Use of indocyanine green angiography in microsurgical subinguinal varicocelectomy - lessons learned from our initial experience

ABSTRACT Microsurgical subinguinal varicocelectomy (MSV) is generally considered the gold standard nowadays in view of the lower risk of complications and recurrence. To achieve complete ligation of veins while preserving testicular artery (TA) during the procedure remains challenging despite the application of high power optical magnification and micro-Doppler ultrasonography. The use of intraoperative indocyanine green angiography (ICGA) with infrared fluorescence operative micro-scope in MSV potentially lowers the incidence of TA injury and shortens the learning curve of novice surgeons. We present our initial experience in the application of the technique in nine patients and explore the potential of the new adjunct.

【摘要】 显微手术经腹股沟下精索静脉结扎术（Microsurgical subinguinal varicocelectomy, MSV）目前因并发症与复发风险更低，被普遍视为当前的金标准术式。术中需实现静脉完全结扎同时保留睾丸动脉（Testicular Artery, TA），即便借助高倍光学放大技术与微多普勒超声辅助，该操作仍具有挑战性。术中联合红外荧光手术显微镜应用吲哚菁绿血管造影（Indocyanine Green Angiography, ICGA），有望降低睾丸动脉损伤发生率，并缩短新手外科医师的学习曲线。本文报告了该技术在9例患者中的初步应用经验，并探讨了这一新型辅助手段的应用潜力。