1
|
Alghoul H, Farajat FA, Alser O, Snyr AR, Harmon CM, Novotny NM. Intraoperative uses of near-infrared fluorescence spectroscopy in pediatric surgery: A systematic review. J Pediatr Surg 2022; 57:1137-1144. [PMID: 35256157 DOI: 10.1016/j.jpedsurg.2022.01.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 01/22/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND The application of near infrared spectroscopy (NIRS) imaging in surgery is growing. This study aimed to systematically review the literature to summarize the intraoperative uses of NIRS in pediatric surgery. METHODS A PRISMA-compliant literature search was conducted in PubMed, Embase, Scopus, and Web of Science from inception to February 2020. Title/abstract and then full-text screening were performed. The Oxford centre for Evidence Based Medicine tool (OCEBM) was used to evaluate the level of evidence of included studies. RESULTS Reviewers identified 53 articles. Of which, 34 studies (64.2%) were case-series and 11 (20.8%) were case reports. Most of the studies (n = 45, 84.9%) were level 4 on the OCEBM tool. The most common uses of NIRS were to visualize the biliary tree and to identify primary and metastatic malignant tissues. Other applications include assessment of perfusion of tissues including bowel anastomoses, and lymphatic surgery. Several advantages of the introduction of NIRS in pediatric surgery exist including having the potential to reduce operative time and intra/post-operative complications. Moreover, NIRS helps in detecting malignant tissues that can be missed by conventional imaging. However, NIRS has important limitations such as difficulty in identification of the biliary tree in obese patients or inflamed gallbladder, detection of small deeply localized malignant tissues, as well as the high cost. CONCLUSIONS NIRS is a promising modality that can be used intraoperatively to augment different pediatric surgical procedures. NIRS has important advantages and limitations compared to conventional surgery, however, more studies are required to evaluate its outcomes and cost-effectiveness. LEVEL OF EVIDENCE IV.
Collapse
Affiliation(s)
- Heba Alghoul
- Faculty of Medicine, Islamic University of Gaza, Palestine
| | - Farah Al Farajat
- Faculty of Medicine, Jordan University of Science and Technology, Jordan
| | - Osaid Alser
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Andrea Rogers Snyr
- Beaumont Children's and Oakland University William Beaumont School of Medicine, 3535 W 13 Mile Rd, Ste 307, Royal Oak, MI 48073, United States
| | - Carroll M Harmon
- Division of Pediatric Surgery, Department of Surgery, Jacobs School of Medicine and Biomedical Sciences, University in Buffalo, NY, United States
| | - Nathan M Novotny
- Beaumont Children's and Oakland University William Beaumont School of Medicine, 3535 W 13 Mile Rd, Ste 307, Royal Oak, MI 48073, United States; Monroe Carell, Jr. Children's Hospital at Vanderbilt, Nashville, TN, United States.
| |
Collapse
|
2
|
Sun HH, Tay KS, Jesse E, Muncey W, Loeb A, Thirumavalavan N. Microsurgical Denervation of the Spermatic Cord: A Historical Perspective and Recent Developments. Sex Med Rev 2022; 10:791-799. [PMID: 37051952 DOI: 10.1016/j.sxmr.2021.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 11/15/2021] [Accepted: 11/16/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The management of chronic scrotal pain is long and varied, with historical treatment algorithms typically ending with orchiectomy. Microsurgical denervation of the spermatic cord (MDSC) is a testicle-sparing option for patients who have failed conservative treatment options and over its forty-year history has seen many technical refinements. OBJECTIVES To review the history and development of MDSC and discuss the outcomes of different surgical techniques. METHODS A literature review using PubMed and Google Scholar was conducted to identify studies pertaining to surgical treatment of CSP, MDSC, and outcomes. Search terms included "chronic," "scrotal pain," "orchialgia," "spermatic cord," "denervation," and "microsurgery." RESULTS We included 21 case reports and series since the first seminal paper describing MDSC technique in 1978. Additional studies that challenged existing conventions or described novel techniques are also discussed. The current standard procedure utilizes a subinguinal incision and a surgical microscope. Open, robotic, and laparoscopic approaches to MDSC have been described, but access to minimally invasive instruments may be limited outside of developed nations. Pain reduction following preoperative spermatic cord predicts success of MDSC. Methods for identifying and preserving the testicular and deferential arteries vary depending on surgeon preference but appear to have comparable outcomes. Future developments in MDSC involve targeted denervation, minimizing collateral thermal injury, and alternative techniques to visualize arterial supply. CONCLUSION For patients suffering from CSP, MDSC is a well-studied technique that may offer appropriately selected patients' relief. Future investigation comparing targeted vs full MDSC as well as in vivo study of new techniques are needed to continue to improve outcomes. Sun HH, Tay KS, Jesse E, et al. Microsurgical Denervation of the Spermatic Cord: A Historical Perspective and Recent Developments. Sex Med Rev 2022;XX:XXX-XXX.
