Objectives. To describe the technique of two-trocar laparoscopic varicocelectomy and compare it with the
standard three-trocar laparoscopic technique in terms of effectiveness, morbidity, and cosmesis.
Methods. Two matched groups of patients with left varicocele were recruited. Each group included 30
patients. One group underwent three-trocar and the other two-trocar laparoscopic varicocelectomy. The
results of the two approaches were compared.
Results. No significant differences were found in terms of mean hospital stay or morbidity between the
two-trocar and three-trocar techniques. A significant difference was found in the operative time and
proportion of patients needing postoperative parenteral narcotic analgesia in favor of the two-trocar
technique. In both approaches, the previously infertile patients had a significant improvement in sperm count
and motility (P
0.05). Cosmetically, the trocar wound scars were aesthetically superior using the two-trocar
technique.
Conclusions. No significant difference was found between two-trocar and three-trocar laparoscopic varicocelectomy
in terms of effectiveness and morbidity. The cost of an extra 5-mm disposable trocar in the
three-trocar technique and the improved cosmesis after the two-trocar technique have made us prefer the
latter technique.