The use of isosulphan blue to identify lymphatic vessels in high retroperitoneal ligation of adolescent varicocele--avoiding postoperative hydrocele.

Abstract

To assess whether identifying and preserving the lymphatic vessels, using vital dyes, avoids postoperative hydrocele in adolescents with varicocele undergoing high retroperitoneal ligation (Palomo procedure). The results were assessed from 28 consecutive adolescent patients undergoing varicocelectomy, treated between 1998 and 1999 by the Palomo procedure. The lymphatic vessels were identified and preserved using vital dyes, to avoid postoperative hydrocele formation. In 24 of the 28 patients (86%) the identification and preservation of lymphatic vessels was feasible. Over a mean (range) follow-up of 14 (4-24) months there were no postoperative hydroceles and no clinical recurrences. Identifying and preserving the lymphatic drainage of the testis and tunica vaginalis using vital dyes prevents the development of postoperative hydrocele in adolescents undergoing the Palomo procedure.