Use of indocyanine green angiography in microsurgical subinguinal varicocelectomy – lessons learned from our initial experience

Vol. 43 (5): 974-979, September – October, 2017

doi: 10.1590/S1677-5538.IBJU.2017.0107

SURGICAL TECHNIQUE

Chak-Lam Cho 1, Kwan-Lun Ho 1, Wayne Kwun-Wai Chan 1, Ringo Wing-Hong Chu 1, In-Chak Law 1

¹ Division of Urology, Department of Surgery, Kwong Wah Hospital, Hong Kong

ABSTRACT

Microsurgical subinguinal varicocelectomy (MSV) is generally considered the gold standard nowadays in view of the lower risk of complications and recurrence. To achieve complete ligation of veins while preserving testicular artery (TA) during the procedure remains challenging despite the application of high power optical magni­fication and micro-Doppler ultrasonography. The use of intraoperative indocyanine green angiography (ICGA) with infrared fluorescence operative micro-scope in MSV potentially lowers the incidence of TA injury and shortens the learning curve of nov-ice surgeons. We present our initial experience in the application of the technique in nine patients and explore the potential of the new adjunct.

Keywords: Varicocele; Microsurgery; Indocyanine Green

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