Role of Indocyanine Green in Laparoscopic Varicocele Ligation in a Tertiary Care Hospital

Abstract Introduction: Varicocele is surgically managed by an open or laparoscopic approach. The complications of the laparoscopic approach, such as artery ligation, lymphatic ligation, postoperative hydrocele, and recurrence, can be reduced with adequate visualisation and identification of the spermatic vein with the help of indocyanine green (ICG). Materials and Methods: A randomised controlled trial was conducted on 20 patients presenting with symptomatic varicocele. They were divided into two groups – group I (patients not given intraoperative ICG) and group II (patients given intraoperative ICG). After giving a test dose of ICG, patients were taken up for laparoscopic varicocele ligation. The perioperative findings were noted and compared between the two groups. Results: Data were analysed with significance considered with a P value < 0.05. Eighty percent of the patients were between 21 and 40 years of age. The mean operative time was significantly less in group II (77.2 ± 28.54 vs. 55.1 ± 28.78 min) ( P < 0.001). Postoperatively, there was a significant difference in sperm count ( P = 0.04) and motility ( P < 0.01) in group I, whereas in group II, there was a significant difference in sperm concentration ( P = 0.03) and motility ( P < 0.001). Conclusion: Intraoperative administration of ICG leads to a significant decrease in operative time due to the early identification of the spermatic vessels and early ligation of the spermatic vein. Postoperative complications such as hydrocele and recurrence of varicoceles are reduced when ICG is used in these cases, with a significant improvement in post-surgical sperm motility and concentration.