicocele ligation is very straightforward.  

The intra­-abdominal vas deferens are identified as structures which join the spermatic cord above and medial to the internal inguinal ring. The gonadal vessels are visualized easily in the retroperitoneum. The posterior peri­toneum is incised with endoscopic scissors.

The gonadal vessels are then mobilized watching out for the spermatic artery and its branches. 

After identifying the gonadal artery, the surgeon isolates the gonadal vein or veins using blunt dissection with atraumatic graspers.  The vein is then clipped and divided. 

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SPIRE Hospital, Bristol. 
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