Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2023 Mar 27:50:e20233468.
doi: 10.1590/0100-6991e-20233468-en. eCollection 2023.

Bilateral inguinal transabdominal pre-peritoneal laparoscopic hernioplasty associated to bilateral laparoscopic varicocelectomy in the same intervention: a feasibility study

[Article in English, Portuguese]
Mikhael Belkovsky  1   2 , Edgar Oliveira Sarmento  2 , Luis Felipe Couto Novaes  2 , Carlo Camargo Passerotti  2 , José Pontes Junior  1   2 , Linda Ferreira Maximiano  1 , José Pinhata Otoch  1 , Jose Arnaldo Shiomi DA-Cruz  1
Affiliations
Randomized Controlled Trial

Bilateral inguinal transabdominal pre-peritoneal laparoscopic hernioplasty associated to bilateral laparoscopic varicocelectomy in the same intervention: a feasibility study

[Article in English, Portuguese]
Mikhael Belkovsky et al. Rev Col Bras Cir. .

Abstract
in English, Portuguese

Introduction: Inguinal hernia and varicocele are common conditions in male population. Laparoscopy brings the opportunity to treat them simultaneously, through the same incision. However, there are different opinions about the risks for testicular perfusion of multiple procedures in the inguinal region. In this study, we assessed the feasibility of simultaneous laparoscopic procedures by studying clinical and surgical outcomes of patients undergoing bilateral inguinal hernioplasty using the transabdominal preperitoneal (TAPP) technique with and without concomitant bilateral laparoscopic varicocelectomy (VLB).

Methods: a sample of 20 patients from the University Hospital of USP-SP with indirect inguinal hernia and varicocele with indication for surgical correction was selected. Patients were randomized into two groups, 10 undergoing TAPP (Group I) and 10 undergoing simultaneous TAPP and VLB (Group II). Data regarding total operative time, complications and postoperative pain was gathered and analyzed.

Results: there was no statistical difference between groups regarding total operative time and postoperative pain. Only one complication (spermatic cord hematoma) was observed in Group I and no complications were observed in Group II.

Conclusions: simultaneous TAPP and VLB in was shown to be effective and safe, which provides a basis for conducting studies on larger scales.

Introdução:: hérnia inguinal e varicocele são doenças comuns na população masculina. O advento da laparoscopia traz a oportunidade de tratá-las simultaneamente, pelo mesmo acesso. Entretanto, existem divergências sobre os riscos para a perfusão testicular de múltiplos procedimentos na região inguinal. Neste estudo, avaliamos a viabilidade de procedimentos laparoscópicos simultâneos estudando resultados clínicos e cirúrgicos de pacientes submetidos à hernioplastia inguinal bilateral pela técnica transabdominal préperitoneal (TAPP) com e sem varicocelectomia laparoscópica bilateral (VLB) concomitante.

Métodos:: uma amostra de 20 pacientes do Hospital Universitário da USP-SP com hérnia inguinal indireta e varicocele com indicação de correção cirúrgica foi selecionada. Os pacientes foram randomizados em dois grupos, sendo 10 submetidos à TAPP (Grupo I) e 10 submetidos à TAPP e VLB simultâneas (Grupo II). O tempo operatório total, complicações e dor pós-operatória foram coletados e analisados.

Resultados:: não houve diferença estatística entre os grupos com relação ao tempo operatório total e à dor pós-operatória. Apenas uma complicação (hematoma do cordão espermático) foi observada no Grupo I e não foram observadas complicações no Grupo II.

Conclusões:: no mesmo procedimento, submeter pacientes à TAPP e à VLB no mesmo procedimento se mostrou eficaz e seguro, o que fornece embasamento para a realização de estudos em maiores escalas.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: no.

References

    1. Mostafa T, Rashed LA, Osman I, Marawan M. Seminal plasma oxytocin and oxidative stress levels in infertile men with varicocele. Andrologia. 2015;47(2):209–213. doi: 10.1111/AND.12248. - DOI - PubMed
    1. Fretz PC, Sandlow JI. Varicocele current concepts in pathophysiology, diagnosis, and treatment. Urol Clin North Am. 2002;29(4):921–937. doi: 10.1016/S0094-0143(02)00075-7. - DOI - PubMed
    1. Eid RA, Radad K, Al-Shraim M. Ultrastructural changes of smooth muscles in varicocele veins. Ultrastruct Pathol. 2012;36(4):201–206. doi: 10.3109/01913123.2011.637663. - DOI - PubMed
    1. Musalam AO, Eid RA, Al-Assiri M, Hussein MRA. Morphological changes in varicocele veins ultrastructural study. Ultrastruct Pathol. 2010;34(5):260–268. doi: 10.3109/01913121003793067. - DOI - PubMed
    1. Serra R. Varicocele in younger as risk factor for inguinal hernia and for chronic venous disease in older preliminary results of a prospective cohort study. Ann Vasc Surg. 2013;27(3):329–331. doi: 10.1016/J.AVSG.2012.03.016. - DOI - PubMed

Publication types