Microsurgery Marmara is a type of surgical intervention for the treatment of an ailment called varicocele. It is prescribed by a urologist when an expansion of the veins of the pampiniform plexus of the testis (varicocele) is detected, when the patient complains of discomfort in the scrotum, or when a decrease in the size of the testicle is noticeable, a decrease in its function.
The advantages of the Marmara operation over other methods of dealing with varicocele
Marmar operation every year more and more doctors are recognized as the most effective and reliable method of therapy for varicocele. The main benefits are:
- in the smallest number of recurrences, which is made possible thanks to microsurgical glasses and a microscope that allow you to process the smallest veins;
- to a small degree of tissue trauma;
- in a small and inconspicuous scar no larger than 2 cm;
- in the almost complete absence of pain after surgery;
- in improving the quality and quantity of sperm;
- in the ability to quickly return the patient to a normal lifestyle.
A few more differences between operational methods forIvanissevich, or laparoscopy, from the Marmar method. The operation according to Ivanissevich involves dissection of the aponeurosis, which can lead to traumatization of the muscles of the anterior abdominal wall, increasing the rehabilitation period and increasing the postoperative pain syndrome. The Marmar operation allows you to cope with both left-sided and right-sided varicocele. And the improvement of spermatogenesis and fertility assessment can be carried out after 6-9 months. Most men after Marmar surgery have the opportunity to become fathers in the next few years.
What are the indications for the appointment of the Marmara operation
The main and, in general, the only indication when the Marmar operation is prescribed is varicocele - a disease that can occur without pronounced clinical manifestations, almost asymptomatic.
But often, when seeking help from specialists, patients complain of heaviness in the scrotum, pain in the testicle. During the examination, deviations in the spermogram are revealed, which indicates a violation of the production of spermatozoa by the testicles. Non-surgical treatment of the disease is impossible, especially when it comes to complications that can cause infertility. The Marmar operation for varicocele, according to world statistics, allows you to fully restore the reproductive function of the organ.
Varicocele: what is it, what is fraught with
The disease involves the expansion of the veins of the testicles of the spermatic cord, which is associated with a malfunction of the check valves located in the veins. That isa he althy valve ensures the movement of blood through the vein in only one direction, damage to the valves does not allow them to restrain the return flow of blood. Any increase in pressure causes the blood to rush back.
Causes of disease
Varicocele can be a manifestation of:
- congenital malformation of venous valves;
- congenital weakness of the vascular wall;
- increased pressure in the pelvis or scrotum, which leads to a kink, change in shape and gradual compression of the veins.
To correct such a pathology, there are many different methods, for example, the Ivanissevich operation or the laparoscopic method. Why has the Marmar method become popular? The operation virtually eliminates the possibility of damage to the muscles of the abdominal wall, damage to testicular arteries, and inflammation.
Contraindications for Marmara surgery
As with any surgical intervention, even the most effective and safe procedure can have contraindications:
- stage of exacerbation in chronic pathologies of internal organs;
- the first six months after a stroke, heart attack or other coronary heart disease;
- inflammatory processes in the genitourinary system;
- influenza, SARS and other infectious diseases.
How to prepare for an intervention
The Marmara operation and preparation for it implies a standard scope of research: general, clinical and biochemicalblood test, coagulogram, ECG, tests for RW, syphilis, HIV, hepatitis, examination by an anesthesiologist before surgery.
Preoperative examination can be expanded or, conversely, reduced depending on the scope of the planned intervention, age and general condition of the patient.
Immediately before the operation follows:
- Shave the hair, if any, in the upcoming area of operation. This should be done carefully, without cutting the skin and causing further irritation.
- Some doctors practice anti-inflammatory or antibiotic therapy, which reduces the risk of inflammation in the invasive area. Medications start a few days before surgery.
- General anesthesia or spinal anesthesia requires the last meal no later than 10 pm. On the day before the operation, it is not allowed to eat, drink, smoke. A cleansing enema is given the evening before the operation and the morning of the operation.
- Local anesthesia does not require fasting or cleansing enema.
- Taking anticoagulants should be stopped 5 days before the upcoming operation. Instead, low molecular weight heparin preparations are prescribed, which reduces the risk of surgical or postoperative bleeding.
Marmar's operation for varicocele, reviews of which indicate the high efficiency of the method, allows you to restore venous flow and prevent blood outflow that poisons the testicles. Postoperative recurrence occursonly in 5-7% of patients.
Types of anesthesia: what can be, what is preferable
The Marmara operation can be performed under general anesthesia, which, like other types, is performed by an anesthesiologist, while the patient falls asleep and wakes up after the end of the operation.
Spinal anesthesia pains the entire lower half of the body. The injection is made in the region of the spinal column.
Local anesthesia will numb only the invasive area, while the patient will be conscious, but will not feel pain. In recent years, more and more doctors prefer local anesthesia.
How is the operation going
The operation begins with the fact that the surgeon cuts the skin of the subgroin area, making an incision measuring 1.5 - 2 cm. The spermatic cord is located, which is removed into the wound for convenience. Using a microscope, the surgeon isolates the testicular veins and ligates them. Doctors prefer to use local anesthesia, as the patient can be asked to breathe in and strain, which allows the doctor to better see all, even the smallest, dilated veins and venous branches. The microscope allows you to make the dressing process as correct as possible, without herbs of nearby nerves, lymphatic vessels and arteries. After suturing all the veins on the wound, drainage is done with a rubber graduate. After that, an aseptic dressing is applied to the incision site.
Surgical intervention lasts for 30-40 minutes. After that, the patient is transported to the recovery room, where he remains under pressure for several hours.doctor's supervision. After two hours, after assessing the patient's condition, the doctor can let him go home.
Post-operative period
The rehabilitation period after the Marmara operation is minimal. It will only be necessary to come to the dressing a few times if it is not possible to carry out the procedure at home. After a few days, the patient can completely return to his usual way of life. True, it is recommended to refrain from sexual relations, from lifting and carrying weights and playing sports so that the integrity of the seams is not violated. This is confirmed by patient reviews. The stitches are removed after 7-8 days. A small scar will be located below the wear line, in the area where the hair grows, so that it will remain invisible. The Marmara operation, reviews of which are extremely positive both from patients and doctors, does not cause testicular atrophy, dropsy, or any other complications that can be expected from other types of surgery. This operation allows you to restore and prevent further expansion of the veins, improve the quality of sperm.
According to many men, the Marmara operation is a quick and effective method of getting rid of varicocele, which allowed them to avoid postoperative complications, pain, discomfort and ugly scars.
