Ligation of the vas deferens on the abdomen

This is an automatically translated article.

Abdominal venous ligation is performed in patients with varicocele. This is a surgical method that helps prevent venous backflow to the testicles and preserves arterial and lymphatic blood flow.

1. Purpose of performing abdominal vein ligation surgery

Abdominal vasectomy is performed in patients with varicocele. Varicose veins are abnormal varicose veins of the testicles and the plexus of the testicles. The majority of patients with varicocele occur on one side and usually on the left side. A vasectomy is performed to prevent venous backflow into the testicle, while preserving arterial and lymphatic blood flow.

2. In which case is vasectomy performed?

Varicose vein ligation surgery is indicated in the following cases:
Male patient has the following symptoms: The patient has palpable varicocele (grade 2 - 3). The patient and his wife are unable to bear children. In case the patient is married and the wife has normal or otherwise normal fertility, there is also the potential for cure. Patients with more than one abnormal data on semen analysis or on sperm function test results. Adult male patient with palpable varicocele and abnormal semen analysis but is not currently trying to conceive. An adult male patient has evidence of a decrease in testicular size on the same side of the varicocele. Varicose veins cause long-lasting pain and discomfort in the scrotum, affecting daily activities and work. In addition, vasectomy is contraindicated in patients with general contraindications to surgery.

3. Preparing for vasectomy surgery

3.1. The person performing the technique The testicular ligation technique is performed by a doctor specializing in andrology - Urology - Pediatrics. The operating team consists of a surgeon and two auxiliary surgeons.
3.2. Before performing the technique, the doctor needs to prepare for the patient a number of issues as follows: The doctor needs to explain to the patient and loved ones about the purpose, possible complications and complications when performing the procedure. performing varicose vein surgery. The doctor should remind the patient to have a light meal the night before and fast the morning of surgery. Carry out enema for the patient the night before surgery. 3.3. Means The technique of vasectomy is performed with the following means:
Central surgical tools The magnifying glass is used to facilitate the dissection of small components such as arteries and lymphatics..

4. How is vasectomy performed?

Varicose vein ligation surgery is performed according to the following steps:
4.1. Position The patient is lying on his back with his legs extended and his head elevated about 15 degrees.
The operating room is arranged as follows:
The anesthesiologist is above the patient. The main surgeon stands on the same side as the operating side and the auxiliary surgeon stands on the opposite side. The instrument table is placed at the patient's feet, the instrument nurse stands on the same side with the assistant surgeon. 4.2. Anesthesia The anesthesiologist administers spinal anesthesia or spinal anesthesia in combination with local anesthesia or general anesthesia.
4.3. Performing surgery Inguinal incision: The doctor uses Schoysman's surgical technique in the following steps:
The doctor makes a skin incision similar to that of an inguinal hernia. The lower end of the incision is the point between the pubic spine and the pubic joint where the inguinal exposure is external. The skin incision penetrates upward and outward, following the bisector of the angle between the femoral cord and the lateral margin of the rectus muscle of the abdomen. The average length of the incision is 8-10 cm. This surgical technique is not applied in patients with a history of inguinal hernia surgery because it is easy to violate the components of the spermatic cord during reoperation. In addition, the seminal vein at this location has branched, so many branches are missed when ligation, the fine artery has branched, so it is difficult to recognize with the naked eye to separate. After the inguinal incision, the doctor performed a retroperitoneal iliac incision by one of the following techniques:
Ivanissevich's technique: The doctor made a skin incision above the deep inguinal ring and below the anterior superior iliac spine with the same dimension. The length of the incision is 8-10 cm. Palomo's technique: The doctor made a 5 cm long horizontal skin incision above the deep inguinal ring, slightly higher than Ivanissevich's technique. The doctor made a large diagonal fascia incision, separating the muscle fibers and dissecting into the retroperitoneal space. Dissecting reveals the seminal veins and separates the rest: arteries, lymphatics.. The doctor performs a ligation and cuts the seminal veins in the posterior peritoneal position, the outer border of the lumbosacral muscle, and preserves the seminal artery. , lymphatics. The doctor stopped the bleeding and stitched up the incision.

5. Follow-up after vasectomy

After performing vasectomy, the doctor needs to monitor the patient's condition with the following indicators:
Progression of the incision: The incision heals well or is inflamed or not. Does the patient have scrotal hematoma, edema, or hydrocele? The patient's degree of testicular and scrotal pain on the surgical side. Long-term follow-up after surgery: The doctor needs to examine the patient's general and local condition, perform semen and hormone tests, and color Doppler SA in the scrotum. Assess the patient's recovery status by the following factors:
Hydroceles

6. Management of complications after surgery

The doctor handles complications after surgery as follows:
The doctor performs surgery to stop bleeding in case the patient has a lot of bleeding, hematoma in the scrotum. Re-operation to drain the fluid in case of large hydrocele. Vinmec International General Hospital is one of the hospitals that not only ensures professional quality with a team of leading doctors, modern equipment and technology, but also stands out for its examination and consulting services. and comprehensive, professional medical treatment; civilized, polite, safe and sterile medical examination and treatment space.

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