A technique for laparoscopic varicocelectomy in children with ICG fluorescent lymphography



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Abstract

   Introduction. Laparoscopic varicocelectomy by the Palomo-Erokhin technique is one of the most common approaches for treating varicocele in children, but postoperative hydrocele is still a major complication after it. The authors present a novel technique of lymphography with indocyanine green (ICG).

   Material and methods. A case of a boy, aged 13, with grade 3 varicocele accompanied by hypotrophy of the left testicle and pain in the left half of the scrotum is described in the article. He was operated on laparoscopically by the Palomo–Erokhin technique using RUBINA manufactured by Karl Storz company. After placing trocars under the tunica albicans of the left testicle, 6.5 mg ICG fluorescent solution was injected. Lymphatic vessels were clearly identified on ICG images. The testicular vein was separated from the vascular bundle, then ligated and transected.

   Results. Intratesticular ICG injection and fluorescent images allowed to identify all lymphatic vessels. Surgery lasted for 25 minutes. No allergies or other adverse reactions caused by ICG were registered. In 6 months, there were no signs of recurrence and hydrocele formation.

   Conclusion. Our initial experience has shown that fluorescent lymphography with ICG is a safe and effective technique for lymph-sparing laparoscopic varicocelectomy in children, when using the Palomo-Erokhin technique.

About the authors

Yu. A. Kozlov

Children’s Regional Clinical Hospital; Irkutsk State Medical Academy of Postgraduate Education; Irkutsk State Medical University

Author for correspondence.
Email: yuriherz@hotmail.com
ORCID iD: 0000-0003-2313-897X

Yuri Yu. Kozlov, MD, PhD, DSc, Prof., head of department

department of newborns

664022

664049

664009

Irkutsk

Россия

S. S. Poloyan

Children’s Regional Clinical Hospital; Irkutsk State Medical University

Email: fake@neicon.ru
ORCID iD: 0000-0001-7042-6646

664022

664009

Irkutsk

Россия

A. A. Marchuk

Children’s Regional Clinical Hospital

Email: fake@neicon.ru
ORCID iD: 0000-0001-9767-0454

664022

Irkutsk

Россия

A. P. Rozhansky

Irkutsk State Medical University

Email: fake@neicon.ru
ORCID iD: 0000-0001-7922-7600

664009

Irkutsk

Россия

A. A. Byrgazov

Irkutsk State Medical University

Email: fake@neicon.ru
ORCID iD: 0000-0002-9195-5480

664009

Irkutsk

Россия

K. A. Kovalkov

Atamanov Kuzbass Regional Children’s Clinical Hospital; Kemerovo State Medical University

Email: fake@neicon.ru
ORCID iD: 0000-0001-6126-4198

650056

Kemerovo

Россия

V. M. Kapuller

Assuta University Medical Center

Email: fake@neicon.ru
ORCID iD: 0000-0003-0076-5778

Ben Gurion in the Negev

Ashdod

Израиль

A. N. Narkevich

Voyno-Yasenetsky Krasnoyarsk State Medical University

Email: fake@neicon.ru

660022

Krasnoyarsk

Россия

S. A. Muraviev

Irkutsk State Medical University

Email: fake@neicon.ru
ORCID iD: 0000-0003-4731-7526

664009

Irkutsk

Россия

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