Robot-assisted laparoscopic varicocelectomy in a pediatric population

Purpose: To present our experience with robot-assisted laparoscopic varicocelectomy in a pediatric population. Methods: : We reviewed 49 consecutive cases performed by the same experienced surgeon. One to four veins were ligated at the internal ring of the inguinal canal, while the testicular artery and lymphatics were spared. Information on patient characteristics, surgical time, complications, and recurrences were collected. Results: : Median patient age was 14 (range 10 – 17) years. Forty-eight had left sided varicoceles and one had a bilateral varicocele. Forty-five were grade 3. All patients were referred due to discomfort/pain and 20 also had reduced testicular size. The median operating time from skin incision was 48 minutes (31 – 89 minutes) and the median console time was 18 minutes (7 – 55 minutes). Forty-seven patients were discharged the same day. Two patients experienced pain and problems urinating respectively. These issues had resolved by the first postoperative day. There were no other complications, but at 6 month, eight recurrences were noted (16%). Scrotal complaints had subsided in all patients. Catch-up growth of the affected testicles was seen in 19/20 cases. Conclusion: Robot-assisted laparoscopic varicocelectomy is feasible and safe in a pediatric population but with a relatively high recurrence rate.