{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T05:46:52Z","timestamp":1791870412229,"version":"4.3.4"},"reference-count":27,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Laparoendoscopic &amp; Advanced Surgical Techniques"],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>This study reports our 5-year experience in performing lymphography using indocyanine green (ICG)-enhanced fluorescence to perform lymphatic-sparing laparoscopic Palomo varicocelectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods:<\/jats:title>\n                    <jats:p>The records of 103 patients who underwent laparoscopic left varicocelectomy from March 2018 to April 2023 were retrospectively evaluated. The average patients\u2019 age was 13.7 years (range: 12\u201316). High-degree varicocele was associated with left testicular hypotrophy, and symptoms were present in all patients. At the beginning of our experience, in 41 cases, we injected 2 mL of ICG solution into the testis, then we reduced the amount of ICG solution to 1 mL, having the same results. The lymphatic vessels were clearly identified and spared, then the entire spermatic bundle was clipped and divided according to Palomo\u2019s principle.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We reported no conversions to open surgery and no adverse reactions induced by ICG. The average operative time was 18 minutes (range: 10\u201335). We performed clinical evaluations at 1 week, 1 month, 6 months, 1 year, and 2 years after surgery, and Ultrasound (US) was performed at 1 and 2 years postoperatively. In 3 patients, we discovered a small calcification due to the injection of the dye inside the testis; for this reason, we reduced the amount of ICG from 2 to 1 mL with the disappearance of this problem. No recurrence of varicocele or postoperative hydrocele was recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Our 5-year experience showed that the intratesticular injection of ICG and use of fluorescence vision allowed identification of lymphatic. ICG fluorescence lymphography is a safe and effective option to perform lymphatic-sparing laparoscopic Palomo varicocelectomy in children and adolescents with high-degree varicocele. No allergy to ICG or postoperative hydrocele was reported in our experience. It is preferable to inject 1 mL of ICG solution in the testis to avoid the risk of having small calcification in the testis at US controls.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10926429261435770","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T01:50:15Z","timestamp":1776995415000},"page":"524-528","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Indocyanine Green Fluorescence Lymphography for Lymphatic-Sparing Laparoscopic Palomo Varicocelectomy in Children: 5-Year Experience and Technical Considerations"],"prefix":"10.1177","volume":"36","author":[{"given":"Ciro","family":"Esposito","sequence":"first","affiliation":[{"name":"Pediatric Surgery unit, University of Naples Federico II, Napoli, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Assunta","family":"Turco","sequence":"additional","affiliation":[{"name":"Pediatric Surgery unit, University of Naples Federico II, Napoli, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fulvia","family":"del Conte","sequence":"additional","affiliation":[{"name":"Pediatric Surgery unit, University of Naples Federico II, Napoli, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9896-3942","authenticated-orcid":false,"given":"Vincenzo","family":"Coppola","sequence":"additional","affiliation":[{"name":"Pediatric Surgery unit, University of Naples Federico II, Napoli, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariano","family":"Paternoster","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical Sciences, Legal Medicine Unit, School of Medicine, University of Naples Federico II, Naples, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Graziano","sequence":"additional","affiliation":[{"name":"Pediatric Surgery unit, University of Naples Federico II, Napoli, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Esposito","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, University of Naples Federico II, Naples, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Escolino","sequence":"additional","affiliation":[{"name":"Pediatric Surgery unit, University of Naples Federico II, Napoli, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariapina","family":"Cerulo","sequence":"additional","affiliation":[{"name":"Pediatric Surgery unit, University of Naples Federico II, Napoli, Italy."},{"name":"Federico II University Hospital, Napoli, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,23]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(05)67604-5"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2010.07.007"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0000112928.91319.fe"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1053\/jpsu.2001.22956"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2011.07.116"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2013.12.022"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1089\/lap.2009.0186"},{"key":"e_1_3_2_9_2","first-page":"10.e1","article-title":"Two decades of experience with laparoscopic varicocele repair in children: Standardizing the technique","volume":"14","author":"Esposito C","year":"2018","unstructured":"Esposito C, , Escolino M, , Castagnetti M, et al. 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