Laparoscopic varicocelectomy is performed for varicocle. Varicocele is an enlargement of veins as a group and it is located in scrotum. The enlargement here is abnormal. The veins plexus drains out the testicles. The blood vessels of testicles are originated in the abdomen and pass through inguinal canal, present in the spermatic cord and move towards the testis. Backflow is prevented and upward blood flow is enabled by one way valves, which are in small sizes. When the veins are compressed or valves become defective by means of the nearby structure, these lead o varicocele formation. When the blood is collected within the veins, it results the temperature to be increased in the testes. It will result in the sperm production efficiency. The entire process causes sbfertility or infertility in the male. The overall motility and sperm count will be decreased and the shape of them are also changed. Most likely it occurs in the testes that are left side, however, the same might possibly present both of the sides.
The condition is caused because of the absence of the valves or incompetent valves present in the spermatic vessels having the blood to be in the backflow. The valves that are defective cannot prevent the blood to flow back. When there are any structural differences present in the left and right testes make it more vulnerable to this problem. Compression of the renal vein at the left side, in between the high pressured superior mesenteric artery and aorta transmitted to left spermatic vein is another cause. It would interfere with the blood flow that is normal and present in the spermatic veins. This syndrome is called as a nutcracker syndrome.
Signs and Symptoms
Symptoms of the varicocele are,
- Shrink of the testicles, either single or both
- Arching or dragging like pain present in scrotum
- Heaviness felt in one or both the testicles
- Palpable or visible enlarged vein close to the scrotum
- Changes found in testosterone levels
Diagnosis needed for the laparoscopic varicocelectomy is the complete physical examination and the following.
- Doppler ultrasound
- Infrared thermometry
The objective of the treatment performed for the varicocele is the obstruction of the refluxing venous drainage to the testis at the same time inflow of arterial and lymphatic drainage are maintained. So, varicocelectomy surgical procedure is the most commonly used procedure performed and recommended for the infertility problems caused in men.
Many of the treatments are available for varicocele and the selection of the treatment is done according to the symptoms and intensity of the symptoms. If the varicocele does not show any symptoms like infertility or pain, there are no treatments required. But the treatment is recommended, when there is any mild discomfort present, such problems can well be managed by wearing the sung-fitting underwear and athletic supporters, while performing any strenuous activities or any exercises.
Laparoscopic varicocelectomy procedure starts with giving the general anesthesia and making three incisions of 5mm each on the abdomen. Then the doctors approach varicoceles, either from left or right, or even on both. A small camera, which is laparoscope inserted through one of these incisions. Some of the small instruments are inserted into other incisions to reach the veins that are abnormal and these are divided after clipping. But the lymphatic and arterial supply is not touched. The venous flow that flows towards the testes and scrotum is made to be rerouted to the veins that are normal.
The advantages are majorly, because of the laparoscope used in the surgery.
- All veins can be identified accurately.
- Injuries to lymphatic vessels and arteries are avoided.
- Further surgical incisions are not needed for correcting varicoceles at both the sides.
- Minimized trauma is experienced to the tissues, as only 5 mm small wound is resulted.
- Rapid recovery
- Minimal pain
Cost of Laparoscopic Varicocelectomy Procedure
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