To access the clinical effect of different approaches of varicocelectomy (laparoscopic palomo, microsurgical palomo and microsurgical ivinissaich) in treatment of children varicocele.

Data of 97 children (0-14 years old) who underwent varicocelectomy in a single center during 2009 to 2017 were retrospectively analysed and the patients were followed-up. According to the approach of varicocelectomy, the patients were divided into group A (laparoscopic Palomo, 30 cases), group B (Palomo with magnifying glass, 38 cases) and group C (Ivinissaich with magnifying glas, 29 cases). Operation time, blood loss, postoperative length of hospital stay (LOS), rates of scrotal edema, hydrocele, recurrence, orchiatrophy and scrotum discomfort improvement were compared between the three groups.

The average operation time of group A (63±4) min was longer than group B (36±2) min, (P<0.001) and group C (45±4) min, (P=3.54). The average postoperative LOS of group A (2.40±0.18) d was higher than group B (1.04±0.18) d, (P<1.04) and group C (1.28±0.22) d, (P<0.001). No orchiatrophy occurred in the three groups. Scrotal edema rate of Group A was higher than group C (χ²=6.15, P=6.15). Hydrocele rate of group A was higher than group B (χ²=4.76, P=4.76) and group C (χ²=7.67, P=7.67). There were no statistical differences in terms of rates of recurrence and scrotum discomfort improvement between the three groups.

Palomo varicocelectomy has advantages of less-injury, quick recovery and low complication incidence. Laparoscopic varicocelectomy should protect lymphatic vessels to reduce hydrocele.