Laparoscopic lymph-sparing mass ligation (Palomo) of left Varicocele A: 10 min after scrotal injection of isofluran blue, B: after opening the peritoneum, C: after ligation of the testicular artery, D: spared lymphatics after ligation of both artery and vein. Quote from "ESPES Manual of Pediatric Minimally Invasive Surgery" by Ciro Esposito, François Becmeur, Henri Steyaert, Philipp Szavay - "The two main techniques performed are: (1) Palomo’s technique which includes dissection and section of the spermatic artery and the spermatic veins and (2) modification of Palomo’s technique which includes only dissection and section of the spermatic veins with sparing of the spermatic artery. When comparing these two techniques, Palomo’s technique seems to offer better results such as less intraoperative time, less intraoperative bleeding, lower risk for recurrence, the same very low risk of testicular atrophy (0–2%) but a slightly higher risk of hydrocele [10, 15]. Moreover, the risk of hydrocele could be decreased from 15% to 0–3% when performing a lymphatic sparing technique with blue dyes [11, 16]." video 1 video 2 video 3 video 4 video 5 video 6 video 7 video 8 video 9 video 10
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