腹腔鏡結紮內精索靜脈施行於18例兩側及4例單測精索靜脈曲張病患，所有病側之精索靜脈皆可利用腹腔鏡找到，並結紮之。其平均手術時間在兩側病患約需80分鐘。手術過程中內精索動脈可在34側中找到並且保留之，佔全部40病側之85%。吾人並發現年齡愈大之病患其內精索動脈愈不明顯且不易與精索靜脈分出，在18例可發現內精索動脈之病患中，其平鈞年齡為28歲，反觀4例無法找到動脈者，其平均年齡則顯著地增加至54歲。此22例病患術後無嚴重併發症。其中有三例發生非感染性術後發燒，僅持續一日即消失。4例產生術後肩膀疼痛，且光檢查發現橫隔膜下氣體殘留，一日後疼痛消失。大多數病患之日常生活于二至三日完全恢復。術後皆無感染現象。術後18例之睪丸漲痛感覺消失。睪丸彩色杜勒超音波發現在16例病側中，15側于手術已無靜脈逆流現象(93.7%)。核子醫學 Tc-m99 紅血球陰囊掃瞄側在15病側中有13側于手術後無血液滯留現象(86%)。其中15例病患術後三個月之精液分析發現精蟲數由 51.4±20.3 增加至 63.0±25.2 (百萬/公攝)，P值=0.034，精蟲活動力亦由48%增至58%，P值=0.046. 吾人以為腹腔鏡結紮內精索靜脈在臨床上應是一有效的方法來治療精索靜脈曲張。此種方法可減輕術後疼痛，尤其是二側病灶仰或鼠蹊部已有刀疤者更為合適。對已有內視鏡經驗之秘尿外科醫師而言，此種手術方式應不困難。

Laparoscopic ligation of intermal spenatic vein were performed in 18 bilateral and 4 unilateral varicocele patients. The average operation time was 80 minutes for bi-lateral cases. The pulsatile internal spermatic artery could be detected among varix and preserved in 34 out of 40 sides (85%) through laparoscopy. The age related atrophy of intermal spermatic artery was found. In patients with identifiable artenies,the mean age was 28 years old, as compared with 54 years old in those without. No major complications were encountered. Only 3 patients had febrile episode of non-infectous origin 1 day postoperatively. Four patients complainedf of shoulder pain, and chest x-ray showed free air subdiaghragmatically. Usual daily activity was resumed in 2 to 3 days. No wound infection was encountered. Scrotal dragging pain subsided in 18 pa-tients. Testicular color Dopplerf ultrasonography no more reflux of pampinform plexus in 15 16 examined sides (93.7%) after operation. The radionuclide Tech-nethium RBC scan had similar result,venous pooling disappeared in 13 out 15 sides (86%). After 3 months of follow-up, semen sperm count increased form 51.4 ± 20.3 to 63.0 ± 25.2 (million/ml), (p value=0.034). Sperm motillity also increased from 48% to 58% (p=0.046) postoperatively. In conclusion, the laparoscopicf ligation of in-ternal spermatic veins seems to be an effec tive clinical modality for the treatment of varicocele especially in patient with bilateral lesions or patients with inguinal scar. The technique is not difficult for any endourologist who has the training of laparoscopic procedure.