title: Intraabdominal laparoscopy-assisted "open" vessel ligation of testicular vessels: a potential treatment for varicocele.
abstract: OBJECTIVE
  We tested our laparoscopy-assisted "open" ligation (LOL) technique on testicular vessels.
  
  
  METHODS
  We ligated the left testicular artery and vein (TAV) in 8-week-old male Wister rats using LOL (LOL group; n=10) or laparotomy (open group; n=10). In LOL, a 0-degree laparoscope was introduced through a 5-mm epigastric trocar. A 3-mm grasper was used to expose the left TAV. A lapa-her-closure (LHC) needle loaded with 3-0 SurgiPro was directly inserted into the left lower quadrant where the left TAV should be and advanced under the vessels, and the suture material was released leaving one end outside. The LHC was then withdrawn a little and advanced again over the vessels to grasp the end of the suture material just released to bring it outside. This was proximally repeated. The two ends of both sutures were conventionally tied outside, and the knot was passed through the insertion site and tightened around the vessels. In the open group, the left TAV were ligated using two 3-0 SurgiPro ties. In both groups, the right side was left intact. All rats were sacrificed 2 weeks postoperatively, and both testes were examined with hematoxylin and eosin.
  
  
  RESULTS
  Treatment time was 5-7 minutes for LOL and 7-8 minutes for the open group. Postoperative recovery was uneventful. No adhesions were present between the ligated vessels and bowel in any rat. Histopathology of all left testes showed coagulative necrosis of germinal cells and seminiferous tubules; all right testes were normal.
  
  
  CONCLUSIONS
  LOL appears to be as effective as open ligation and may find application for treating varicocele.
authors.affiliation: Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan. go1993@hotmail.co.jp
authors.forename: Go
authors.initials: G
authors.lastname: Miyano
authors.forename: Katsumi
authors.initials: K
authors.lastname: Miyahara
authors.forename: Abudebieke
authors.initials: A
authors.lastname: Halibieke
authors.forename: Geoffrey J
authors.initials: GJ
authors.lastname: Lane
authors.forename: Tadaharu
authors.initials: T
authors.lastname: Okazaki
authors.forename: Atsuyuki
authors.initials: A
authors.lastname: Yamataka
mesh_terms: D000818:Animals; D010535:Laparoscopy; D007813:Laparotomy; D008026:Ligation / Q000379:methods; D008297:Male; D051381:Rats; D017208:Rats, Wistar; D013536:Suture Techniques; D013737:Testis / Q000098:blood supply*; D014646:Varicocele / Q000601:surgery*