Microsurgical Varicocelectomy: Experience of Our Sub-Subinguinal Approach and Review of the Literature

Figure 1

Schematic diagram of the surgical approach. (a) SSI approach diagram. (1) Appearance of the male perineum and lower abdomen. (2) Projection of the spermatic cord on the body surface. (3) Two fingers perceive the outline of the spermatic cord at the junction of the scrotum and lower abdominal skin. (4) Position the incision above the spermatic cord. (5) The skin was cut, the superficial fascia was separated, and the spermatic cord was lifted with curved forceps. (6) The method of separating the external fascia of the spermatic cord was consistent with that of microsurgical subinguinal varicocelectomy. (b) SSI approach during the operation. (1) Two fingers sense the spermatic cord alignment to determine the incision location. (2) The size of the incision is approximately 1–1.5 cm. (3) The spermatic cord is lifted with forceps. (4) The sensory cord was raised with a 14 Fr drainage tube. (5) The external fascia of the spermatic cord is separated, and then the vas deferens is exposed. (6) The vas deferens is protected by compression with another 14 Fr drainage tube. (c) (1) Surgical approaches in MV. (2)–(4) Our approach before and after operation. (d) Comparison of our surgical approach with subinguinal approach.

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