A feasible ambulatory mini-incision microsurgical vasovasostomy under local anaesthesia using a specially designed double-ringed clamp that simplifies surgery

• Published in: Singapore medical journal Vol. 56; no. 4; pp. 228 - 232
• Main Author: Moon, Hyun Joon
• Format: Journal Article
• Language: English
• Published: Singapore Singapore Medical Association 01.04.2015
• Subjects: Adult; Anesthesia, Local - methods; Equipment Design; Feasibility Studies; Follow-Up Studies; Humans; Male; Microsurgery - methods; Middle Aged; Original; Retrospective Studies; Surgical Instruments; Suture Techniques - instrumentation; Vasovasostomy - methods; surgical procedures; minimally invasive; vasovasostomy; microsurgery; ambulatory surgical procedures
• ISSN: 0037-5675
• DOI: 10.11622/smedj.2014191

In line with the effort to evaluate feasible surgical options for vasectomy reversal and to increase patients' willingness to undergo the procedure, this study reported on a 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. Ambulatory mini-incision microsurgical vasovasostomy was conducted on 263 patients who satisfied the surgical eligibility requirements for vasovasostomy and the safety criteria for local anaesthesia. The operation time, details on postoperative recovery and results of the postoperative semen analysis were recorded and retrospectively analysed. The mean time used to isolate the bilateral vas deferens was 25.5 minutes. All patients were discharged on the day of surgery and all patients returned to their normal activities within 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. Ambulatory mini-incision microsurgical vasectomy reversal using Moon's clamp and under local anaesthesia is a surgically feasible option that offers the advantages of a low-risk operation. It also achieves successful vasovasostomy without other accessory devices and allows patients to return to their daily activities quickly with minimal complications.