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  Indian J Med Microbiol
 

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.

Figure 2: The spermatic cord double-traction approach elevates the surgical plane. (<b>a</b>) 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>b</b>) The surgical plane A shifts up to B after spermatic cord traction using a rubber surgical drain. (<b>c</b>) 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. (<b>d</b>) All  of the internal spermatic veins are double-ligated with clips and then divided.