title: Comparison of different ligation techniques in laparoscopic varicocelectomy.
abstract: OBJECTIVE
  To evaluate the effects of different intracorporeal ligation techniques with titanium clips, Plasma Trisector (Gyrus, USA) (PTG), and surgical silk on bilateral laparoscopic varicocelectomy (LPVx).
  
  
  METHODS
  Between May 2009 and August 2012, 100 patients who underwent bilateral LPVx were evaluated. The demographic parameters of patients, preoperative radiological findings, semen analysis, operative data, and follow-up were recorded. All of the patients were divided into 3 groups, randomized prospectively. The patients whose veins were ligated by 5-mm titanium clips were included in group I, those whose veins were ligated by PTG were included in group II, and those whose veins were ligated by surgical silk were included in group III. The recorded data of the groups were analyzed.
  
  
  RESULTS
  Mean follow-up time was 18.8 + 1.1 months. According to the demographics of age, body mass index, spermiogram, and diameter of veins before surgery, there were no statistical differences between any of the groups (P > 0.05). However, operation time was longer in group III (P < 0.0001), while total numbers ofligated veins did not differ among the groups (P > 0.05). Additionally, hospital stay, oral intake, and complications were not different among the groups (P > 0.05). In follow-up the sperm count analysis was higher than the preoperative count analysis for all of the groups (P < 0.05).
  
  
  CONCLUSIONS
  PTG may provide a shorter operation time than using titanium clips and/or surgical silk in LPVx. Additionally, PTG may increase sperm count with fewer complications than the other ligation techniques in LPVx. Therefore, PTG may be the new candidate electrosurgical standard device for LPVx in the nearby future.
authors.forename: Yiğit
authors.initials: Y
authors.lastname: Akin
authors.forename: Mutlu
authors.initials: M
authors.lastname: Ateş
authors.forename: Selçuk
authors.initials: S
authors.lastname: Yücel
authors.forename: Işil
authors.initials: I
authors.lastname: Başara
authors.forename: Orçun
authors.initials: O
authors.lastname: Çelik
authors.forename: Aliseydi
authors.initials: A
authors.lastname: Bozkurt
authors.forename: Bariş
authors.initials: B
authors.lastname: Nuhoğlu
mesh_terms: D000328:Adult; D004598:Electrosurgery / Q000295:instrumentation*; D006488:Hemostasis, Surgical / Q000295:instrumentation*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008026:Ligation / Q000295:instrumentation; D008297:Male; D061646:Operative Time; D011183:Postoperative Complications; D011446:Prospective Studies; D013537:Sutures; D014025:Titanium; D014646:Varicocele / Q000601:surgery*
chemical_list: D014025:Titanium