Introduction. Varicocele is one of the most common diseases in urology for both adults and children. The frequency of surgical treatment of the disease is significant and can reach about 67% of outpatient operations for male infertility. Meanwhile, the issue of choosing a surgical treatment method remains controversial. One of the priority techniques is the subinguinal ligation of the testicular veins by Marmar, but its use is not without complications and recurrence of the disease.
Material and Methods. PubMed databases were used to search for literature on the topic of the review, Google Scholar, and Scientific Electronic Library Elibrary.ru. 41 articles were selected that satisfy the specified topic and are published in scientific peer-reviewed journals.
Results and discussion. This technique has a forty-year history and is considered by a number of authors to be the «gold standard» of varicocele treatment. At the same time, for the possibility of both inpatient and outpatient use, reducing the time of intervention, or with insufficient technical equipment, the method is performed using a binocular magnifier (x2,0–6,0) or without optical magnification. As a result, the frequency of recurrence and complications such as hydrocele, testicular artery damage, pain syndrome, and scrotal edema is higher than when performing surgery using an operating microscope (x8,0–20,0). This is due to the anatomically large number of smaller vessels at this level, which requires more careful and careful separation of veins and lymphatic vessels.
Conclusion. Microsurgical subinguinal varicocelectomy according to Marmar requires from a specialist not only a good knowledge of anatomy, but also proficiency in microsurgical techniques. It is the use of an operating microscope with magnification from x8,0 that makes it possible to minimize the incidence of complications and recurrence of the disease.