Figure 2: The spermatic cord double-traction approach elevates the surgical plane. (a) The conventional approach. The vas deferens and associated vasculature are isolated and preserved under a plastic strip. The surgery is performed on plane “A.” (b) The surgical plane “A” shifts up to “B” after spermatic cord traction using a rubber surgical drain. (c) The spermatic cord (without the vas deferens and associated vasculature) is retracted downward and fixed using a rubber band. The surgical plane “B” shifts up to “C.” (d) All of the internal spermatic veins are double-ligated with clips and then divided.