A varicocele, characterized by the enlargement of testicular veins within the spermatic cord, is a common condition in reproductive medicine, affecting up to 15% of healthy men and 35% of men with primary infertility. While its precise cause remains uncertain, proposed factors include reflux of adrenal metabolites, testicular hypoxia, oxidative stress, and elevated testicular temperature. This article was a narrative review on the robotic approach in varicocele treatment. They used three databases (PubMed, Scopus, and ISI Web of Knowledge) to search for articles. Varicocelectomy is indicated in certain instances, such as in male infertility, hypogonadism, scrotal pain, and testicular hypotrophy. The surgical approach is ligation of the internal spermatic venous drainage of the testicle, while preserving arteries and lymphatics. Surgical treatment options, particularly the subinguinal microscopic approach, have shown significant benefits in improving semen parameters and potentially improving fertility outcomes. This approach has higher spontaneous pregnancy rates and lower recurrence rates compared to laparoscopic and radiologic embolization techniques. The laparoscopic approach offers advantages such as preserving the testicular artery, but its limitations are high cost and the need for general anesthesia. Robotic assisted microscopic varicocelectomy has emerged as a safe and effective alternative, with studies reporting improvements in sperm concentration, testicular volume, and reductions in testicular pain. Therefore, it was concluded that robotic assistance for microsurgical procedures in male infertility is safe and feasible.

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