Introduction Identification and preservation of testicular artery and lymphatic vessels during microsurgical varicocelectomy can be tedious if adhered encompassing venous network is encountered. A venous bypass from internal spermatic to saphenous or inferior epigastric vein, that have been described for varicocele treatment, may be used in such situations. This paper describes a simplified modification of the venous bypass technique that reroutes the testicular blood to the superficial epigastric vein, which can easily be found in the incisional wound. Surgical technique and anastomotic patency test are described, and indications and results are discussed.

Materials and Methods During 2020 and 2021, 32 adolescent patients underwent microsurgical varicocelectomy. In eight patients additional microsurgical testicular vein-superficial epigastric vein microvascular bypass was done. The indication for bypass was difficult identification of testicular artery and/or lymphatic vessels due to adhered venous plexus.

Results Varicocele resolution was noted in all eight patients with clinical and/or semen analysis improvement. There were no complications or recurrences. Average length of procedure was 65 minutes. All patients were discharged within 24 hours and no antiplatelet or anticoagulant therapy was used.

Conclusion Testicular vein to superficial epigastric vein anastomosis is a useful and simplified venous bypass technique that reroutes the blood from the pampiniform plexus to the femoral vein. It can be done as an adjunct to microsurgical varicocelectomy in selected patients through a standard incision.

简介 如果遇到粘附的包围静脉网络，在显微精索静脉曲张切除术中识别和保存睾丸动脉和淋巴管可能会很乏味。从精索内静脉到隐静脉或腹壁下静脉的静脉旁路，已被描述用于精索静脉曲张治疗，可用于这种情况。本文描述了静脉旁路技术的简化修改，该技术将睾丸血液重新路由到腹壁浅静脉，这很容易在切口伤口中找到。描述了手术技术和吻合口通畅性测试，并讨论了适应症和结果。

材料和方法 在 2020 年和 2021 年期间，32 名青少年患者接受了显微精索静脉曲张切除术。在 8 名患者中，进行了额外的显微外科睾丸静脉-腹壁浅静脉微血管旁路术。旁路术的指征是由于静脉丛粘连而难以识别睾丸动脉和/或淋巴管。

结果 所有八名临床和/或精液分析改善的患者均注意到精索静脉曲张消退。没有并发症或复发。手术平均时长为 65 分钟。所有患者均在 24 小时内出院，未使用抗血小板或抗凝治疗。

结论 睾丸静脉至腹壁浅静脉吻合术是一种有用且简化的静脉旁路技术，可将血液从 pampiniform plexus 重新引导至股静脉。它可以作为通过标准切口对选定患者进行显微精索静脉曲张切除术的辅助手段。