Collapse
Affiliation(s)
- Helen H Sun
- Urology Institute, University Hospitals/Case Western Reserve University School of Medicine, Cleveland, OH, USA.
| | - Kimberly S Tay
- Urology Institute, University Hospitals/Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Erin Jesse
- Urology Institute, University Hospitals/Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Wade Muncey
- Urology Institute, University Hospitals/Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Aram Loeb
- Urology Institute, University Hospitals/Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Nannan Thirumavalavan
- Urology Institute, University Hospitals/Case Western Reserve University School of Medicine, Cleveland, OH, USA
| |
Collapse
|
3
|
Ediz C, Temel MC, Şahin Ediz S, Akan S, Yenigürbüz S, Pehlivanoğlu M, Yılmaz Ö. Contribution of pre-varicocelectomy color Doppler ultrasonography finding to surgery and its correlation with semen parameters. ACTA ACUST UNITED AC 2021; 93:227-232. [PMID: 34286561 DOI: 10.4081/aiua.2021.2.227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 02/03/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND This study aimed to determine the contribution of color Doppler ultrasonography (CDUS) performed before varicocelectomy to the success of surgical treatment and to evaluate the correlation between CDUS findings and semen parameters. METHODS A total of 84 patients diagnosed with grade 3 left varicocele in our clinic between 2016 and 2018 were evaluated. The patients in whom the decision for varicocelectomy was based on only physical examination (PE) findings and abnormal semen analysis (SA) were defined as Group 1, while the patients undergoing varicocelectomy based on PE, CDUS and SA findings were defined as Group 2. The patients diagnosed with varicocele based on PE and CDUS findings who were included in a followup protocol due to normal semen parameters were defined as Group 3. RESULTS In Group 1, there was a total of 28 patients and the mean number of ligated internal spermatic veins was 4.53 (range, 2-10). In Group 2, there was a total of 30 patients and the number of ligated internal spermatic veins was 3.76 (range, 1-8). No statistically significant difference was found between Group 1 and 2 in terms of the number of internal spermatic veins ligated during varicocelectomy. No statistically significant correlation was found between semen parameters and the number of veins ligated during varicocelectomy in Group 1 and 2 and between semen parameters and CDUS findings group 2 and 3. CONCLUSIONS In patients with primary grade 3 varicocele, diagnosed by physical examination there is no need for additional imaging in primary cases.
Collapse
Affiliation(s)
- Caner Ediz
- Department of Urology, Sultan Abdulhamid Han Education and Research Hospital, Istanbul.
| | - Muhammed Cihan Temel
- Department of Urology, Sultan Abdulhamid Han Education and Research Hospital, Istanbul.
| | - Suna Şahin Ediz
- Department of Radiology, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul.
| | - Serkan Akan
- Department of Urology, Sultan Abdulhamid Han Education and Research Hospital, Istanbul.
| | - Serkan Yenigürbüz
- Department of Urology, Sultan Abdulhamid Han Education and Research Hospital, Istanbul.
| | - Mehmet Pehlivanoğlu
- Department of Urology, Sultan Abdulhamid Han Education and Research Hospital, Istanbul.
| | - Ömer Yılmaz
- Department of Urology, Sultan Abdulhamid Han Education and Research Hospital, Istanbul.
