Research Article ISSN: 2574 -1241 DOI: 10.26717/BJSTR.2023.51.008125 Laparascopic Palomo Procedure in the Treatment of Pediatric Varicocoele Using Ligasure Vessel Sealing System K Karavdić 1 *, A Firdus 1 , N Džiho 1 and A Brković 2 1 Clinic for Pediatric Surgery, Clinic Center of University Sarajevo, Bosnia and Herzegovina 2 Clinic for Pediatric Surgery, University Clinical Centre of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina *Corresponding author: K Karavdić, Clinic for Pediatric Surgery, Clinic Center of University Sarajevo, Bosnia, and Herzegovina Copyright@ : K Karavdić | Biomed J Sci & Tech Res | BJSTR. MS.ID.008125. 42844 ABSTRACT Introduction: Varicocele is the abnormal tortuosity and dilatation of the testicular vein within the spermatic cord. The incidence of varicocele is approximately 16% in the normal adult population, 6% in10-year-old boys,15% in13-year-old boys and about 30% in men in infertile couples. There are different treatments for varicocele, as open surgery, microsurgery, laparoscopy, sclerotherapy, and other techniques. We describe the effective use of the bipolar vessel-sealing device: Liga Sure for the division of the internal spermatic vessels in a laparoscopic varicocelectomy. Material and Methods: Between 2012 and 2022, 50 patients were treated because of varicocoele, 17 patients were treated minimal invasive surgery,9 patients using a metal clip and 8 by laparoscopic Palomo varicocele ligation using Liga Sure vascular sealing. Patient ages ranged from 9 to 18 years (mean, 14.1 years). Indications for surgery included grade III varicocele, ipsilateral testicular hypotrophy, or complaints such as pain or discomfort during physical activities. We placed a 5-mm umbilical port for access (open Hadson procedure) and kept pneumoperitoneum below 12 mm Hg. Under laparoscopic guidance, two additional ports of 5 mm were inserted in the lower right quadrant and supraumbilical, respectively. Oncethe vessels were isolated, the vascular sealant was applied 3–4 times to ensure coagulation of the spermatic vessels; the vessels were then divided with laparoscopic 5-mm scissors. Results: Mean follow-up time was 18.8 ± 1.1 months. Open procedure had next complications: hydrocoele 5/33 (15,15%) and recurrence 3/33 (9.09%), laparascopy procedure (using methal clips) hydrocoele 1/9 (11,11%) and recurrence 1/9 (11,11%) and laparascopy procedure (using LigaSure device) did not have complications hydrocoele 0/8 and recidive 0/8. Conclusions: Laparoscopic Palomo varicocele sealing is a safe, effective, and simple method for correcting varicoceles in young males. This method seems to take less time than clip application and open procedure. The advantage of this procedure is also the possibility to correct the associated inguinal hernia or patent processus vaginalis. Keywords: Vericocole; Laparascopy; Ligasure ARTICLE INFO Received: July 06, 2023 Published: July 18, 2023 Citation: K Karavdić, A Firdus, N Džiho and A Brković. Laparascopic Palomo Procedure in the Treatment of Pediat- ric Varicocoele Using Ligasure Vessel Sealing System. Biomed J Sci & Tech Res 51(4)-2023. BJSTR. MS.ID.008125.