Comparing Fisch’s artery-sparing technique with the microsurgical subinguinal varicocelectomy

Objective: The aim was to evaluate the reduction of operation time using a new artery-sparing varicocelectomy technique.
Patients and methods: This study compares a new surgical technique introduced by Fisch and colleagues, which elevates the testicular artery and ligates the pampiniform plexus in one or more vein groups, with subinguinal microsurgical varicocelectomy. The study was conducted retrospectively on a control group of 51 patients who had conventional microsurgical varicocelectomy (group 1) and the experimental group of 44 patients who underwent the new technique (group 2).
Results: We compared the outcome measures including operative time (in minutes), postoperative complications, semen percentage improvement, and pregnancy outcome rate. Both groups had significantly improved semen count, motility, and abnormal form improvements. Group 2 had significantly greater sperm motility and 11.6% less abnormal forms. Both groups had similar pregnancy rates (40% for the microsurgical group vs. 35.7% for the Fisch technique group; P=0.3). Group 1 had an average operating time of 94±6.9 min compared with 44.5±8.4 min for group 2 (P=0.001).
Conclusion: The Fisch technique dramatically reduces operative time with similar patient outcomes when compared with the traditional subinguinal microsurgical varicocelectomy.