Different types of vasectomy reversals

Vasectomy reversals are performed to reconnect the vas deferens in order to allow the passage of sperm. This procedure is an elective surgery for men who would like to become fathers after having had a vasectomy. While there are different vasectomy reversal types, they are all performed under general anesthesia at a surgery center or hospital.

During the operation, a urologist will remove the disconnected ends of the vas deferens created by the vasectomy. The urologist will then extract a fluid sample –  from the end closest to the testicle –  to determine if it contains sperm. When sperm are present in the fluid, the passage can be reestablished by reconnecting the ends of the vas deferens.

Vasectomy reversal types

Modified one-layer method or microsurgery

When using the modified one-layer method, a series of tiny stitches are placed through the entire thickness of the vas deferens to join the ends. Once these stitches (the first layer) are tied, a second set (or layer) of stitches – that only pierces the outer portion of the vas deferens – is placed between each adjacent pair of stitches. Urologists use microsurgery to produce better results using high-powered microscopes that can magnify structures from five to 20 times their actual size. An operating microscope allows the urologist to manipulate stitches – that are smaller in diameter than an eyelash – to join the ends of the vas deferens.

Robot-assisted vasectomy reversal

During this technique, the urologist uses a medical robot to perform the vasectomy reversal. The robot offers the surgeon an ability to rotate instruments more than 360 degrees through tiny incisions. This flexibility assists in making the precise maneuvers involved in advanced, minimally invasive surgeries, such as a vasectomy reversal. The robot’s every move is controlled by the surgeon. At no time is the machine in control. The major advantages of using robotic technology to perform vasectomy reversals include:

• 3-D view:  Conventional microscopic vasectomy reversals only allow a 2-D view.  Depth perception is enhanced with the robotic platform, which is critical when operating in a field where sutures are finer than the human hair.
• Angulation of the camera: During conventional surgery, the microscope only offers one, top-down view.  With the robotic technology, the surgeon can easily change the angle of the camera to get a better view.
• Scaling of movement:  The robotic instruments can be scaled down to make very small, precise movements.  This precision far exceeds the movements made by a surgeon’s hands.

Even with the different vasectomy reversal types, and the use of state-of-the-art technology, there is no guarantee that a vasectomy reversal will be successful. Success rates, as well as risks, will be discussed with the patient during their initial consultation. If you would like to discuss the possibility of having a vasectomy reversal, contact Urology Austin to schedule an appointment with one of our urologists.