目的探讨采用单一小切口经腹膜外入路腹腔镜下进行精索内静脉高位结扎术治疗精索静脉曲张的技术可行性、安全性及治疗效果。方法取平行腹股沟小切口,依次切开进入腹膜后腔,扩张腹膜后隙,经此切口置入Trocar,用镜鞘钝性分离,或在同切口内置入另一小通道换用输尿管镜照明,分离显露曲张的精索内静脉,采用钛夹夹闭或LigaSure切断、或自制静脉牵出钩牵出精索内静脉行丝线结扎离断。结果本组8例手术全部取得成功,手术时间18～50min,平均手术时间32.5min,5例完全在单一通道内完成,3例采用同一切口下置入相邻两个小通道操作。术中无并发症发生。术后平均随访时间8.5个月,疗效满意。结论单一小切口腹膜外入路腹腔镜下精索内静脉高位结扎术治疗精索静脉曲张技术可行、操作简便安全、疗效确切,可作为精索静脉曲张手术治疗方法之一。 Objective To investigate the technical feasibility, safety and therapeutic effect of using a single small incision laparoscopic extraperineal ligation of the spermatic vein in the treatment of varicocele. Methods A small groin parallel incision was made and incised into the retroperitoneum in turn to expand the retroperitoneal space. Trocar was placed in this incision. Blunt dissection was performed with a mirror sheath, or another small channel was placed in the same incision for ureteroscopic illumination. Separation of varicose vein revealed varicose vein, the use of titanium clip clamp or LigaSure cut off, or homemade pull the suture pull the spermatic vein to take off the wire ligation. Results All the 8 surgeries were successful. The operation time was 18-50 minutes and the average operation time was 32.5 minutes. Five cases were completely completed in one single channel. Three cases were operated under the same incision with two adjacent small channels. No complications occurred during surgery. The mean follow-up time was 8.5 months, with satisfactory results. Conclusion Single small incision extraperitoneal laparoscopic ligation of the spermatic vein in the treatment of varicocele feasible, safe and easy to operate, the exact effect, can be used as one of varicocele surgical treatment.