V1556: Robot assisted bilateral vasoepididymostomy: evolution of robotic microsurgical techniques for complex reconstruction of male genital tract
VideoIntroduction and Objectives
Urologists perform close to one million vasectomies each year in the United States. Up to 6% of men request reversal after vasectomy. Robotic assistance is one such technique of vasectomy reversal that allows for high-definition three-dimensional viewing as well as scaling settings to allow for more precise movements by the surgeon. Numerous studies suggest that robot-assisted reversal may have advantages over a microsurgical approach in terms of ease of performing the procedure, precision of suture placement, and possible improved patency rates. In this video, we present our technique of a robotic-assisted microsurgical vasoepididymostomy using an enhanced four-arm DaVinci type S robotic system.
A video presentation of a single-institution, single-surgeon robotic-assisted microsurgical vasoepididymostomy. During intraoperative examination, the vasal fluid bilaterally was noted to be sparse and pasty in consistency. This fluid was aspirated and microscopic examination revealed absence of sperm. Based on these findings, the decision was made to proceed with a vasoepididymostomy. A two-layer 10-0 and 9-0 suture anastomosis was performed.
There were no major perioperative and postoperative complications. Narcotic analgesic drugs were not needed during the postoperative period for this outpatient procedure.
Robotic-assisted microsurgical vasoepididymostomy may have potential benefits over standard microsurgical techniques. Further evaluation and follow-up are needed in order to further assess the clinical potential and cost-benefit ratio of this technique.