| |
Collapse
|
4
|
Esteves SC, Cocuzza MS. The obesity paradox in varicocele - is the protective effect real? Int Braz J Urol 2021; 47:20-22. [PMID: 33047910 PMCID: PMC7712690 DOI: 10.1590/s1677-5538.ibju.2019.0210.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Sandro C Esteves
- ANDROFERT, Andrology and Human Reproduction Clinic, Campinas, SP, Brasil.,Departamento de Cirurgia, Divisão de Urologia, Universidade Estadual de Campinas - UNICAMP, Campinas, SP, Brasil.,3 Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Marcello S Cocuzza
- Centro de Reprodução Humana, Divisão de Urologia, Universidade de São Paulo, SP, Brasil
| |
Collapse
|
5
|
Campos MEC, de Oliveira MMR, Reis AB, de Assis LB, Iremashvili V. Development and validation a task-specific checklist for a microsurgical varicocelectomy simulation model. Int Braz J Urol 2020; 46:796-802. [PMID: 32539251 PMCID: PMC7822372 DOI: 10.1590/s1677-5538.ibju.2019.0571] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 01/18/2020] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To develop and validate a new test of specific technical skills required for microsurgical varicocelectomy. MATERIALS AND METHODS An electronic questionnaire was sent to 558 members of the Brazilian Society of Urology for the validation of the task-specific checklist (TSC) for assessment of microsurgical varicocelectomy. Participants who had experience in this procedure were selected as judges. For construct validation, 12 participants including attending urologists and urological residents in training were recruited for voluntary participation. We formed a group of three experts and a group of nine novices, who had to perform the steps of microsurgical varicocelectomy on a simulation model using human placenta. Each participant was filmed and two blinded raters would then evaluate their performance using the TSC of microsurgical varicocelectomy. RESULTS 14 judges were recruited. The assessment tool was reformulated, according to the judges suggestions and had the content validity achieved. The final version of the TSC was comprised of the task-specific score, a series of 4 items scored in a binary fashion designed for microscopic sub-inguinal varicocelectomy. The differences between the performance of participants with different levels of experience reflected the construct validity. The reliability between the raters was high. The mean time required to complete the training of microsurgical varicocelectomy in simulation model was significantly shorter for experts compared to novices (201 vs. 496 seconds, p=0.01). CONCLUSIONS This preliminary study suggests that the task-specific checklist of microsurgical varicocelectomy is reliable and valid in assessing microsurgical skills.
Collapse
Affiliation(s)
| | | | - Augusto Barbosa Reis
- Departamento de Cirurgia, Universidade Federal de Minas Gerais - UFMG, Belo Horizonte, MG, Brasil
| | | | - Viacheslav Iremashvili
- Department of Urology, United Hospital Center, Bridgeport, West Virginia, USA, United States
| |
Collapse
|
6
|
Cho CL. Improved Arterial Preservation achieved by Combined Use of Indocyanine Green Angiography and Doppler Detector during Microsurgical Subinguinal Varicocelectomy. J INVEST SURG 2020; 33:948-949. [PMID: 33222577 DOI: 10.1080/08941939.2019.1580324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Chak-Lam Cho
- Department of Surgery, Union Hospital, Tai Wai, Shatin, Hong Kong
| |
Collapse
|
7
|
Mombeini H, Khazaeili D, Esmaeili S. Comparison of the result of Doppler sonography before and after laparoscopic artery and lymphatic sparing varicocelectomy with microsurgical subinguinal varicocelectomy. J Family Med Prim Care 2020; 9:4005-4008. [PMID: 33110802 PMCID: PMC7586502 DOI: 10.4103/jfmpc.jfmpc_1152_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 02/21/2020] [Accepted: 04/08/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Based on the importance of varicocele, the aim of this is to compare the comparison between doppler sonography before and after laparoscopic lymphatic sparing varicocelectomy and microsurgical subinguinal varicocelectomy. Patients and Methods: Patients with primary varicocele who were referred to Ahwaz Imam Khomeini Hospital after informed consent were included. Primary information included varicocele severity, pain intensity, latency, Doppler sonography (Resistive index (RI), venous return, venous diameter before and after Valsalva) were obtained, and then patients were entered into one of the two groups of surgery. The admission duration, return to work duration, the pain and analgesic consumption, and the length of anxiety were recorded in patients. Patients were examined 3 months later, and the severity of varicocele in the examination, pain score, latency, Doppler sonography indices, sperm indices in both groups were registered. In the end, the information is entered into Statistical Package for the Social Sciences (SPSS) statistical software and evaluated. Results: We observed that the severity of varicocele (P = 0.34), pain (P = 0.45), latralite (P = 0.56), RI (P = 0.65), intravenous diameter (P = 0.75) did not show statistically significant difference between the two groups, also in evaluating these indices after surgery, there were significant differences between the two groups in pain (P = 0.04) and time for return to work (P = 0.036). Conclusions: The methods used in varicocelectomy did not have any effect on the outcome of the treatment. Accordingly, using any of these methods can improve the post-surgical state of the patients and promote the fertility performance and reduction of complications due to surgery in patients.
