ABSTRACT
The indications for the minimally invasive or operative treatment of a varicocele can be divided into absolute and relative reasons. According to the European Association of Urology guidelines, a reduced testicular size, a pathological spermiogram, a bilateral varicocele, and other factors that influence fertility are absolute indications for operative treatment. Grade two varicocele, recurrent pain, and anxious patients represent relative indications for surgery. Beside the minimally invasive options such as retrograde and antegrade sclerotherapy, the laparoscopic procedure has significantly gained clinical importance during the last years. Following infra-umbilical incision, placement of the Veress needle, and establishment of the pneumoperitoneum, three trocars have to be placed. It is strongly recommended that good relaxation and a head down position of the patient are secured.
