OBJECTIVE: To investigate the safety, feasibility and effectiveness of transumbilical Laparoendoscopic Mini-dual-site Surgery (U-LEMDS) in the treatment of varicocele. METHODS: The 60 cases were all male infertility patients admitted to the reproductive medicine center of our hospital. The age ranged from 21 to 38 years old, with an average of 28 years old. There were 40 cases on the left side alone, 4 cases on the right side alone, and 16 cases on both sides. There were 18 cases of degree I, 36 cases of degree II, and 6 cases of degree III. The disease duration was 12 months to 36 months. Preoperative color Doppler ultrasonography was performed in all patients, and the diameter of the internal spermatic vein was >2.0 mm, and blood reflux was seen by Valsalva test. All 60 patients underwent semen analysis and all had weak spermatozoa. All 60 patients underwent semen analysis for the presence of weak spermatozoa. A 5-mm Trocar was placed in the left and right lateral margins of the umbilicus, and a 5-mm 30° laparoscope and instruments were inserted. The spermatic vein was exposed and freed by cutting the retroperitoneum about 2-3 cm above the internal ring opening, and two spermatic veins were ligated with 5mm Hemlock clamps, without disconnecting the vessels. If the lesion is bilateral, the opposite side is treated in the same way. The incision was closed with 5-0 absorbable sutures. Semen changes and the incidence of testicular atrophy and testicular syringomyelia were observed on follow-up. SPSS14.0 statistical software was used to analyze and compare the changes of semen parameters before and after surgery in 60 patients. RESULTS: All 60 surgeries in this group were successfully completed. The unilateral operation time ranged from 8 to 15 min, with an average of 9.5 min; the bilateral operation time ranged from 16 to 30 min, with an average of 18 min. The internal spermatic artery was successfully isolated and preserved in 8 cases, and the remaining 52 cases were collectively ligated. The follow-up period was 6 months~24 months. The semen was reexamined after surgery, and sperm motility improved in 47 cases (78.3%, 47/60), sperm motility returned to normal in 16 cases (26.7%, 16/60), testicular syringomyelia appeared after surgery in 8 cases (13.3%, 8/60), recurrence in 4 cases (6.67%, 4/60), and there were no cases of testicular atrophy. The umbilical incision healed well and was obscured by the surrounding folds, with inconspicuous scarring and good cosmetic results. CONCLUSION: U-LEMDS high level ligation of the internal spermatic vein is safe, effective and feasible for the treatment of varicocele with the advantages of less trauma and better cosmetic results, however, due to the difficulty in separating and preserving the internal spermatic artery and tying the knot with only one operating rod operation, caution is still needed although no cases of testicular atrophy occurred in this group.