Figure 1: The procedure of DVC ligation with pretightening technique. (a) After the overlying tissues were swept from the DVC, the laparoscopic intestinal clamp (arrow) was opened and the DVC was tucked in the clamp. (b) The laparoscopic intestinal clamp (arrow) was locked to operate successive ligation of DVC. The needle was inserted from the right side to the left side. When the needle was inserted, the scope was changed to 30° left. (c) Clamped by the laparoscopic intestinal clamp (arrow), the flat and thick DVC become compact and thinner. The needles can transverse the DVC easily. When the needle was withdrawn, the scope was changed to 30° right or down. (d) The needle was pulled through the loop (arrow) of the suture and the tying was locked automatically by the barbs on the suture. DVC: dorsal venous complex.