Introduction: In line with the effort to evaluate feasible surgical options for vasectomy reversal and to increase patients' willingness to undergo this procedure, we report on the technique for ambulatory mini-incision microsurgical vasovasostomy using a double-ringed clamp (i.e. Moon's clamp).
This technique does not require the use of dilators, approximators and other accessory devices.
Methods: Ambulatory mini-incision microsurgical vasovasostomy was conducted on 263 patients who satisfied the surgical eligibility requirements for vasovasostomy and the safety criteria for local anesthesia. We recorded and retrospectively analysed the operation time, the details on postoperative recovery and the results of the postoperative semen analysis.
Results: The mean time used to isolate the bilateral vas deferens was 25.5 min. All patients were discharged on the day of surgery and all patients returned to their normal activities 24- 48 hours after surgery. No haematoma or infection occurred, except in one patient. Postoperative semen analysis showed that the surgery was successful in 182 (96.8%) of the 188 patients who complied with the postoperative patient instructions.
Conclusion: Ambulatory mini-incision microsurgical vasectomy reversal using Moon's clamp and under local anaesthesia is a surgically feasible option that has the advantages of a low-risk operation. It also allows the achievement of successful vasovasostomy without other accessory devices and patients to return to their daily activities quickly with minimal complications.
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Reference: Singapore Med J. 2014 Dec 10. Epub ahead of print.
doi: 10.11622/smedj.2014191
PubMed Abstract
PMID: 25502335