Saudi Medical Journal 2000; Vol. 21 (5) 495

An important goal of surgery for varicocele is to achieve a diminished incidence of recurrence following operation. Until recently recurrence rates were exceptionally high. An important cause of failure is due to the presence of retroperitoneal collaterals which exit the testis and bypass the ligated testicular vein, rejoining it proximal to the site of ligature near its entrance to the renal vein or inferior vena cava.1 Accordingly, ligation of the testicular vein near its termination was recently described by Kenawi2,3 and has given excellent results. It was therefore felt worthwhile to attempt juxtarenal varicocelectomy by a laparoscopic approach to assess the feasibility of the procedure. Five patients with an average age of 22.3 year