Saw a young man in clinic today with complaints of left testicular pain, that gets worse as the day goes. On examination, was found to have a large grade IV varicocele on the left. In all men, the right testicular vein drains to the vena cava, but on the left, the venous drainage goes into the left renal vein, and then the vena cava. This increased resistance may cause a back-up of blood, causing congestion, and then, a varicocele. We now have ability to treat varicoceles on an outpatient basis, with laparoscopic technique.
One incision is made at the umbilicus (belly-button), with two tiny 4mm incisions near the belt line.
Via the incisions, we identify the gonadal vein, and transect it.
The entire procedure is completed in approximately 30 minutes.
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