Collapse
Affiliation(s)
- Hayat Mombeini
- Department of Urology, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran
| | - Dinyar Khazaeili
- Department of Urology, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran
| | - Sepehr Esmaeili
- Department of Urology, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran
| |
Collapse
|
8
|
Teng J, Jia Z, Ai X, Luo X, Guan Y, Hao X, Fei W. Robotic-assisted laparoscopic artery-sparing varicocelectomy using indocyanine green fluorescence angiography: Initial experience. Andrologia 2020; 52:e13774. [PMID: 32786090 DOI: 10.1111/and.13774] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 06/18/2020] [Accepted: 06/28/2020] [Indexed: 11/30/2022] Open
Abstract
We reported our initial experience of robotic-assisted laparoscopic artery-sparing varicocelectomy using indocyanine green (ICG) fluorescence angiography in treatment of varicocele. A total of 45 varicocelectomies in 27 patients were performed. The mean operation time was 49.1 ± 8.5 min for unilateral and 65.6 ± 8.3 min for bilateral repair. 47.2 s after ICG injection, testicular artery (TA) was visualised. After an interval of 31.3 s, fluorescent veins were identified. Of all the 45 spermatic cords, 68.9% had a solitary artery, while 31.1% had 2 arteries. The mean hospital stay was 1.6 ± 0.9 days. Semen concentration and motility were significantly improved 6 months after surgery, no recurrence, hydrocele or testicular atrophy was observed. Our study demonstrated that robotic-assisted laparoscopic artery-sparing varicocelectomy using ICG fluorescence angiography is a safe, effective and promising technique in treatment of varicocele.
Collapse
Affiliation(s)
- Jingfei Teng
- Department of Urology, the Seventh Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Zhuomin Jia
- Department of Urology, the Seventh Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Xing Ai
- Department of Urology, the Seventh Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Xiao Luo
- Department of Urology, the Seventh Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yawei Guan
- Department of Urology, the Seventh Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Xuemei Hao
- Department of Anesthesiology, the Seventh Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Weiwei Fei
- Department of Anesthesiology, the Seventh Medical Center, Chinese PLA General Hospital, Beijing, China
| |
Collapse
|
9
|
Kaplan-Marans E, Fulla J, Tomer N, Bilal K, Palese M. Indocyanine Green (ICG) in Urologic Surgery. Urology 2019; 132:10-17. [PMID: 31129192 DOI: 10.1016/j.urology.2019.05.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 05/07/2019] [Accepted: 05/10/2019] [Indexed: 01/06/2023]
Abstract
Indocyanine green (ICG) is a dye used for fluorescent-guided surgery. This review article addresses the recent surge in reported uses of ICG in various surgical fields and provides a comprehensive and up to date review of the uses of ICG in urologic surgery.
