探讨吲哚菁绿荧光显像技术应用在腹腔镜腹膜后集束结扎精索血管（Palomo）术中保留精索淋巴管的可行性。

选取2020年6月至2021年12月广州市妇女儿童医疗中心51例原发性精索静脉曲张患者的临床资料进行分析，将患者随机分为两组，研究组25例采用吲哚菁绿荧光辅助下保留淋巴管的腹腔镜Palomo术，术中将1 ml吲哚菁绿溶液（2.5 mg/ml）注射到患侧睾丸内，在荧光腹腔镜下识别并保留精索淋巴管；对照组26例单纯行腹腔镜Palomo术，比较两组一般资料、手术时间、术中出血量及术后恢复等情况。

所有患者手术均顺利完成，无中转开放。研究组患者精索淋巴管均成功显影，术中保留淋巴管2～3根，显影中位时间20 s（15～30 s）。研究组和对照组的手术时间相比，差异无统计学意义。对照组睾丸鞘膜积液发生率较研究组高，两组相比差异有统计学意义（P=0.041）。研究组和对照组在复发、睾丸萎缩方面比较，差异无统计学意义。与术前比较，两组患者术后双侧睾丸体积均有明显改善（P<0.001）。

吲哚菁绿荧光显像技术在腹腔镜Palomo术中保留精索淋巴管的应用是安全、有效的，可使淋巴管快速、精准显影，避免术后发生睾丸鞘膜积液等并发症。

To investigate the feasibility of applying indocyanine green fluorescence imaging technique to preserve thelymphatic vessels of the spermatic cordduring laparoscopic Palomo.

The clinical data of 51 patients in Guangzhou Women and Children Medical Center with primary varicocele were analyzed from June 2020 to December 2021. They were randomly divided into 2 groups. Twenty-five cases in the research group underwent ICG-aided laparoscopic Palomo to preserve lymphatic vessels. 1ml of indocyanine green solution (2.5 mg/ml) was injected into the testis of the affected side during the operation, the lymphatic vessels of the spermatic cord were identified and preserved under laparoscopy. Twenty-six cases in the control group received traditional laparoscopic Palomo. The common data, operation time, intraoperative blood loss and postoperative recovery were compared.

All the operations were successfully completed without conversion to open surgery. The lymphatic vessels of the spermatic cord were successfully identified in the research group, with 2-3 lymphatic vessels preserved and a median development time of 20 s (15-30 s). The operation time had no significant difference between the two groups. The rate of postoperative hydrocele testis in control group was higher than that of the research group (P=0.041). The relapse and testicular atrophy had no significant difference between the two groups. The postoperative bilateral testicular volume of the two groups increased significantly (P<0.001).

The application of indocyanine green fluorescence imaging technique for preserving the lymphatic vessels of the spermatic cord during laparoscopic Palomo is safe and effective, and allows for rapid and accurate identification of the lymphatic vessels, avoiding postoperative complications such as hydrocele testis.