Comparison of Open Versus Laparoscopic High Ligation Varicocelectomy For The Treatment Of Varicocele

Varicocele is a common condition in which veins around the testis become enlarged, and it may be associated with scrotal discomfort and reduced fertility. Surgical treatment aims to stop the backward flow of blood in these veins so that the testicular environment improves. This randomized controlled trial was conducted in the Department of Urology, PGMI, Lahore General Hospital, Lahore, over a six-month period.

Male patients aged 20 to 60 years with diagnosed varicocele and planned varicocelectomy under general anesthesia were enrolled after informed consent. Patients with recurrent varicocele, secondary varicocele, associated undescended testis, or a history of orchidopexy were excluded. Eligible participants were allocated into two groups using a lottery method. In Group A, high ligation was performed by the open method through a lower abdominal incision, with identification and ligation of the dilated testicular veins at a high level. In Group B, high ligation was performed laparoscopically using three small ports, with the testicular vein identified, clipped, and divided. Standard perioperative care was provided, including intravenous antibiotics and postoperative analgesia.

The study compared the two techniques in terms of mean operation time , length of hospital stay , and wound infection . The hypothesis was that a difference existed between open and laparoscopic high ligation varicocelectomy regarding operation time, hospital stay, and wound infection.