Angiography with fluorescent angiography (indocyanine) is effective in preserving the testicular artery during microscopic varicocele ligation

• Published in: Japanese Journal of Endourology and Robotics Vol. 36; no. 2; pp. 285 - 289
• Main Authors: 北風 宏明, 木山 祐亮, 井之口 舜亮, 松村 聡一, 関井 洋輔, 本郷 祥子, 奥見 雅由, 髙田 晋吾
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of Endourology and Robotics 2023; 一般社団法人 日本泌尿器内視鏡・ロボティクス学会
• Subjects: fluorescent angiography; ICG; 精索静脈瘤; 血管造影; 顕微鏡
• ISSN: 2436-875X
• DOI: 10.11302/jserjje.36.2_285

  We introduced microscopic low-level ligation for varicocele in December 2018 and have encountered 40 cases by October 2022. It is difficult to identify and preserve the testicular artery during microsurgery, and we often encounter cases in which preservation is difficult.  In June 2022, we introduced a method of identifying and preserving the testicular artery by intraoperative administration of indocyanine green (ICG), a fluorescent angiographic agent, and performed this method in 5 cases.  We compared the operation time, number of arteries preserved, postoperative complications, and treatment efficacy between 35 cases using the conventional method and 5 cases using the ICG method.  No differences were found in patient backgrounds, operation time, postoperative complications, or treatment efficacy between the conventional and ICG methods. However, the ICG method allowed us to preserve the testicular artery significantly more (3.0 vs 1.5, p＝0.02).  Our study suggests that intraoperative ICG administration is useful in identifying and preserving arteries.