Abstract:【Objective】 To investigate the safety and feasibility of umbilical laparoendoscopic single-site varicocelectomy using the two-trocar technique. 【Methods】 Between April 2011 and October 2012, 18 consecutive patients underwent umbilical laparoendoscopic single-site varicocelectomy (U-LESV) using the two-trocar technique. 16 cases on the left side and 2 cases on both sides. An approximately 1.0~1.5 cm arc incision was made in the inferior edge of the umbilicus, then a Veress needle was directed through this skin incision and CO2 was insufflated. After the pressure of the pneumoperitoneum reached 15 mm Hg pressure, the primary 5 mm Trocar was punctured on the left side at the ends of the wound, followed by a 5 mm rigid 30 degree cystoscope introduced to allow the placement of the second 5-mm trocar under direct vision on the right side at the ends of the incision. Using conventional laparoscopic grasper and scissors, a parallel incision was made in the posterior peritoneum 2~3 cm proximal to the internal ring. The spermatic vessels were then dissected and two or three nonabsorbable polymer Hem-o-lok clips were applied on the spermatic vessels, both veins and artery. 【Results】 All procedures were performed successfully and no complications occured. The mean operative time was 14.5 minutes (range, 10 to 25 minutes) on the left side and 32.5 minutes (range, 30 to 35 minutes) on both sides．The mean postoperative hospital stay was 3.4 days (range, 2 to 5 days). The postoperative follow-up was 3 to 24 months by physical examination and Doppler ultrasonography, and there was no evidence of varicocele recurrence or testicular atrophy. 【Conclusion】 Umbilical laparoendoscopic single-site varicocelectomy using the two-trocar technique is a feasible alternative to varieocele with the advantages of simple procedure,less trauma, quick recovery and improved cosmetic results.
