Indocyanine green fluorescence-guided transumbilical three-port laparoscopic suprainguinal varicocelectomy with testicular artery and lymphatic preservation for pediatric varicocele: a retrospective cohort study.

Zhao Y, Yang Y, Zhang X, +5 more, Zhou H.

Journal ArticleAbstract only — full text under license

AI summary — for doctors, generated from the abstract only

Indocyanine green-guided transumbilical laparoscopic varicocelectomy preserving the testicular artery and lymphatics was feasible, with favourable short-term and cosmetic results.

What was studied

A retrospective cohort of 42 procedures in paediatric varicocele patients (2023-2024), assessing perioperative outcomes, complications, cosmetic results and changes in testicular volume and volume discrepancy at 6 months.

Key findings

All 42 procedures were completed laparoscopically with no conversion or intraoperative complications; median operative time was 26 min
Lymphatics were visualised and preserved in all patients, and during a median 11 months of follow-up there was no hydrocele, recurrence or testicular atrophy
At 3 months, 73.8% were very satisfied and 26.2% satisfied with cosmesis
Mean ipsilateral testicular volume rose from 9.45 to 10.84 mL and mean volume discrepancy fell from 14.92% to 7.65%

Clinical relevance

Offers a lymphatic-sparing technique that may reduce hydrocele risk and scarring.

Who should care

Pediatric Surgery

Limitations

Retrospective, single-arm, no comparison with other techniques, short follow-up, and testicular growth may partly reflect natural growth rather than the operation.

A technically feasible and well-tolerated approach, but comparative and longer-term data are needed.

This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.

Abstract

Purpose

To evaluate the technical feasibility and short-term perioperative and cosmetic outcomes of indocyanine green (ICG) fluorescence-guided transumbilical three-port laparoscopic suprainguinal varicocelectomy with testicular artery and lymphatic preservation in pediatric patients, and to describe changes in testicular volume and testicular volume discrepancy (TVD) at 6 months after surgery.

Methods

A retrospective analysis was conducted on pediatric patients with varicocele who underwent surgical treatment at our institution between January 2023 and December 2024. All patients underwent ICG fluorescence-guided transumbilical three-port laparoscopic suprainguinal varicocelectomy with testicular artery and lymphatic preservation. Perioperative outcomes, postoperative complications, cosmetic outcomes, and ultrasonographic testicular-volume measurements were analyzed. Paired preoperative and 6-month postoperative testicular-volume measurements were compared.

Results

All 42 procedures were completed laparoscopically without conversion or intraoperative complications. The median operative time was 26 min, median estimated blood loss was 2 mL, and postoperative hospital stay was 1 day. Lymphatic vessels were visualized and preserved in all patients. During a median follow-up of 11 months, no hydrocele, recurrent varicocele, testicular atrophy, or Doppler-detected venous reflux was observed. At 3 months, the median Vancouver Scar Scale score was 1; 31 patients (73.8%) were very satisfied and 11 (26.2%) were satisfied with the cosmetic outcome. At 6 months, mean ipsilateral testicular volume increased from 9.45 to 10.84 mL, while mean TVD decreased from 14.92% to 7.65%.

Conclusion

ICG fluorescence-guided transumbilical three-port laparoscopic suprainguinal varicocelectomy with testicular artery and lymphatic preservation was technically feasible in this retrospective cohort and was associated with favorable short-term perioperative and cosmetic outcomes.

DOI

10.1007/s00383-026-06669-z

PMID

42862399

Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.

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