Comparison of different ligation techniques in laparoscopic varicocelectomy

Aim: 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). Materials and 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 of ligated 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). Conclusion: 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.