Laparoscopic Varix Ligation with Nd:YAG Laser

We have performed 47 translaparoscopic varix ligations in 35 patients (23 unilateral and 12 bilateral). The spermatic artery has been spared in 94% of cases and in all cases since instituting the use of the Nd:YAG laser with a contact probe for coagulation of small veins adherent to the spermatic artery. Preliminary follow-up indicated only one recurrent varicocele (2.9%). The average time required by the patients to resume their preoperative levels of activity was 3.7 days, and the average analgesic use was 9.2 tablets of acetominophen with codeine. Of 12 patients treated for male factor subfertility who completed 1 year of follow-up, 5 have reported pregnancies (42%). Laparoscopic varix ligation provides an alternative to other operative techniques with reduced time to full recovery and minimal analgesic requirements.