Use of surgical clips prevents suture slippage when ligating folded vas deferens during vasectomy

作者：Hadj Moussa Miriam; Brown James A^*

来源：Canadian Journal of Urology, 2010, 17(3): 5213-5215.

• vasectomy
• ligation
• urological surgical procedures male
• suture techniques

Objective: We describe a technique of surgical clip placement, which prevents slippage when ligating the folded vas deferens during vasectomy.
Methods: We utilized this technique in 25 consecutive vasectomy procedures. After isolating the vas, two mosquito clamps are placed approximately 2 cm-3 cm apart and a small 5 mm-10 mm section of full thickness vas is removed. The lumen of each cut end is cauterized. Surgical clips (Ethicon Ligaclip Extra LS-200, Medium) are placed at approximately 2 mm, 3 mm and 15 mm (on the opposite side of the hemostat) from each cut end. By rotating the hemostat, the vas is folded on itself and a 3-0 or 4-0 chromic suture is placed between the two proximal clips and distal to the third clip. The hemostat is carefully removed and the vas gently ligated.
Results: A single surgeon noted no instances of suture slippage in 25 consecutive vasectomies. All patients underwent postoperative semen analysis that showed azoospermia.
Conclusion: Placement of the ligating suture between two proximal clips and past a third distal clip prevents suture slippage when ligating the folded end of the vas deferens during vasectomy.

• 出版日期2010-6