Collapse
Affiliation(s)
| | - Juan Fulla
- Department of Urology, Mount Sinai Health System, New York, NY
| | - Nir Tomer
- Department of Urology, Mount Sinai Health System, New York, NY
| | - Khawaja Bilal
- Department of Urology, Mount Sinai Health System, New York, NY
| | - Michael Palese
- Department of Urology, Mount Sinai Health System, New York, NY
| |
Collapse
|
10
|
Kurihara S, Shibata Y, Arai S, Sekine Y, Miyazawa Y, Koike H, Matsui H, Ito K, Suzuki K, Nakamura T. Improved Arterial Preservation Achieved by Combined Use of Indocyanine Green Angiography and Doppler Detector During Microsurgical Subinguinal Varicocelectomy. J INVEST SURG 2019; 33:941-947. [PMID: 31070068 DOI: 10.1080/08941939.2019.1577516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objectives: The microsurgical approach is considered the most reliable procedure in varicocelectomy. However, as there are difficulties in identifying the spermatic artery at the peripheral level, we had introduced intraoperative indocyanine green angiography (ICGA) for identification of arteries. In this study, we further investigated the usefulness of intraoperative ICGA in combination with an ordinary Doppler detector in microsurgical subinguinal varicocelectomy. Methods: A total of 140 men who underwent microsurgical subinguinal varicocelectomy at Gunma University Hospital were included. An operating microscope equipped with a near-infrared charge-coupled device was used for intraoperative ICGA. After exposing the vessels, arteries were identified using endoscopic vision only or with assistance of Doppler detector or ICGA, or of both. The number of preserved arteries was compared among the groups. Results: ICGA clearly visualized the internal spermatic arteries in all cases, allowing the surgeon to perform real-time identification and isolation of the spermatic artery intraoperatively. The use of ICGA or Doppler detector significantly increased the number of preserved arteries compared to the microscope-only operation from 1.11 to 1.75 (p < 0.05) and 1.57 (p < 0.05), respectively. The additional use of ICGA with Doppler detector further increased the number of preserved arteries to 2.41 (p < 0.05). Conclusions: Intraoperative ICGA facilitated safe and quick microsurgical subinguinal varicocelectomy by enabling visualization of thin spermatic cord blood vessels. Improved preservation of thin arteries, which is essential for patients with infertility, can be achieved with the combined use of ICGA and ordinary Doppler detector.
Collapse
Affiliation(s)
- Sota Kurihara
- Department of Urology, Gunma University Graduate School of Medicine, Maebashi, Japan.,Department of Clinical Investigation and Research Unit, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Yasuhiro Shibata
- Department of Urology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Seiji Arai
- Department of Urology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Yoshitaka Sekine
- Department of Urology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Yoshiyuki Miyazawa
- Department of Urology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Hidekazu Koike
- Department of Urology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Hiroshi Matsui
- Department of Urology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Kazuto Ito
- Department of Urology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Kazuhiro Suzuki
- Department of Urology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Tetsuya Nakamura
- Department of Clinical Investigation and Research Unit, Gunma University Graduate School of Medicine, Maebashi, Japan
| |
Collapse
|
11
|
Esposito C, Turrà F, Del Conte F, Izzo S, Gargiulo F, Farina A, Severino G, Cerulo M, Escolino M. Indocyanine Green Fluorescence Lymphography: A New Technique to Perform Lymphatic Sparing Laparoscopic Palomo Varicocelectomy in Children. J Laparoendosc Adv Surg Tech A 2019; 29:564-567. [DOI: 10.1089/lap.2018.0624] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Ciro Esposito
- Pediatric Surgery Unit, “Federico II” University of Naples, Naples, Italy
| | - Francesco Turrà
- Pediatric Surgery Unit, “Federico II” University of Naples, Naples, Italy
| | - Fulvia Del Conte
- Pediatric Surgery Unit, “Federico II” University of Naples, Naples, Italy
| | - Serena Izzo
- Pediatric Surgery Unit, “Federico II” University of Naples, Naples, Italy
| | - Francesca Gargiulo
- Pediatric Surgery Unit, “Federico II” University of Naples, Naples, Italy
| | - Alessandra Farina
- Pediatric Surgery Unit, “Federico II” University of Naples, Naples, Italy
| | - Giovanni Severino
- Pediatric Surgery Unit, “Federico II” University of Naples, Naples, Italy
| | - Mariapina Cerulo
- Pediatric Surgery Unit, “Federico II” University of Naples, Naples, Italy
| | - Maria Escolino
- Pediatric Surgery Unit, “Federico II” University of Naples, Naples, Italy
| |
Collapse
|
12
|
Cocuzza M. Editorial Comment: Use of indocyanine green angiography in microsurgical subinguinal varicocelectomy - lessons learned from our initial experience. Int Braz J Urol 2018; 43:980-981. [PMID: 28792187 PMCID: PMC5678533 DOI: 10.1590/s1677-5538.ibju.2017.0107.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 07/25/2017] [Indexed: 12/20/2022] Open
|