Vasectomy reversal surgery
Microsurgical vasectomy reversal using a state of the art, high-powered surgical microscope and the highest quality microsurgical instruments is scientifically proven to be superior than any other method. Microsurgical techniques enable optimal visualisation of the vas deferens allowing accurate and precise placement of each suture. Using a multi-layered technique of extremely fine sutures provides far better results than older less precise methods and also allows an uneventful recovery.
A light general anaesthetic is given and throughout your reversal your heart rate, blood pressure, breathing, and oxygen level are continually monitored to ensure your safety. Our anaesthetic and surgical nursing staff are highly experienced and together they have been performing reversals for many years.
To perform a vasectomy reversal two incisions of about 2.5cm are made on either side of the scrotum above the testes. These permit access to the scrotal contents including the vas deferens, testes and epididymis.
This involves manually identifying the structures of the scrotum. The amount of vas deferens which is absent or damaged is assessed. Occasionally so much vas deferens has been damaged that it is necessary to consider the surgical technique called microsurgical vaso-epididymostomy.
Dissection of the vas deferens
The vas deferens is then dissected free of the surrounding tissue. It is usually possible to identify normal vas deferens on either side of the vasectomy site. Having dissected the vas deferens free a cut on either side of the vasectomy site so that a normal open tube is available for re-anastomosis.
In the most common method known as vaso-vasostomy the cut ends of the vas deferens are brought into close proximity with each other and stabilised in position by a small non-traumatic clip. An operating microscope is then used to magnify the site approximately 40 times. A series of very fine microscopic sutures (much finer than a human hair) are placed around the circumference of the lumen of the vas deferens (which is less than the diameter of a pin) to bring the ends together and establish patency. A second layer of sutures is then added to provide support and stability to the site of the anastomosis. It is always possible to visibly see the ends of the vas deferens come together and be certain at the time of the surgery that the vas deferens is open.
Video of vasectomy reversal
This is a video of me performing the microsurgical component of a vaso-vasostomy procedure for vasectomy reversal. Initially, you can see the two prepared ends of the vas deferens. Prior to this point in the operation, incisions have been made on either side of the site of the previous vasectomy, the cut ends have then been positioned in a small clasp which holds them very close together.
The operation then proceeds with a series of circumferential microscopic stitches which go through the muscle and then lumen (the tube) of the vas deferens on one side and out through the opposing side. These stitches slowly bring the two opposing lumen together to re-establish a patent (open) vas deferens. Just prior to the final closing stitch particular attention is paid to ensure the vas deferens is open. Following this part of the microsurgical vasectomy reversal an second (and when required third) layer of fine stitches is placed to support the anastomosis of the vas deferens and complete the operation.
Should it not be possible to re-connect vas deferens to vas deferens due to extensive damage (vaso-vasostomy - usually the case), vaso-epididymostomy will be performed connecting the vas deferens to the epididymis (which is the extremely fine tube between testis and vas deferens).
Small soft drains are placed on either side of the scrotum near the site of the vasectomy reversal. The drains act to prevent an accumulation of fluid and blood near the operation site - minimising the chance of complications (haematoma and infection) and maximising the success rate by reducing tension on the stitches.
Once the microsurgery is finished the scrotum is closed in two layers: the first an inner continuous suture to bring the tissues together, and then the skin edges are closed by a very fine stitch which is beneath the skin.
›› Recovery from vasectomy reversal.
›› Risks and complications of vasectomy reversal.
›› Post operative instructions following vasectomy reversal.