研究目的：我們報告以腹腔鏡體內打結法進行精索靜脈結紮的初步經驗。材料與方法：從2002年1月至2004年三月總共有20位病患接受迷你腹腔鏡精索靜脈結紮手術。平均年齡是29.5歲（範圍10到48歲）。我們將臨床上可偵測到的精索靜脈曲張根據世界衛生組織的精索靜脈曲張分類來區別精索靜脈曲張嚴重程度，且經險襄彩色都普勒超音波確定診斷。分別有11(55%)位及9(45%)位病患進行左側及雙側內精索靜脈的結紮。在手術適應症方面，14位病患以陰襄疼痛爲表現，4位爲不孕，2位爲兩者皆有。手術時我們使用三個2或3毫米的迷你套管及腹腔鏡器械，將精索靜脈分離出之後以打結的方式進行結紮。我們仔細地保留精索動脈及淋巴管。結果：平均手術時間爲56±32分鍾（25～100分鍾）。所有病患均在術後1天內出院。沒有手術相關併發症，且14個以睪丸不適爲表現的病患中，有12個人完全改善，另2個人有改善。66.6%的不孕症病患其精液品質獲得改善。平均追蹤6、7個月之後，沒有複發的精索靜脈曲張及陰襄水腫的産生。結論：以迷你腹腔鏡手術進行精索靜脈結紮及動脈、淋巴管保留的手術方式是安全且有效的。

OBJECTIVE: To present our experience using pure laparoscopic intracorporeal knot tying to 1igate internal spermatic veins. MATERIALS AND METHODS: Between January 2002 and March 2004, 20 men underwent min-laparoscopic varicocelectomies. The mean patient age was 29.5 (range, 10 to 48) years. All varicoceles were detected clinically according to the World Health Organization classification and confirmed by scrotal color Doppler ultrasonography. The varicocele was on the left side in 11 (55%) and was bilateral in 9(45%). The surgical indications were scrotal pain in 14, infertility in 4, and both in 2. Three 2 or 3mm mini-laparoscopic ports were used for the operation. The internal spermatic veins were separated and ligated with intracorporeal knot tying. The internal spermatic artery and lymphatic vessels were carefully preserved. RESULTS: Mean operation time was 56±32(range, 25~100) minutes. All patients were discharged within 24 hours postoperatively. Neither immediate nor late procedure-related complications were noted. Of the 14 patients with scrotal symptoms, 12 were free of symptoms, and 2 had significant improvement. Of the 6 patients presenting with infertility, 4 (67%) had improvement in semen quality. Neither recurrent varicocele nor hydrocele was detected with a mean follow-up of 6.7 (range, 0.25-24) months. CONCLUSIONS: Our preliminary results revealed that a mini-laparoscopic varicocelectomy combined with preservation of the artery and lymphatic vessel is a safe and effective procedure.