Laparoscopic leakage ligature in deep dorsal veins of penis. Surgical technique step by step

Congenital penile veno-occlusive dysfunction is increasingly recognized as a cause of erectile dysfunction, particularly in young patients.Pathophysiological explanations have evolved, and diagnostic methods allowing for better characterization of this condition have significantly improved, making this a field with new therapeutic approaches available.Among these, dorsal venous leakage ligation has historically faced challenges in becoming standardized.The aim of the present review article is to describe a step-by-step proposal for the laparoscopic surgical technique of venous ligation in the Santorini plexus, based on the authors' experience.The article emphasizes that accurate diagnosis is the cornerstone of successful management of this condition, for which we present a surgical technique that is accessible even in settings with technological limitations, reproducible, and associated with favorable short-and mid-term outcomes.When there is suspicion of a deep dorsal venous leakage causing hemodynamic alterations that explain a specific type of erectile dysfunction, a defined entity known as deep dorsal vein leakage syndrome can be established, characterized by typical clinical and ultrasonographic findings.Although certain medical treatment options are available, laparoscopic surgical correction of venous leakage is proposed as a viable and reproducible therapeutic alternative.