Varicocoelectomy (Laparoscopic)

Product Summary: Ligation of the testicular veins as they enter the retroperitoneal space through the internal inguinal ring.

Item Number: 30635, 105

An informed consent is required from the patient.
Patients may not eat or drink from midnight the previous evening.
Patients are to refrain from smoking before the procedure.
Patients allergic to IODINE / CHLORHEXIDINE should clearly state this to theatre staff and Dr Schoeman.
Any anti-coagulants such as Warfarin or Aspirin must be stopped 7 days prior to surgery.
Patients with cardiac illnesses require a cardiologist / physician’s report.
A chest X-ray is required for patients with lung disease.
Pre-op blood tests are required 4 days prior to surgery.
The inguinal area (area from navel to pubic bone, hip bone to midline, on affected side) is shaved once hospitalised.
Please ensure that the ward admission staff, the theatre staff and Dr Schoeman are made aware of the correct side on which the procedure is to be done.
Be prepared for an overnight stay.

This procedure is done under general anaesthetic.
Two options are available: Laparoscopic and open (inguinal/flank).
Laparoscopy: involves 3 small incisions spaced in a triangle on the lower abdomen.
The veins are clipped and cut as they enter the abdomen from the scrotum.
Subcutaneous skin sutures (which need not be removed) are used in closing, unless stated otherwise by Dr Schoeman.
A dressing is then applied, which should be removed after 72 hours.
A local anaesthetic is injected into the wound, thus giving post-operative pain relief for the next 4-6 hours.
A catheter will be inserted overnight.

Any anaesthetic has its risks and the anaesthetist will explain such risks.
Bleeding is a common complication.
A haematoma (blood collection under the skin) may form and needs to be reviewed by Dr Schoeman as soon as possible. Bruising is normal.
An infection of the wound may occur and requires immediate review.
Shoulder pain, as air is trapped under the diaphragm.
A further complication may be that the testis may become smaller after the operation.
DANGER SIGNS: A wound that swells immediately, fever, or puss. Contact Dr Schoeman or the hospital immediately as this may occur in up to 10-15% of all cases.
There is up to a 50-60% recurrence rate after any procedure

The dressing should be kept dry for the initial 72 hours after surgery and then removed by soaking in a bath until it comes off easily.
The dressing may sometimes adhere to the wound causing slight bleeding on removal. Don’t panic, the bleeding will stop.
On discharge, a prescription may be issued for patients to collect.
Patients should schedule a follow-up appointment with Dr Schoeman 2 weeks after the procedure.
There will be signs of bruising for at least 10 days.
The suture-line will be hard and indurated for at least 8-10 weeks.
Sick leave will be granted for 14 days.
Please direct any further queries to Dr Schoeman’s rooms.
PLEASE CONTACT THE HOSPITAL DIRECT WITH ANY POST-OPERATIVE CONCERNS AND RETURN TO THE HOSPITAL SHOULD THERE BE ANY SIGNS OF SEPSIS.

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Varicocoelectomy Laparoscopic