Laparoscopic varicocelectomy does not offer any significant advantage in comparison to sclerotherapy or open surgical procedures. Invasiveness (transperitoneal approach, intraoperative complications, general anesthesia, duration of operation, possible ligation of the spermatic artery) is not less, but the technical expenditure and costs are higher than those in competing procedures. Laparoscopic treatment is not the procedure of first choice and even in recurrent varicocele it should only be performed if prior treatment by-repeated antegrade sclerotherapy is not successful and distal reflux has been ruled out. Therefore, the laparoscopic approach is of only minor value in the treatment of varicocele testis.